TB outbreaks in the USA, current developments

[Gert van der Hoek]

TB Outbreak Confirmed At Drop Inn Center

Travis Gettys, WLWT.com

POSTED: 12:28 pm EDT May 4, 2007

UPDATED: 12:45 pm EDT May 4, 2007

CINCINNATI -- Health officials have confirmed seven cases of tuberculosis among people who stayed at the Drop Inn Center.

Officials from Hamilton County Tuberculosis Control want to screen everyone who spent at least four hours at the homeless shelter between Oct. 12 and Feb. 7, including residents, employees and volunteers.

Nearly 800 people spent the night at the shelter during that three-month period, officials said, but only about 200 have been screened so far.


About 25 to 30 cases of the airborne bacterial infection are identified each year in Hamilton County, health officials said.

Bacteria from the seven recent cases share the same DNA and were found among people who stayed at the shelter, and each of those people also used other social services.

"There's certainly no reason to overreact here but, if you or any of your clients from Over-the-Rhine's social service agencies think you might have been exposed to the disease during this time, the best thing to do is call," said Dr. Lisa Haglund, medical director for Tuberculosis Control.

Tuberculosis is treated with antibiotics, and those experiencing symptoms or those who think they may have been exposed should call Tuberculosis Control at 946-7618 or 946-7604.

http://www.wlwt.com/news/13258834/detail.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

TB outbreak reported at homeless shelter

CINCINNATI (AP) ? Officials of a homeless shelter are calling social service agencies in an attempt to find anyone who may have come in contact with people diagnosed with tuberculosis over a four-month period.

Seven people who stayed at the Drop-Inn Center tested positive for TB, were treated and no longer are contagious, said Lynn Kilbane, coordinator of the Hamilton County Tuberculosis Control Clinic.


The clinic screened about 200 adults at the shelter as well as staff and volunteers, but it wants to test another 600 people it estimates stayed at the shelter between Oct. 12 and Feb. 7.

Most people exposed to TB bacteria don?t develop a full-blown infection and are not contagious, Kilbane said. Antibiotics can kill most strains of TB.

The first person identified with the disease was diagnosed in Missouri, and health officials in that state notified the Ohio Department of Health. All seven have the same strain of TB.

The shelter had a TB outbreak in 1999, when some 11 people contracted the disease, said Charles Woode, section chief of health services for Hamilton County Job and Family Services, which oversees the TB clinic.

Residents living in close quarters are more likely to pass infections, and many are malnourished or chronically ill, which makes them more vulnerable.

Information from: The Cincinnati Enquirer, http://www.enquirer.com


http://www.coshoctontribune.com/apps/pbcs.dll/article?AID=/20070507/UPDATES01/70507007/1002/NEWS01

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

WPEC may have been exposed to tuberculosis


By MELISSA E. HOLSMAN

May 11, 2007

Employees of WPEC News 12 in West Palm Beach were told Friday they might have been exposed to tuberculosis by an employee who county health department officials said had contracted the highly infectious disease.

Deborah Mills, the station's senior director of human resources, said they were first informed by officials with the Palm Beach County health department.

It was brought to our attention... that there had been an individual identified at WPEC with TB," she said. "We're fully cooperating with the Palm Beach County Health Department and we set up education classes today."
Mills said that during the morning and afternoon education sessions employees at the CBS affiliate ? which also produces WFLX Fox 29's Ten O'clock News ? were given a chance to be tested for TB.

"We had two nurses over here that were available to provide testing," she said. "Or you could go to your own family practitioner ? just like it would happen at a school."

Mills declined to identify the sick employee or say how many staff members had taken advantage of the TB testing.

"I think the education is what we're trying to get across to everyone," she said. "The Palm Beach County Health Department has just been really great."

Mills said they were given a presentation by the health department's division director of communicable diseases, a TB program manager and public information officer Tim O'Conner, who answered questions.

She said she didn't know whether the ill employee was currently undergoing treatment or exactly when and where exposure initially occurred.

