Tuberculosis in two Texas schools
What parents need to know about TB
Last week, two schools in Texas sent home reports of students diagnosed with tuberculosis (TB), including one in the Lewisville ISD.
A letter was sent to Hebron High School and Hebron 9th Grade Campus parents to let them know a student had been diagnosed with active tuberculosis. The note stated that “medical officials have informed us there is a very low probability of this student being contagious.”
In Houston, parents of Sugar Grove Academy Middle School were also sent a letter saying a student was suspected of TB, but was recovering. School officials told parents they were monitoring the situation, and would let parents know if their child needed to be tested by Feb. 1.
“Fortunately because the health departments are monitoring the situation, the risk to other students is very low,” said Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s. “People in close contact with someone who is contagious for tuberculosis are at highest risk. If the health department determines a teenager at the school is contagious they will notify families and arrange testing of those who may have been exposed.”
When a person who is contagious for tuberculosis coughs, their bacteria is airborne. If another person inhales this bacteria it goes into their lungs. They are at that point considered officially infected with TB. They may or may not ever develop symptoms of TB, but their TB skin test is likely to be positive after this event for life. This doesn't mean they are contagious for life, just that they will always test positive. People who have a positive skin test have to get chest X-rays every year to make sure they don’t have an active disease.
Dr. Whitworth says there’s about a 10 percent chance that the person will become clinically ill sometime during their lifetime with tuberculosis. The risk of becoming ill is much higher and can occur quickly in children under the age of 5 years. This is why a person who has been exposed is tested.
“If the test is positive they are considered officially infected and placed on oral medications to prevent those few bacteria in their lungs from developing into pneumonia or other forms of illness sooner or later in their lifetimes,” Dr. Whitworth said. “It takes a long time for someone to become contagious for TB, typically many years. This is why young children are almost never considered contagious. Even if they are sick with tuberculosis, they do not have a large enough bacteria count in their lungs to spread this to others nearby. “
Tuberculosis typically causes pneumonia with cough, fever, weight loss, night sweats, and chills. It can also cause meningitis, bone infection, and other more rare forms of disease.
The treatment varies from one medication for a child who has infection but is not ill, to several medications for up to a year in others. These are almost always given by mouth. Treatment is monitored by the health department. For ill individuals of any age the medications are delivered directly to the patient every day at home by the health department to make sure every dose is taken.
“When a person is fully treated, they most often have a full recovery, and also very importantly, there is minimal risk that they will ever be contagious to others again,” Dr. Whitworth said. “This is why our country has much less tuberculosis than many others, because we have good health departments who take this seriously.”
About the source
Mary Suzanne Whitworth, M.D. is the medical director of Infectious Diseases at Cook Children’s, which offers care for children and teens with diseases caused by bacteria, parasites, fungi or viruses. Our team provides a broad range of services including diagnosis, inpatient and outpatient consultations, immune deficiency evaluations and treatment of recurring infections.