Tuberculosis expert recommends aggressive treatment for TB positive babies; Health Dept. doesn’t specify treatment

An infectious disease expert who’s treated dozens of babies and children with Tuberculosis said the baby who tested positive for the infection should be immediately treated with at least three medications, hospitalized and given a spinal tap to ensure the infection has not traveled to the brain.

Dr. Gilbert Handal, a professor in the Department of Pediatrics Texas Tech University Health Sciences Center, said babies that young have not fully developed their lymph nodes which means doctors can’t truly discern if the baby has active or latent TB once the babies test positive using a skin test. “If they become positive, you have to treat them like (active) TB, the treatment of TB is with four drugs,” Handal said Monday.

The Department of Public Health announced Saturday five babies have tested positive for TB. Though four had a vaccine, administered in foreign countries, that can produce a false positive. The fifth baby, a 7-month old, did not have the vaccine and also tested positive for the TB infection using a skin test.

Even if babies test negative for TB, the Health Department will offer their parents Isoniazid for three months to prevent them from getting TB.

As for those who tested positive, Handal said there needs to be more treatment than just Isoniazid. “Active TB is a very serious disease that can kill a child and Isoniazid is not going to protect the child if it has active TB – provided it’s really positive,” said Handal.

He added Isoniazid only suppresses the growth of the bacteria and some TB bacteria can be resistant to the drug.

Rebecca Rincones, a parent whose baby was exposed said she’s concerned for Isoniazid’s affects on her babies and wants the Health Department to test her baby’s liver function while on the medication. She said Health Department officials told her they’d only do liver screenings if the babies showed signs of liver strain, like jaundice or vomiting.

Handal said he’d have a baby on Isoniazid checked for liver function at least twice. “The standard care is that you give Isoniazid for a week, you get the liver tested. If it’s negative, you test them another month. If after the month it’s negative, you don’t worry about it,” he said.

ABC-7 emailed the Health Department asking if the Health Department will be treating the babies as recommended by Handal and if they’d be screened for liver strain. They have not responded to the questions.

Handal said it’s important for babies who test positive for TB to be aggressively treated because they’re at greater risk of getting Miliary TB, which occurs when the TB bacteria goes beyond the lungs and lymph nodes and into the blood which can then spread into the brain and other organs.

“You don’t take it lightly.”