"The health department handles all of that," she said.

http://www.tcpalm.com/tcp/local_news/article/0,2545,TCP_16736_5532591,00.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

11 May 2007 12:36PM

Outbreak of New Strain of TB in SF


SAN FRANCISCO, Calif. (KCBS) - As recently as last week, San Francisco health officials were adding to their list of patients with a new drug-resistant strain of tuberculosis.

They're calling this an outbreak with origins in a San Francisco residential hotel.

It was in January of last year when the first patient showed up. However, Dr. Masae Kawamura, the city's director of TB Prevention and Control, didn't realize how serious the case was until six weeks later when lab results came back.

"Subsequent to that we found six other individuals with this same strain of TB," she explained. "And it's been a deadly strain. We've already had on death from it and another is in critical condition in the hospital."

Five of the patients all lived in one Tenderloin SRO, or single room occupancy hotel. In response, the city continues to monitor the facility for new cases.

"TB is like a time bomb," warned Kawamura. "You don't know when it's going to happen. And the fact that we have five cases in one hotel, we know that there's been a lot of spread of this disease."

Because not all the residents agree to be tested, Kawamura worries there may be more infected carriers. The strain which originated in the former Soviet Union does respond to secondary drugs, the weaker, less tested ones that cause severe side effects including mental illness.

"The patients with this strain are getting injections every day, five days a week. And their treatment will be for much longer than the usual 6 months. It will be at least a year."

http://www.kcbs.com/pages/445210.php?contentType=4&contentId=491013

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

CMS employee has TB


Mecklenburg County health officials plan to administer tuberculosis tests today to people who might have come in close contact with a Huntersville school security officer who has been diagnosed with the disease.

Charlotte-Mecklenburg Schools officials say a security associate who worked at Bailey Middle School contacted the school's principal Thursday and reported that he had been diagnosed with tuberculosis.

CMS officials say the employee has been out of work for more than a month.

However, health officials have told the school system that they will administer tests today to people who worked closely with the officer. There is no word as to how many school employees might be involved in the testing.

Tuberculosis is a contagious disease of the respiratory system. It can be spread by coughing and sneezing, and the disease can be fatal if not treated. It has been brought under control, for the most part, in the United States and can be treated effectively with medication when caught early.

http://www.charlotte.com/115/story/118139.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Possible TB exposure at Crawford High Ed. Complex

4:13 p.m. May 10, 2007

SAN DIEGO ? About 100 students, teachers and staff at Crawford High Educational Complex may have been exposed to tuberculosis and should get tested, San Diego County health officials said Thursday.

A student who attended classes at Crawford High Educational Complex's Law and Business campus from Feb. 1 through May 3 was diagnosed with TB, according to the San Diego County Health and Human Services Agency.

School officials have identified about 100 students, teachers and staff that were potentially exposed, according to the HHSA.

Letters were sent out Thursday notifying those who may have been exposed to the disease. Testing will be conducted on campus next week.

Symptoms of active TB include persistent cough, fever, night sweats and unexplained weight loss, according to the HHSA. Most people who are exposed to TB do not develop the disease.

http://www.signonsandiego.com/news/metro/20070510-1613-tb.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Dozens exposed to tuberculosis through Valley health agency

HIV-positive patients among those at risk of infection

Melissa McEver

May 19, 2007 - 7:36PM

HARLINGEN ? Cameron and Hidalgo county health departments are testing about 80 people, some of them HIV-positive patients, for active tuberculosis after they were exposed to someone with the disease at Valley AIDS Council, officials have confirmed.

State and county health officials have initiated a tuberculosis-contact investigation that will involve employees and patients from both counties, said Dr. Brian Smith, regional director for Texas Department of State Health Services? Region 11, which includes the Rio Grande Valley.

Smith declined to specify whether the person with active tuberculosis was a Valley AIDS Council employee or patient.

Once the person was diagnosed with tuberculosis, he or she was quarantined immediately, Smith said.

