Nordholm AC, Holden IK, Hartling UB, et al. - As most pediatric tuberculosis (TB) cases occur among immigrants in Western Europe, researchers sought to stratify data by first/second-generation immigrants. From 2009 to 2014, they identified 145 cases in Denmark; 99 were immigrants (68%) of which 54 (55%) were second-generation immigrants. Passive case finding led to diagnosis of most first-generation immigrants (73%) and nearly half of the second-generation immigrants (52%), in contrast to Danish children who were mostly diagnosed by active case finding (70%). Findings revealed occurrence of the majority of pediatric TB among immigrant children with symptomatic TB, whereas diagnosis at earlier disease stages was reported for more Danish children. Nearly one-third of TB cases may represent missed opportunities to limit TB disease. Based on findings, they emphasize improved adult case detection with comprehensive contact investigation among children, tailored screening and vaccination of immigrant children, and enhanced awareness of diagnosing and treating latent TB infection in children.