Rise in TB cases to prompt CDC response

Talk about it

WORTHINGTON — As a result of some reclassification, the number of active tuberculosis cases in Nobles County now stands at four, including two adults and two children under the age of 5, while the number of suspected cases has grown to nine. All of the cases have surfaced since April.

According to Nobles-Rock Community Health Services, which is required to report both active and latent, or inactive, TB cases to the Minnesota Department of Health, the county sees just one TB case on average each year. With the spike in the number of active cases, the number of latent cases has more than doubled — going from an average of 30 to 40 cases per year to 72 cases in Nobles County in just the first seven months of 2008, said NRCHS administrator Brad Meyer.

The increase in TB cases has health professionals concerned, and is one of the reasons the Centers for Disease Control is sending representatives from its agency to Minnesota and Nobles County in the next few weeks to investigate. It is the first time the CDC has been requested to come into the state for a tuberculosis outbreak.

An outbreak means there are two confirmed cases of the disease in any one location, according to Deb Sodt, Minnesota Department of Health TB program manager. She said there are two definite outbreaks in the state at this time — in the Twin Cities and in Nobles County.

During a conference call with local community leaders and health professionals on Tuesday afternoon, Sodt said the main reason for the request of CDC assistance is because of evidence that the current outbreak involves more than one state.

“Also, it’s because this includes children,” she said. Children are more difficult to diagnose, and MDH is banking on the CDC’s knowledge to help with the investigation. In addition to providing expertise, Sodt said the federal agency will interview NRCHS staff and community leaders, and review the medical records of those with active forms of the disease.

TB not easily transmitted

Despite the county’s TB outbreak classification, health officials are quick to point out that the disease is not easily transmittable. In fact, Sodt said the cases in the county are among a “very small group” of individuals.

The bacterial infection usually attacks the lungs, and is spread through the air when an infected individual coughs or sneezes.

Proper hygiene, such as coughing or sneezing into one’s sleeve or wearing a mask, can greatly reduce the spread of the disease for those who are infected.

The spread of TB requires prolonged exposure to an individual infected with the disease. Sodt said it would require exposure to someone with active TB for several hours at a time for days or even weeks for the disease to spread. That said, only about 35 percent of people who live with someone with active TB actually get the disease.

Diagnosis and treatment

Among the signs of active TB are weight loss, night sweats, extreme fatigue, coughing and, or coughing up bloody sputum. Those experiencing symptoms, especially those coughing up blood, should seek medical attention immediately.

Persons with the latent form, also termed TB infection, are treated with medication. Treatment includes one pill a day for a period of about six months, along with a monthly visit to public health. Unless treated, those infected are more at risk for the full-blown disease if they are exposed to someone with the active form of TB.

Individuals with active TB are prescribed a four-drug cocktail, and may be monitored for a longer period of time, depending on the severity of the disease.

MDH covers the cost of treating TB, and local public health agencies are tasked with following up with infected individuals to ensure they continue their treatment.

Meyer said the increase in active and latent TB cases has had a significant impact on staff within the local public health agency. He has had to pull staff from Maternal Child Health programming, and the agency has reduced its number of immunization and vaccination clinics in order to respond to the outbreak.

For more information regarding TB, contact the NRCHS office at 295-5272, or visit the Minnesota Department of Health Web site at www.health.state.mn.us/tb.

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