Because some of the people exposed are HIV positive, and thus especially vulnerable to developing active tuberculosis, the health departments will conduct an extensive array of tests to check for infection, Smith said. Many of those who were exposed will be put on preventive medications or tuberculosis-treating drugs if they test positive, he said.

The investigation and testing process will take about three to six months, officials said.

?It will be a very careful and thorough investigation,? Smith said.

HIV and tuberculosis are a ?lethal combination,? according to the World Health Organization. Each disease hastens the other?s progress, further weakening an HIV-positive patient?s suppressed immune system. Tuberculosis is a leading cause of death among HIV and AIDS patients across the world, WHO reports.

Officials declined to say from which Valley AIDS Council clinic the exposure originated.

Cameron County Health Department has identified about 13 people so far who could have been exposed to TB through the person with the active disease, said Herb Tolentino, the health department?s director of nurses. The department is still investigating whether anyone else has been exposed, Tolentino said.

Hidalgo County Health Department officials referred questions about the investigation to Smith of DSHS.

Tuberculosis-exposure investigations usually have several stages, Smith said. First, health workers test immediate family members of the person with the disease, then widen the circle to include work and school contacts, he said. Because some of the people who were exposed are HIV positive, however, everyone who came into contact with the person is being tested quickly, he said.

People who test positive on a skin test then undergo chest X-rays and sputum tests to check for active infection, officials said.

Bob Smith, executive director of Valley AIDS Council, emphasized ?there was no outbreak? within the council?s clinics and that current patients shouldn?t be alarmed.

?We?re going to take good care of (patients) ? it?s our job,? he said.

He said all council employees undergo TB testing before starting work and then are tested annually.

He referred further questions to the Department of State Health Services.
____
http://www.themonitor.com/news/health_2504___article.html/tuberculosis_valley.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

King County says tuberculosis cases have doubled this year

11:59 AM PDT on Saturday, May 19, 2007

Associated Press

SEATTLE - Tuberculosis cases have doubled in King County this year when compared to the same period last year, health officials said.

Most cases have affected foreign-born residents, and health officials do not think there is a threat of spread to other parts of the community.

Health workers are overwhelmed with the TB case load, however, and need more help, said Dr. Masa Narita, director of TB control for Public Health -- Seattle & King County.

From January through March, 38 TB cases were reported, compared with 18 in the same period last year. In 2006, the annual total was up 16 percent from 2005, to 145 cases. Eighty percent of TB patients in King County were foreign-born.

"It is concerning, and we have to continue the thorough job we're doing with case management and timely ... investigations," Narita said.

Immigration from countries where TB is widespread -- Eastern Africa, Central America and Southeast Asia -- has increased at the same time TB cases in King County have risen.

Worldwide, about a third of the population is infected with TB, according to the federal Centers for Disease Control. Nearly 2 million die of TB in the world each year.

It costs a minimum of $7,000 to treat each TB patients, but for those rare individuals who are resistant to the most common drugs, treatment can cost up to $250,000 a patient. About two patients a year in King County are drug resistant.

http://www.king5.com/health/stories/NW_051907WABtbcasesSW.855a84c4.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

TB scare at Vallejo High School

By Andrew McGall

CONTRA COSTA TIMES

Article Launched: 05/21/2007

VALLEJO - Health andschool workers are moving quickly to learn who may have had contact with a person at Vallejo High School diagnosed with active contagious tuberculosis, the Solano County health department reported today.

"Although the risk of contracting TB is generally low, we must find anyone who had significant contact with the contagious person, test them, and treat them if necessary, to stop the potential spread of this disease," said Dr. Ronald W. Chapman, deputy director of Solano County Health and Social Services.

The few days left before school ends has added urgency to the investigation, Vallejo high principal Phil Saroyan said in a release issued by the health department.

"Dr. Chapman and I ask for everyone's full cooperation so that we can move through the screening and testing . . .quickly to protect our students and staff."

All students and staff who have a positive skin test will receive further testing and medication to ensure that they do not develop active TB disease.

