TB outbreaks in the USA, current developments

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

It is not much, some information about the man's wife:

Doctors have said the man’s wife, who accompanied him on the private flight to Denver, apparently has not been infected with TB.

http://www.nytimes.com/2007/05/31/health/31cnd-tb.html?hp


Interestingly, S.'s father-in-law is Dr....., who works in a lab at the Centers for Disease Control and Prevention and specializes in TB.

http://www.foxnews.com/story/0,2933,276613,00.html


Foxnews has more details about the identity of the man, the Passenger Flight Itinerary, and more.

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Extensively drug-resistant tuberculosis (XDR-TB): Am I at risk?

I just read about the XDR-TB scare in the news. Should I be worried that I could catch it?


Mayo Clinic infectious disease specialist James Steckelberg, M.D., and colleagues answer select questions from readers.

Answer

Probably not. Extensively drug-resistant tuberculosis (XDR-TB), like other strains of tuberculosis (TB), is rather difficult to spread.

XDR-TB spreads like other forms of TB. Infected people release the bacteria that cause TB in the air by coughing, sneezing, talking, laughing or singing. The bacteria can float in the air for hours, but you need to be in close contact with an infected person for a prolonged period to risk becoming infected with TB. You are more likely to get TB from a close family member or co-worker ? someone you spend a lot of time with ? than from a stranger on a plane. Even if you are infected with TB, your immune system can attack the bacteria on its own. The infection could clear completely, or it may remain present without any symptoms.

The discovery of the XDR-TB case has alarmed public health officials because this strain of the disease doesn't respond to any of the first-line drugs doctors usually prescribe for TB. This means that doctors must resort to less effective medications, making recovery difficult. The Centers for Disease Control and Prevention (CDC) estimates that only about 30 percent of XDR-TB-affected people can be cured.

Resistant strains of TB generally develop as a result of partial or incomplete treatment ? either because people skip doses or don't finish their entire course of medication or because they're given an ineffective treatment regimen. This gives bacteria time to undergo mutations that can resist treatment with first-line TB drugs.

If you think you may have been exposed to someone with TB or XDR-TB, you should contact your doctor or local health department about getting a TB skin test and evaluation. The test, which involves the injection of a small amount of a substance called PPD tuberculin under the skin, will reveal if you are infected.

http://www.mayoclinic.com/health/xdr-tb/AN01636

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Father-in-law of TB patient works at CDC

Thu May 31, 2007 3:14PM EDT

WASHINGTON (Reuters) - The father-in-law of a tuberculosis patient who sparked an international investigation when he fled health authorities said on Thursday that he works at the U.S. Centers for Disease Control and Prevention.

CDC microbiologist Robert Cooksey issued a statement saying he works with tuberculosis himself. He confirmed the patient is 31-year-old Andrew Speaker, an Atlanta lawyer.

"As part of my job, I am regularly tested for TB. I do not have TB, nor have I ever had TB. My son-in-law's TB did not originate from myself or the CDC's labs, which operate under the highest levels of biosecurity," Cooksey said in a statement.

http://www.reuters.com/article/domesticNews/idUSN3123541420070531?src=053107_1525_DOUBLEFEATURE_

Article on CDC statement here: http://www.reuters.com/article/domesticNews/idUSN3042596520070531?src=053107_1531_DOUBLEFEATURE_

 

[AlaskaDenise]

Re: TB outbreaks in the USA, current developments

I'm personally convinced that it's difficult to catch.

As a child I was exposed to my aunt's case of TB. Nobody in her family or any of her contacts ever got it from her. I had a positive test for years - which I was told acted like a vaccine.

She originally got her first TB infection from her father who died of TB when she was a child. She was the only member of his immediate family who caught it - his wife and 3 sons were fine.

.

 

[hawkeye]

Re: TB outbreaks in the USA, current developments

Thanks for all the articles Dutchy!

 

[Siam]

Re: TB outbreaks in the USA, current developments

May 31, 2007

Contact: CDC Media Relations
(404) 639-3286
Statement by Robert C. Cooksey
Research Microbiologist, Division of Tuberculosis Elimination, CDC

First and foremost, I am concerned about the health and well being of my son-in-law and family, as well as the passengers on the affected flights.

I am the father-in-law of Andrew Speaker, who was recently publicly identified as a person infected with extensively drug resistant tuberculosis. I do work at the Centers for Disease Control and Prevention. I have worked at the CDC for 32 years. I´m a research microbiologist in CDC´s Division of Tuberculosis (TB) Elimination, and my work does involve working with a wide range of organisms, including TB. As a research microbiologist, my laboratory work involves identifying the characteristics and features of bacteria.

