Case of TB confirmed on campus

An e-mail sent to about 235 students, faculty and staff advised recipients to visit the Student Health Center yesterday to undergo tuberculosis skin testing.

This e-mail came after the Adair County Health Department notified the University Monday of a confirmed case of active TB disease in a Truman student. The student remains hospitalized and isolated outside the Kirksville community, and no risk exists on campus at this point, said Kelly Freeland, family nurse practitioner at the Student Health Center.

A phone call from within the Truman community alerted the University to the TB case, Freeland said. Shortly after that report, a phone call from the Adair County Health Department confirmed the case. The student already had been hospitalized and isolated by that point, she said.

"We can report that those very close associates have been tested, and today, none have tested positive for TB," Freeland said.

The University has mandated that those who received the e-mail requesting skin testing undergo the procedure, Freeland said. The health center offered the test for free and asked those tested to return Friday to have their results read, she said. Additionally, those tested are asked to have another skin test after June 23 before their return to Truman in August, Freeland said.

"I do want to point out that at any given time, if you tested any 200 people at random, this meaning without a known exposure, 12 might come back positive," Freeland said.

She said the ACHD recommended close contacts undergo testing first, such as roommates and suitemates.

"[Then] we go the next level down, just to make sure we're not missing anyone, which would be day-to-day contacts, such as classroom contacts," she said.

Lou Ann Gilchrist, dean of student affairs, said the University had discussed TB testing prior to this case.

"About the same time that we learned that this person was being tested for TB, we were talking about a policy that will actually identify those people who are at higher risk, and they will be tested before the beginning of the fall semester, beginning this year," Gilchrist said.

Gail McCurdy, epidemiology specialist for the Adair County Health Department and to 11 other counties, said slow-growing bacteria cause tuberculosis. When these bacteria exist in a person's lungs, they can be expelled through coughing, sneezing or even singing, she said. Another person then can breathe in the bacteria. The bacteria can be transmitted in other ways, but McCurdy said there are very few typical exposures from a public health perspective.

Tuberculosis occurs in two forms, a latent TB infection and active TB disease, in which the bacteria can be transmitted, McCurdy said. In the latent infection, which happens very frequently, the bacteria may be present in the body but cannot be transmitted, she said.

McCurdy said skin testing, one of the simplest, least invasive and most sensitive tests available at this time, can identify individuals who have the bacteria in their bodies, but it does not identify from whom the bacteria came.

"If I'm exposed to [the bacteria] today and I actually get it in my body, and it sits there, there is a 5- to 10-percent chance that I will go on to develop the disease [in my lifetime]," McCurdy said.

She said those whom skin tests identify as actually having the bacteria in their bodies should follow up with their health care provider to find out if it is appropriate to seek treatment. People involved in known exposures through close contact situations should undergo testing, McCurdy said.

"We wouldn't want to test the whole campus because we know there was one person on campus who had it," she said.

McCurdy encouraged students to contact the health center or the Adair County Health Department with concerns or questions about TB.

"Everyone who was involved in this situation identified their part exactly when they should have done it, and every one of the students who were supposed to be helping out with getting us information were cooperative," McCurdy said. "That's exactly what we need in this situation. The people are getting what they need and the information they should have so they can follow up appropriately."

McCurdy said the incidence of active TB disease in the United States started to drop in about 1994 and has continued this trend. She said TB is not a high-risk problem in the U.S., and if health care providers identify a latent TB infection, antibiotics can reduce the risks of developing active TB disease.

There were 13,779 TB cases reported in the U.S. in 2006 (4.6 cases per 100,000 persons), according to the Centers for Disease Control Web site (cdc.gov). This "rate was the lowest recorded since national reporting began in 1953," according to the Web site.