The school and the health department have set an information meeting for 7 p.m. May 31 at the Vallejo High School library, 840 Nebraska Street. For urgent issues regarding TB exposure, callers can leave contact information at 707-553-5570.

http://www.contracostatimes.com/news/ci_5950402

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Officials sure Vallejo High is 'perfectly safe'


By J.J. MCLAUGHLIN/Times-Herald staff writer

Article Launched: 05/24/2007 07:08:39 AM PDT


When Solano County public health and Vallejo Unified School District officials met Wednesday night at the Vallejo High School library for a Q-and-A session with concerned parents, they made one thing very clear.
"We are absolutely certain that tuberculosis is not in the air and our children at Vallejo High are completely safe," said Mark Maus, medical director of the county Department of Public Health.

Health officials said they feel very confident about the direction the investigation is going in determining who needs to be tested for TB.

A case investigation is under way to determine who is at "high risk" for contracting the bacterial lung disease by analyzing the infected individual's close contacts and where they "lurk, work and live," Maus said.

Health officials have not identified who has contracted the disease, or whether the person is a student or staff member.

Those deemed "high-risk" were categorized as a "contact" while those not at risk are noted as "non-contact," Maus said.

Parents and residents expressed concern when it came to testing everyone at the high school for their own safety, but Ronald W. Chapman, a Solano Public Health official, said testing everyone would be counterproductive.

"There's a very good scientific reason why we don't test everyone," Chapman said. "If we start testing people who weren't exposed, the tests could still show up positive even though they in fact don't have the bacteria and that could cause more harm than good."

The major challenge health officials said they face is the time-frame in which to complete the "contact" investigation and still receive the results before the end of the school year.

"We worry that with the summer break we may lose track of the seniors who leave, since testing could take up to two months," Muas said.

School officials said "contact" letters will be sent out May 29, adding that the process requires time to scientifically determine who has been exposed. Skin tests will be offered at Vallejo High for those who receive a "contact" letter.

http://www.timesheraldonline.com/ci_5976105

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

Elementary Student With TB In Escondido

ESCONDIDO, CA - (5-23-07) Health officials are warning and staff at one Escondido elementary school about possible exposure to Tuberculosis.

A student was diagnosed with the A student who attended Felicita Elementary School was diagnosed with TB.

Anyone who spent time at the school between November 1st to May 16th, 2007 should be tested. For more information call the County TB Control Program at (619) 692-8621.


http://www.primenews.com/sdhn_052307_tb.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

TB in SD? Bummer, Dude


SAN DIEGO (CNS) -- County health officials are urging about 70 students, teachers and staff at an Escondido elementary school to get tested for tuberculosis.

A student who attended classes at Felicita Elementary School from Nov. 1 through May 16 was diagnosed with the disease, according to the San Diego County Health and Human Services Agency.

''HHSA is working with the Escondido Union School District to notify the individuals who may have been exposed,'' said Dr. Wilma Wooten, interim county deputy public health officer.

School officials have identified about 70 students, teachers and staff who were potentially exposed to TB in classrooms 27 and 41, and during an afternoon SOS Program run by Palomar YMCA, according to HHSA. Tests will be conducted on campus next week.

Symptoms of active TB include persistent cough, fever, night sweats and unexplained weight loss. Most people who are exposed to TB do not develop the disease.

Courtesy CNS

http://www.knx1070.com/pages/498422.php?contentType=4&contentId=536863

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

UTAH

Friday, May 25, 2007

TB diagnosed in Provo High student

BROOKE BARKER - Daily Herald

You may have thought he had a cold or just a case of the flu that didn't seem to go away.

But it was actually an active case of tuberculosis -- and you could be affected.

Approximately 250 students at Provo High will be receiving letters within the next week asking them to get a tuberculosis skin test after one student at the school was recently diagnosed with active TB, according to Greg Hudnall, director of student services in Provo School District.