As part of my job, I am regularly tested for TB. I do not have TB, nor have I ever had TB. My son-in-law´s TB did not originate from myself or the CDC´s labs, which operate under the highest levels of biosecurity.

I wasn´t involved in any decisions my son-in-law made regarding his travel, nor did I ever act as a CDC official or in an official CDC capacity with respect to any of the events of the past weeks.

As a parent, frequent traveler, and biologist, I well appreciate the potential harm that can be caused by diseases like TB. I would never knowingly put my daughter, friends or anyone else at risk from such a disease.

I would ask the media to respect my privacy and that of my family, and I will be respectfully declining all media requests. My thoughts and focus over the next few months will be with my family, and we are hopeful that Andrew will have a fast and successful recovery.

Robert C. Cooksey

http://www.cdc.gov/od/oc/media/pressrel/2007/r070531.htm

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

I'm personally convinced that it's difficult to catch.

As a child I was exposed to my aunt's case of TB. Nobody in her family or any of her contacts ever got it from her. I had a positive test for years - which I was told acted like a vaccine.

She originally got her first TB infection from her father who died of TB when she was a child. She was the only member of his immediate family who caught it - his wife and 3 sons were fine.

.

That is funny, you are telling my story: my father had TB as a kid, they put him in a "chickenpen" for sun and fresh air to cure him; when I am tested I'm still positive, never was ill, X-rays OK.

A few months ago I met a top TB researcher here in Holland; when he is tested, to say he is positive is an understatement: his arm will walk away with him.....; he is not ill, nor does he get treatment.

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Thanks for all the articles Dutchy!

Your welcome! And thank you for your newshounding!

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Four Bowie High School students in Arlington test positive for tuberculosis

By Pegasus News wire


ARLINGTON ? Weirdly coincidentally on the heels of the story about the lawyer from Atlanta who knew he had tuberculosis but flew on a bunch of airplanes anyway comes this revelation that four students from Bowie High School in Arlington tested positive for tuberculosis after being exposed to another student with the disease. None of the students showed symptoms. The high school is conducting tests after learning that 500 students and teachers may have been exposed.

The FWST reports that 108 cases of tuberculosis were reported last year in Tarrant County, with seven or eight people dying; that about 10 million Americans have the tuberculosis bacterium, but only 10 percent will develop the disease; and that it can be spread through the air by laughing, sneezing, singing, or talking. How many times have you heard that "laughter is the best medicine"? Now it turns out that "laughter spreads a deadly disease called tuberculosis." So, no laughing. And no sneezing, singing, or talking, either.

http://www.pegasusnews.com/news/2007/may/31/four-high-school-students-arlington-test-positive-/

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Two Test Positive for TB in S.C.

Monday, Jun 04, 2007 - 07:32 AM Updated: 07:50 AM

By Associated Press

South Carolina health officials say two people tested for tuberculosis after riding on trans-Atlantic flights with a man carrying the disease have tested negative. State Department of Health and Environmental Control spokesman Adam Myrick says additional test results are expected Monday.

More than two dozen University of South Carolina Aiken students were aboard a flight to Paris with Atlanta lawyer Andrew Speaker, who's been quarantined with a dangerous strain of tuberculosis. Myrick would not say whose tests were negative, whether they were students or which flights they took with Speaker.

U-S-C Aiken senior Laney Wiggins confirmed she received the news. Earlier, Wiggins and a classmate said they accepted the televised apology from Speaker, who's the first person infected with T-B who was quarantined by the U-S government since 1963.

http://origin.wcbd.com/midatlantic/cbd/news.apx.-content-articles-CBD-2007-06-04-0009.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Severe tuberculosis case diagnosed in New Mexico


By ASSOCIATED PRESS
June 2, 2007

ALBUQUERQUE ? State health officials said a New Mexico man with a drug-resistant form of tuberculosis has been in court-ordered quarantine for about two months.

The length of time the patient must remain in quarantine depends on the progress of treatment but ?it could be months,? said Dr. Steve Jenison, medical director of the state Department of Health?s infectious disease program.

The man?s identity wasn?t released, nor would officials disclose any personal information about him on Friday.

An Atlanta lawyer has made national headlines after being quarantined with a dangerous strain of tuberculosis. Jenison said the New Mexico man has been diagnosed with a less-serious multi-drug-resistant form of the illness.

