Extensive Transmission of Mycobacterium tuberculosis from a Child

Young children rarely transmit tuberculosis. 1 , 2 In five recently published reports of school-based outbreaks, all source patients were adults or adolescents. 3 – 7 Tuberculosis in young children is rarely infectious, because young children are less likely than adults to have a productive cough, to generate the force needed to aerosolize organisms into droplet nuclei, or to have cavitary lesions on chest radiography. 1 , 2 In July 1998, infectious tuberculosis was identified in a nine-year-old child residing in North Dakota. The child was screened because extrapulmonary tuberculosis had been diagnosed in his female guardian. Bilateral cavitary tuberculosis was diagnosed in the child. Because . . .