"We are just asking anyone who may have had contact with this student to go to the Utah County Health Department to be diagnosed," said Hudnall.

Tuberculosis is a contagious respiratory disease that spreads like the common cold, according to the World Health Organization.

Some of the common symptoms include night sweats, fatigue, unexpected weight loss, a slight fever and a long lasting cough.

"It's an unusual disease, but it can be very serious," said Joseph Miner, the executive director of the Utah County Health Department.

In Utah County, there is an average of four to five active cases of TB diagnosed each year.

There are two types of tuberculosis: the disease, which is also known as active TB, and the infection. Many people could be infected with the disease and be unaffected and not contagious. Some people have tuberculosis in their body for years, Miner said, without showing any symptoms.

"Only about 10 percent of the time tuberculosis develops into an active disease," said Miner. "But just because it is slow growing doesn't mean it isn't a serious disease. Millions of people die every year from tuberculosis."

If treated now, students who may have a tuberculosis infection can take antibiotics, he said, and prevent the disease from developing in their bodies.

According to the Centers for Disease Control, there were more than 14,000 cases of the disease reported in the United States in 2005.

The World Health Organization estimates that the curable disease kills 5,000 people every day and that virtually all TB deaths are among young adults in developing countries.

The Utah County Health Department will be providing skin tests free of charge to students and faculty who had close contact with the student. His name wasn't released because of the Health Insurance Portability and Accountability Act, which keeps a patient's identity confidential.

A student whose skin test comes up negative will need to be re-evaluated in three months, and if the test is positive, a chest X-ray will be required. If the X-ray reveals the student has a TB infection, the Health Department will recommend preventative antibiotics.

All of the services and antibiotics will be provided free of charge as long as the teenager has the letter sent to them from the Health Department saying they were in close proximity of the student with the disease.

For more information, contact the Utah County Health Department at 851-7000.

Brooke Barker is available at 344-2559 or bbarker@heraldextra.com.

http://www.heraldextra.com/content/view/222824/3/

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

US urges Air France, Czech Air passengers to test for TB

Published: Tuesday May 29, 2007

US health authorities Tuesday urged passengers of two Air France and Czech Air flights to be tested for a particularly virulent strain of tuberculosis that may have been spread by a fellow traveler.

Dr. Julie Gerberding, head of the Atlanta-Georgia based Centers for Disease Control and Prevention (CDC) told a press conference that the especially drug-resistent XDR strain of tuberculosis can cause severe illness or death.

"Most likely to be at risk would be the passengers who were seated in seats immediately close to the patient," she said, recommending they undergo testing to determine whether or no they were in fact exposed.

The infected passenger, a US citizen who has been placed in isolation, traveled on Air France flight A385 from Atlanta to Paris on May 12, and on a Czech Air flight from Prague to Montreal on May 24.

http://rawstory.com/news/afp/US_urges_Air_France_Czech_Air_passe_05292007.html

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

2 TB cases investigated in county

Health officials suspect cases in different areas to be unrelated


By DAVE RANK - GM Today Staff

May 30, 2007


Two local cases of tuberculosis are being investigated by county and state health officials, the Washington County Health Department announced Tuesday.

The two individuals with the contagious disease "are in different geographic areas of the county and there is no indication they are related," said Linda Walter, county health officer and director of the Health Department. "This is really just a heads-up for the public."

Tuberculosis (TB) is a disease caused by germs spread from person to person through the air. It usually affects the lungs and can lead to symptoms such as chest pain and coughing up blood.

http://www.gmtoday.com/news/local_stories/2007/May_07/05302007_05.asp

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

May 30, 2007

CDC Addresses TB Scare

The Center for Disease Control renewed its investigative efforts in earnest today, trying to track down any air passengers who may have been contaminated with tuberculosis bacteria by a Georgia man on two transatlantic flights in May.

Yesterday, the CDC declared an isolation order -- the United States' first in over 40 years -- to prevent the spread of the drug-resistant strain.

