On November 15, 2016, a letter was released to parents to inform parents that an individual at La Plata High School has been diagnosed with tuberculosis (TB) disease. Individuals, who had prolonged exposure at the school to this individual, received an exposure letter and a TB testing consent form. After completing the consent form, these individuals were then to be tested the week of Monday, December 5th, and are to be tested again in early February.
What is Tuberculosis?
Tuberculosis is a disease that can be spread through the air from person to person when an individual affected with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. The TB germs can stay in the air for several hours, depending on the environment. People who breathe in the air containing these germs can become infected.
There to two types of infection. Those deemed to have latent TB infection have inactive TB bacteria in their body. Whereas, with TB disease, the TB germs are active, meaning that they are multiplying and destroying tissue in the body.
People with TB disease express symptoms of fever, night sweats, cough, weight loss, and feelings of sickness or weakness. TB generally attacks the lungs, but it can also attack the brain, spine, or kidneys. If the TB is attacking the lungs, the individual may also express symptoms of coughing, chest pain, and coughing up of blood.
There are two ways to be tested for tuberculosis – the tuberculosis skin test (TST) and TB Blood Tests. However, these tests only indicate if the individual has been infected with TB bacteria, not what type of infection they may have.
Tuberculosis Skin Test
With the Mantoux tuberculin skin test, a health care provider will inject a liquid called tuberculin into the skin of the lower part of the arm. After injected, a small, pale bump will appear. The patient is then to return within two to three days in order to have a trained health care worker look for a reaction on the arm where the tuberculin was injected. They will look for a raised, hard area or swelling; if present, the size of it must be measured. Swelling is not considered a reaction.
The result of the TST depends on the size of the hard area or swelling, in addition to the person’s risk of being infected with the bacteria. If the result is positive, the person was infected with TB bacteria, but whether the person has latent TB infection or TB disease is still undecided. If the result is negative, the person did not have a reaction, and infection of the person with TB is unlikely.
Tuberculosis Blood Tests
The blood test is another way of determining whether the person is infected with TB bacteria. With this, the patient’s blood is collected into special tubes using a needle; it is then delivered to a laboratory, where an interferon gamma release assay (IGRA) is ran. This test works to measure how strong a person’s immune system reacts to TB bacteria. The results are then reported to the health care provider.
If the test result is positive, the person is infected with TB bacteria, but additional tests are needed to determine what type. If the test result is negative, the person’s blood didn’t react to the test and neither infection nor disease are likely.
Testing Positive: Diagnosis of Infection or Disease
If the person tests positive on either test and is found to be infected with TB disease, other tests are needed in order to determine if the individual has TB disease. TB disease can be diagnosed by reviewing medical history or through a physical examination, chest x-ray, and other laboratory tests. If the person does not have TB disease, but has TB bacteria in the body, then the individual’s diagnosis is latent TB infection.
Being diagnosed with either means that the individual requires treatment. Individuals with latent TB infection may have to take treatment in order to kill the bacteria and prevent development of the infection into TB disease.
To treat TB disease, the individual must take several drugs for six to twelve months correctly and exactly as prescribed, other the bacteria may stay alive and develop a resistance to the drug. If a resistance is made, it is still treatable, but is more difficult to treat and is much more costly.
Although tuberculosis can cause death, being infected with tuberculosis bacteria does not have to mean death. When diagnosed, and with proper treatment, the bacteria can be destroyed. The testing at La Plata H.S. is not something to be faced with trepidation, and neither is the patient zero. The testing allows us to be sure of our health, and, if any were infected with bacteria, it allows treatment. It is not whether or not individuals have tuberculosis that is the issue – it is ensuring that those who do receive treatment so that the issue may be eradicated.