Health officials obtained a court order under the federal Public Health Act to quarantine the man. Jenison said the order was pursued because the patient has the drug-resistant TB and a contagious pulmonary form of the disease.

The patient is receiving ?multiple antibiotics? and making progress toward recovery, Jenison said.

Quarantine for tuberculosis requires a specially designed ?negative airflow room? that filters the outgoing air to eliminate TB bacteria. Several county jails and hospitals in the state have such rooms.

Jenison declined to say where the man is quarantined.

?We have certainly used both options? in previous cases, he said.

The Health Department is managing 50 cases of active tuberculosis infection. Of those, 28 were diagnosed this year. Officials said only up to three cases were diagnosed as multi-drug-resistant tuberculosis.

http://www.freenewmexican.com/news/62385.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Three More from High School Test Positive for TB

Last Update: Jun 3, 2007 10:53 PM


ARLINGTON, Texas (AP) - Health officials say another three Tarrant County residents have tested positive for tuberculosis.

Seven people have now tested positive for the disease.

The Tarrant County Health Department says they were all exposed to a Bowie High School student who was diagnosed in late May.

The student was diagnosed with pulmonary tuberculosis -- which is not the dangerous, extensively drug-resistant strain like that carried by an Atlanta lawyer quarantined by the U-S government this week.

Most healthy people exposed to T-B do not get sick.

The Fort Worth Star-Telegram reported that about 500 students and teachers at the high schools have been urged to get tested for T-B.

http://www.woai.com/news/local/story.aspx?content_id=9e966943-3ea1-4885-847b-aee509a21a88

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Tuberculosis quarantine lifted

By Charles Keeshan
ckeeshan@dailyherald.com

Posted Saturday, June 02, 2007


After more than six months under virtual house arrest, a Lake in the Hills man afflicted with tuberculosis can finally leave home.

A McHenry County judge Friday morning lifted a long-running quarantine placed on the man since November when he first tested positive for the potentially fatal and easily spread disease.

?He?s relieved,? said the man?s attorney, Tamara Marshall. ?It?s safe to say this took a lot longer than anyone thought it would.?

Judge Michael Caldwell imposed the quarantine in November after the man, identified as John Doe in legal documents and in court proceedings, tested positive for the disease.

The man did not have the rare, antibiotic-resistant strain of the disease that afflicts the internationally traveling Atlanta attorney placed this week under the first federally imposed quarantine since 1963.

Since John Doe?s quarantine was ordered, he has produced several samples of sputum ? a mucus-like substance coughed up from the lungs ? showing the disease may have been cleared from his system. But until this week he?s not been able to produce three consecutive negative tests that health officials wanted before lifting the restrictions.

According to the three tests taken this week, he no longer is a threat to pass along the disease.

Marshall said her client was not angry about the court-imposed quarantine, but frustrated that he had been portrayed as uncooperative with health officials.

?He feels that?s he?s been portrayed wrongly,? Marshall said. ?He?s not a lab rat, and there were some treatments they were giving him that were causing side effects and raised concerns for him about his long-term health.

?At no time did he ever break his quarantine or expose anyone else to this,? she said.

The man declined to answer questions over the phone Friday.

More than anything, Marshall said, the quarantine has been a hardship financially for the man and his family. Without the ability to work, the man has relied on his 67-year-old mother?s fixed income to support them both.

Now, because both are facing eviction, he is asking a court to order McHenry County to pay his landlord $5,275 for back rent owed since the quarantine?s imposition.

?If you confine someone for six months and then let them be evicted, that?s not going to encourage people to disclose (an illness) and seek treatment,? Marshall said.

A hearing on the request has been scheduled for June 11.

http://www.dailyherald.com/news/mchenrystory.asp?id=319077&cc=k&tc=&t=

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Provo High Student Diagnosed with TB

By Steffanie Wynn - 4 Jun 2007

The Utah County Health Department is working with the Provo School District to prevent and detect the possible transmission of tuberculosis after a Provo High School student tested positive for the illness.

The student was diagnosed with mycobacterium tuberculosis - a strain that is treatable with antibiotics unlike some of the other national cases, said Lance Madigan, Utah County Health Department (UCHD) public information officer.

The patient was confirmed to have tuberculosis on May 18. By that time, the UCHD had already started working with Provo High School to identify who else might have been exposed.

The UCHD held an internal meeting on May 21, and sent letters to students on May 22 encouraging about 250 students get tested for tuberculosis free of charge at UCHD.

Several students have already to come to the UCHD to be tested, but they hope that every student who received a letter will be tested, Madigan said.