CDC official Dr. Martin Cetron said today that the patient from Georgia will be moved to National Jewish Hospital in Denver, which specializes in respiratory infections. (He is still in isolation, Cetron said, but not in quarantine.) After he flew back from Montreal on May 24, the Georgia man was isolated in New York City and then hospitalized in Atlanta.


Cetron also said the investigation is concentrating on the two flights that lasted eight hours -- Air France 385 from Atlanta to Paris on May 13 and Czech Air Flight 0104 from Prague to Montreal on May 24 -- but the man did take five shorter flights within Europe. Transmission risk diminishes with shorter exposure times.

Fifty or 80 passengers on the two longer flights are in the most danger, and CDC officials are working on getting lists that will help them identify exactly where the man was sitting and the names and nationalities of the people seated near him. Cetron stressed that the investigation would be an international effort, since multiple countries are involved.

The CDC does have a complete list of all the flights that could have been contaminated, and concerned air travelers can call 1-800-CDC-INFO to get specific advice to "manage the risk," Cetron said. People who suspect they may have been exposed take an initial skin test to check for the disease and then a second test eight to 10 weeks later.

A tuberculosis expert at the CDC, Dr. Ken Castro, tried to reassure the public that drug-resistant tuberculosis is rarely passed from person to person in periods of short contact. Cetron re-emphasized that passengers on the short flights or other people who might have had contact with the infected man in the airports, for example, would not be at significant risk.

The officials also revealed a few more details about the logistics of the patient's travel, saying he had been advised not to fly but that no laws were broken when he did. Cetron said the CDC tried to track down the man in Rome, but he wasn't found until after his flight landed in Montreal and he had crossed back into the United States.

When a reporter asked about the public's right to be protected from the disease, Cetron cited the need for a balance between "individual freedoms and the public good," and said "the individual had a compelling interest from his own perspective" to go to Europe. He stressed that no legal order was issued to keep the patient from traveling.

Cetron declined to reveal the man's name or other details about him -- which Cetron said they "never do" -- but said he has been fully compliant and not broken any laws. He said the patient does exhibit some signs of pulmonary tuberculosis, but he doesn't have "overt symptoms of active, hectic cough or coughing up lots of sputum or blood" and the possibility of his infecting others is "on the lower end of the spectrum. It's certainly not zero.... The context of the pathogen he has is that the consequences of it being spread are quite high."

http://thegate.nationaljournal.com/2007/05/cdc_takes_more_steps_to_contai.php

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

TB Patient In Denver For Treatment

(AP) A tuberculosis patient under the first federal quarantine since 1963 left an Altanta hospital Thursday and arrived at a Denver facility that specializes in respiratory disorders, officials said.

The 31-year-old man walked into the building wearing a mask around 8 a.m. and said he felt fine, Denver National Jewish Hospital spokesman William Allstetter said.

Allstetter said doctors plan to begin treating him today with two antibiotics, one oral and one intravenous. He will also undergo a basic physical exam, a test to evaluate how infectious he is and a CT scan and lung X-ray. Doctors hope to also determine where he contracted the disease.

He will be kept in a special unit with two rooms and a special ventilation system, Allstetter said.

"He may not leave that room much for several weeks," he said.

The man, who has not been publicly identified beyond his age, knew he had TB when he flew from Atlanta to Europe in mid-May for his wedding and honeymoon, but he didn't find out until he was already there that it was an extensively drug-resistant strain considered especially dangerous.

Despite warning from federal health officials not to board another long flight, the man flew home for treatment.

Health officials in North America and Europe are trying to track down about 80 passengers who sat near him on the two trans-Atlantic flights, and they want passenger lists from four shorter flights the man took while in Europe. Patients on the shorter flights are not expected to be as much at risk, health officials said.

Among those being tested are more than two dozen University of South Carolina Aiken students, school spokeswoman Jennifer Lake said Thursday. Two were apparently sitting near the man, possibly on the same row, she said.

One of those students, Laney Wiggons, is awaiting her skin test results, which are expected Friday.

