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Tuberculosis at CdA High

Sat., Oct. 22, 2005

Confirmation that a hospitalized Coeur d’Alene High School student has tuberculosis prompted the Panhandle Health District to announce Friday the testing of all students and staff at the school.

The school’s 1,485 students and 100 employees will undergo tuberculin skin testing for the contagious disease Monday and Tuesday in the school auditorium, health officials said.

They emphasized that the decision to test everyone in the school does not indicate a medical emergency.

“There is no current outbreak of tuberculosis,” said Dale Peck, the health district’s director of Environmental Health, Response and Information Technology.

“It’s not highly contagious,” he said.

Tuberculosis is caused by bacteria that attacks the lungs and can be spread when a person with TB coughs, sneezes, laughs or sings.

The infectiousness of the disease depends on how close the contact is with the infected person, the length of the contact and how much bacteria is contained in each droplet that’s airborne, said Panhandle Health epidemiologist Jeff Lee.

Symptoms of the disease are a bad cough that lasts three weeks or longer, pain in the chest, coughing up blood or phlegm from deep inside the lungs, weight loss, fatigue, lack of appetite, chills and fever.

The disease can be treated with antibiotics.

Health officials would give no details about the sick student, other than to say that they thought the disease had been contracted outside the United States.

The student last attended school a week ago Friday or Monday, and the tuberculosis diagnosis was confirmed Thursday, Peck said.

The student is being kept in a negative-pressure room, from which germs cannot escape and where the air is filtered out and cleaned 12 times an hour to prevent spread of the disease, Lee said.

The student will remain there for about two weeks, at which time he or she should no longer be contagious, Lee said. Treatment calls for six months of antibiotics.

No one in the student’s family has tested positive, Peck said. But TB has a long incubation period, so the student’s family, and all Coeur d’Alene High School students and staff, must be tested again in three months.

Tuberculosis is rare in Idaho, occurring only about 12 times a year. Most cases involve a person with easily identifiable contacts who can be tracked down and tested relatively easily by public health workers.

“Typically they are older or an IV drug user,” Lee said. “This is the first time we’ve had a case with someone this young.”

In this case, the number of possible contacts required that the entire school be tested, health workers said.

During a Friday afternoon press conference, Principal Steve Casey volunteered to be the first person tested. The school district had a cameraman videotaping Casey to familiarize students with the procedure on Monday.

Casey held a stuffed Viking mascot and asked Lee questions about the procedure while Lee cleaned an area on his forearm and injected a small amount of noninfectious tuberculin solution under the skin.

Lee gave Casey a cotton ball and asked him not to press directly on the area where the solution was injected, but to just dab around it, and then chastised Casey when he pressed right on the injected solution.

“The next 24 hours, you might see a little redness,” Lee said, reassuring him that it was normal.

On Thursday and Friday, three days after being given the injection, students will be called back into the auditorium to have their arms examined by health workers who will look for a specific reaction and measure it.

If they have the reaction, it doesn’t necessarily mean they have tuberculosis, Lee said, but they probably will be referred to their doctor for further testing.

To prepare students, Casey made an announcement Friday on the intercom, and drew some parallels to Hurricane Katrina and the Sept. 11 terrorist attacks.

“Sometimes we can prepare for situations. Sometimes they just happen,” he said. But, Casey added, if all students adhere by the testing regimen, they can prevent further spread of the disease.

“Do not panic,” Casey said. Chances of contracting the disease are “extremely minimal,” he said.

And to underscore that point, school and extracurricular activities are continuing as normal.

School officials sent students home with letters and packets of information prepared by the health district, and mailed another set to all parents. The cost of the testing is being covered by the state of Idaho.


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