No additional cases of tuberculosis have been identified at this time, but it can take two to three months for a person exposed to show symptoms or test positive, according to the UCHD.

"We are asking all the exposed individuals to be tested again in two to three months," Madigan said. "By doing this, we will have greater confidence to say 'you were negative in May, but positive now, so you probably were exposed at that time."

Tuberculosis is primarily an illness of the respiratory system, is very contagious and is spread by coughing and sneezing. Each year about 1.6 million people die from this curable disease, according to the World Health Organization.

Not all people infected with tuberculosis will become sick, since the bacilli can remain dormant for years.

However, a person with active, untreated tuberculosis will infect an average of 10-15 people each year, according to the World Health Organization.


http://newsnet.byu.edu/story.cfm/64506

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

MAINE

40 workers tested for tuberculosis

JAY - A team of public health nurses were at the Verso Paper mill Tuesday conducting skin tests on about 40 workers to determine if they have been infected with tuberculosis.

A worker at the mill has been confirmed to have active tuberculosis disease and has been hospitalized for more than a week, state epidemiologist Dr. Kathleen Gensheimer said Tuesday.

The workers tested Tuesday were determined to have been in close, prolonged contact with the infected individual, she said.

Verso Paper worker Kurt Hawes said he was very upset that he has been given no information even though he had asked several times Tuesday.

"I'm upset. I'm very angry," Hawes said. "I kept asking about it and was getting no answers. They kept saying it was under control."

Hawes said he was concerned about his children.

There have been 10 confirmed cases of tuberculosis in Maine this year, Gensheimer said. There were 17 cases in 2006.

When contacted Tuesday, Verso spokeswoman Peggy Willihan referred calls to the state Department of Health and Human Services.

According to the Centers for Disease Control Web site, www.cdc.gov, tuberculosis is a disease caused by bacteria called Mycobacterium tuberculosis. The bacteria usually affects the lungs, but TB bacteria can affect any part of the body such as the kidney, spine and brain. If not treated properly, the disease can be fatal.

TB is spread through the air from one person to another. Bacteria are put into the air when a person with active TB disease of the lungs or throat coughs or sneezes.

People nearby may breathe in the bacteria and become infected, but usually only after prolonged exposure.

However, not everyone infected with TB bacteria becomes sick, the CDC site states. People who are not sick have latent TB infection. Those with latent TB do not feel sick, do not have any symptoms and cannot spread TB to others. The bacteria can remain inactive for a lifetime without causing disease. But some people with latent TB go on to get TB disease, according to the CDC.

People with active TB can be treated and cured. People with latent TB infection can take medicine so that they will not develop active TB.

When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body.

Symptoms of TB depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs. TB in the lungs may cause symptoms such as a bad cough that lasts three weeks or longer, pain in the chest and coughing up blood or phlegm.

Other symptoms of active TB are weakness or fatigue, weight loss, no appetite, chills, fever and sweating at night.

http://www.sunjournal.com/story/215460-3/Franklin/40_workers_tested_for_tuberculosis/

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

FLORIDA

Local TB case nothing to worry about, officials say

By JESSICA COSDEN?, Daily News Correspondent

Wednesday, June 6, 2007

A report about a case of tuberculosis in Lee County is nothing to worry about, authorities say.

Lee County Health Department epidemiologist Dr. Robert South said while he could not confirm the new case, the contagious disease known as TB is not unusual at the health department.

Currently, 22 people in Lee County are under treatment for TB, South said. But none of the cases have the dangerous strain of TB that infected an Atlanta man who made national headlines.

Lee Memorial Health System officials were unable to confirm a report by WBBH-2 TV in which a LaBelle woman said her daughter has been diagnosed with TB and was admitted to Lee Memorial Hospital on Saturday.

The Daily News was unable to contact Paula Martin, who said in the report that her 34-year-old daughter Andrea Page was suffering from TB. Lee Memorial Hospital said that Page was not a patient in its facility Wednesday morning. LMHS public relations representative Pat Dolce said that Andrea Page was not in her directory and refused further comment.

The Southwest Florida scare comes after Andrew Speaker, 31, traveled overseas while infected with an extensively drug-resistant rare form of TB called XDR-TB. His case received international attention because he traveled to and from Rome, Italy for his wedding and honeymoon against orders by the U.S. Centers for Disease Control and Prevention. Speaker is currently quarantined in Denver.

?We don?t have anybody associated with that case,? South said. ?I think it?s got everybody stirred up,? but TB monitoring and treatment happen regularly in the US, he said.