"I'm very nervous," Wiggans told The (Columbia) State newspaper. "It's kind of sad that this is overshadowing the wonderful time we had in Europe."

The man flew to Paris on May 12 aboard Air France Flight 385, also listed as Delta Air Lines codeshare Flight 8517, according to the Centers for Disease Control and Prevention.

He and his bride also took four shorter flights while in Europe _ Paris to Athens on May 14; Athens to Thira Island May 16; Mykonos Island to Athens May 21; and Athens to Rome May 21 _ but CDC officials said there was less risk of infection during the shorter hops compared to the trans-Atlantic flights, which each lasted eight hours or more.

It was while the man was in Rome that he learned further U.S. tests had determined his TB was the rare, extensively drug-resistant form, far more dangerous than he knew. They told him turn himself over to Italian health officials and not to fly on any commercial airlines.

Instead, on May 24, the man flew from Rome to Prague on Czech Air Flight 0727, then flew to Montreal aboard Czech Air Flight 0104 and drove into the U.S., according to CDC officials.

Officials are trying to contact people who sat within five rows of him on the two longest flights for testing.

Other passengers are not considered at high risk of infection because tests indicated the amount of TB bacteria in the man was low, Cetron said Wednesday.

The man told The Atlanta Journal-Constitution that doctors did not order him not to fly and only suggested he put off his long-planned wedding. "We headed off to Greece thinking everything's fine," he told the newspaper.

Dr. Charles Daley, head of the infectious disease division at National Jewish, said the hospital has treated two other patients with what appears to be the same strain of tuberculosis since 2000, although that strain had not been identified and named at the time. He said the patients had improved enough to be released.

http://www.cbsnews.com/stories/2007/05/31/ap/national/main2870233.shtml

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

TB case in Vallejo generates 'frenzy'

School district mails letter to those at risk of catching disease

By RACHEL RASKIN-ZRIHEN/Times-Herald staff writer
Article Launched: 05/31/2007 07:13:21 AM PDT


The Vallejo school district is mailing letters to Vallejo High School parents, letting them know if their children are at risk for catching tuberculosis from a recently identified active case, a district spokeswoman said.

This will help narrow the number of families who need to worry about getting the infection, said district spokeswoman, Tish Busselle. The Solano County Health Department still hasn't released any specifics about the patient, saying only that he or she is "associated with Vallejo High School," she added.

"We're not telling people not to be concerned, but we want people to know that just being on the same campus with someone with TB doesn't mean you're going to get it," Busselle said.

"Having a TB-diagnosed student at Vallejo High School does not mean that all students and staff must rush out to get a TB test," said Karen Fulton-Holine, regional vice president of the American Lung Association of California in a prepared statement. "Only those people who are at high risk for getting or transmitting TB or those whose jobs require testing should get a skin test annually."

Fulton-Holine said the district's first step is to find out with whom the student has had prolonged contact, and those are the ones who need to be tested, though "the odds of them contracting the TB disease are extremely low."

http://www.timesheraldonline.com/ci_6028257

 

[Gert van der Hoek]

Re: TB outbreaks in the USA, current developments

500 at Bowie High exposed to TB

By PAUL BOURGEOIS

Star-Telegram Staff Writer

ARLINGTON -- Skin tests for exposure to tuberculosis administered Tuesday and Wednesday at Bowie High School will be read today and Friday, a school district spokeswoman said.

About 500 students and teachers may have been exposed to the disease this month at the school. Officials released no information about the age or sex of the person who may have exposed the others.

For the tests, a chemical is injected under the skin. Exposure to TB causes a bump at the test site.

Arlington school district spokeswoman Veronica Sopher said that students and parents were notified a week ago of possible exposure and that testing was ordered as a precaution.

It's not yet known what strain of TB is involved, said Gerry Drewyer, Tarrant County's division manager for tuberculosis elimination. The disease can be transmitted through the air.

Drewyer said it "is possible but unlikely" that anyone could be infected so quickly, although infection can go undetected for up to 10 weeks.

People who test negative this week will be retested in September, she said.

Testing was not mandatory but was strongly recommended, Drewyer said.

A student at Martin High School in Arlington tested positive for tuberculosis in March.

About 300 people who had close contact with the student were tested.

Last year, 108 cases of tuberculosis were reported in Tarrant County, Drewyer said. Of those, seven or eight people died, she said.

http://www.star-telegram.com/arlington_news/story/120515.html

 

[T. ModestoPhD]

Re: TB outbreaks in the USA, current developments

I have so many thoughts racing through my mind on this highly disturbing event.

I have not seen any comments on the testing or well being of the man's new wife. (He went to Europe to get married and enjoy a honeymoon! He KNEW he was infected before he left).

Additionally this is a list of my off the top of my head of questions I hope will be answered in the near future. Can anyone help provide answers?

WHAT ABOUT HIS WIFE?

1-Where is the WIFE?

• Is she in isolation as well since it is presumed that she had extended and intimate / close contact with the infected man?
• Or is she walking around Atlanta after being exposed?

WHERE DID HE GO?

2- Where did this man go from the time he got off the plane in Montreal to the hospital in NYC?

• What gas stations?
• Restaurants
• Restrooms, etc?

That is a LONG trip with NO stops!!! Who was involved there?

CAR RENTAL SAFETY ISSUES

3- The car he rented in Montreal - has that been de-contaminated?

• What procedure is used to safeguard the public when using a rental car? New air freshener? (sigh)
• Who if anyone has changed the interior air filter in the car? How was it done?
• What safety measures were followed to ensure that that infected equipment on the vehicle was securely dealt with by trained personnel?
• Who cleaned the rental desk that the man was at to rent the car?
• If he even coughed once, where is the pen he signed the rental agreement with?

I just did a rough calculation through Map Quest from the airport in Montreal to New York City

• Total Est. Drive Time: 6 hours, 24 minutesto drive from the airport in Montreal to New York City and the
• Total Est. Distance is 377.81 miles! Who all did this person come into contact with?

GUESTS & STAFF IN EUROPE?

4- Where are all the people and staff that were at the wedding and possible reception TODAY?

• Have they been contacted?
• Have THEY traveled
• If so where have they been?

WHAT SAFETY ISSUES & HIS HONEYMOON LODGINGS?

5- How has the honeymoon lodgings been cleaned and by whom?

• What is being done to monitor the staff of the lodging?
• Where are the items that he may have infected?

DISINFECTION OF INTERNATIONAL PLANES - WHO'S RESPONSIBLE?

6- What national and international protocols are being used to ensure that ALL SEVEN air planes this man was on is disinfected appropriately and comprehensively and by whom?

• What standards are used?
• Who over sees those task?
• Where and how are the items used to disinfect the airplane being disposed of?
• How is the pubic informed and by whom?

EUROPEAN TRAVEL EXPOSURE?

7- Did this man and possibly his new wife a rent car(s) while in Europe? If so,

• Are these cars being appropriately and comprehensively disinfected as well?
• By whom?
• How are they being disinfected?
• How are we to be certain? Especially if we are traveling in the same areas?

HOW WE LEARN

What we learn from this medical disaster occurrence can certainly help to reduce any potential dangers from this medical crisis but also it is a learning opportunity to become prepared for other medical disasters that will occur at some point in every country and continent.

INTERNATIONAL TRAVEL: A HELP AND A HINDERANCE?

International travel is a major convenience to all of us. Yet it also is a major vehicle of disastrous proportions when considering exposure and spread of a highly infectious and deadly disease.

How we learn from these medical disaster occurrences can help us improve and address as effectively as possible our actions and reactions so our potentially lack of actions are diminished as much as possible and the safety of all the world is heightened.

Terrie Modesto, PhD, CPT Chief Thanatologist ~TEAR Center
Author of: When So Many Die ~ Congregational Preparation For Pandemics & Epidemics www.tearcenter.com