Approximately one third of the world?s population is infected with TB, according to the World Health Organization. While those infected people are not sick and cannot spread TB germs, some will go on to develop the disease and become contagious.

Overall TB rates in the US are falling. According to CDC, in the US, 16,527 people died of TB in 1954. 50 years later in 2004, TB deaths totaled 662. Still, it?s no extreme rarity. ?TB is not an unusual illness,? South said. ?We have enough of it that the health department has a dedicated unit that does nothing but monitor TB.?

Treatment lasts from six months to a year or more. According to the Bureau of TB and Refugee Health, Lee County had 19 new TB cases reported in 2006, or 3.3 cases per 100,000.

The same year, five of 1,038 statewide TB cases were multiple-drug resistant, or MDR-TB ? meaning that the two most powerful anti-tuberculosis drugs were not effective in treatment ? but none was XDR-TB, according to the Florida Department of Health.

CDC statistics show that of the 49 XDR-TB cases reported since 1993, none has been in Florida.

While doctors and hospitals are required to report every new case of TB within 72 hours of diagnosis, the patient?s identity is not normally released to the public.

?We watch over it very carefully and there are no real risks to public health if people go through treatment properly,? South said.

http://www.naplesnews.com/news/2007/jun/06/local_tb_case_nothing_worry_about_officials_say/

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Quarantined TB patient may be able to leave room; tests reveal low chance of spreading disease

By COLLEEN SLEVIN
Associated Press Writer

DENVER (AP) — The Atlanta lawyer quarantined with a dangerous strain of tuberculosis has a relatively low chance of spreading the disease, possibly allowing him to leave his isolation room for a short time as soon as next week, one of his doctors said Tuesday.

A third test of Andrew Speaker’s sputum — a mixture of saliva and phlegm — turned up negative for the presence of TB bacteria, confirming the results of earlier tests at National Jewish Medical and Research Center.

Normally, TB patients with three negative sputum tests who have undergone at least two weeks of treatment are allowed to leave their isolation rooms briefly as long as they wear a mask. Additional precautions are advised for patients, like Speaker, with drug resistant strains of the disease.

If his drug regimen is established and if he wears a face mask, Speaker could be allowed outside on hospital grounds with an escort as early as next week, said Dr. Charles Daley at a news conference.

“I think it’s important for people’s treatment ... to get outside,” Daley said.

However, given the attention Speaker’s case has attracted, Daley said it’s possible hospital officials or Speaker himself could decide against outside walks to protect his privacy.

Doctors could decide as early as this week whether Speaker should undergo surgery to remove infected tissue, Daley said.

Doctors are hopeful Speaker’s tuberculosis can be cured because it is not widespread, he is otherwise healthy and young, and National Jewish has extensive experience treating drug-resistant infections with a combination of drugs and surgery.


(snip)

http://www.indeonline.com/printable.php?ID=17163

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Health department confirms TB death at Memorial Hospital

The Colorado Springs Department of Public Health and Environment has confirmed that a patient who died at Memorial Hospital on Friday died of tuberculosis.

An investigation is underway to find anyone who may have been in direct contact with the patient while she was contagious. Once those people have been found, appropriate TB testing will take place.

The health department says it's unlikely the patient's death was from Multi-Drug Resistant TB, but that still has to be confirmed.

The woman was a student at CSU-Pueblo and was living in Colorado Springs.

http://www.koaa.com/news/view.asp?ID=8036

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

TB suspected in woman's death

By The Denver Post

Article Last Updated: 06/11/2007 01:33:14 PM MDT



Colorado Springs - The El Paso County Department of Health and Environment expects to know later today whether a 19-year-old woman from Nepal died of a communicable disease - perhaps tuberculosis.

The woman was an international student at Colorado State University-Pueblo until summer break and was recently living in Colorado Springs, according to the Colorado Department of Public Health and Environment.

The name of the woman, who died Friday morning after seeking help at Memorial Hospital's emergency room, has not been released.

Memorial Hospital spokesman Mark Goldberg said the woman was placed in an isolation room and employees were told to wear protective masks after the woman arrived at the hospital.

The hospital notified the county health department's communicable disease specialists.

Memorial Hospital sees about six TB patients a year.

"We're considered a low risk area and a low risk facility for that," Goldberg said. "The doctors and our infectious control people are telling us that TB is not an easy disease to get. You have to have prolonged close contact."

The hospital tests each of its employees annually for exposure to TB.

http://www.denverpost.com/news/ci_6114492

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

More on TB in Nepal here:

http://www.flutrackers.com/forum/showthread.php?t=21226