Testing for TB is urged after cases rise to 10

Turnout for testing worries Fort Bend health officials

The investigation into tuberculosis at a Fort Bend County high school has confirmed six more infections, bringing the total to 10, according to officials.

The investigation into tuberculosis at a Fort Bend County high school has confirmed six more infections, bringing the total to 10, according to public health officials.

The officials this week lamented a lackluster turnout for last week’s testing at George Bush High School, site of the clustering of the contagious disease, which can be effectively treated but is deadly if not. Only about a third of 674 students and staffers deemed at primary risk of contracting the bacterium showed up for the June 19 testing.

“We’re very disappointed at the turnout, which suggests people aren’t comprehending the seriousness of TB,” Dr. Kaye Reynolds, deputy director of the Fort Bend County Health and Human Services Department, said Wednesday. “It’s critical to identify everyone who’s been infected so we can get them on treatment.”

Reynolds said the six individuals newly found to have the infection are all symptomfree, when TB is not contagious and the treatment is easier. Even so, prophylactic medication to prevent the bacterium from progressing to disease must be taken for six to nine months.

The cluster that triggered the investigation involved four individuals with active TB. Treatment for active TB involves the use of antibiotics for as long as two years, though the duration usually is nine to 15 months.

TB is one of history’s great scourges. It declined steadily in the United States throughout most of the 20th century before increasing slightly in the mid-1980s and again recently, partly, experts say, a

result of complacency that the disease was on the way to eradication. Roughly 10,000 cases occur annually in the United States, including about 1,400 in Texas, 350 to 400 in the Houston area and 20 to 30 in Fort Bend County.

TB primarily attacks the lungs but can affect other organs, as well. Most infections do not cause symptoms — latent tuberculosis — and are, thus, not contagious. About 10 percent progress to active disease, which kills about half of those infected if left untreated.

In those contagious, it usually takes prolonged close contact to pass on the infection, which is not spread as easily as a cold, flu or measles. It may be passed on if droplets coughed or sneezed into the air reach the lungs of another person.

Cause for concern

The cluster at George Bush is a particular cause for concern because of the potential for transmission at a large high school. It is not uncommon for TB to occur at schools, but four cases of active disease at one is very unusual, said Dr. Jeffrey Starke, a Houston expert on the disease.

“The good news, so far, is that there’s no evidence of mass transmission,” Starke, a professor of pediatrics and infectious diseases at Baylor College of Medicine and Texas Children’s Hospital, said Thursday. “With two-thirds of those exposed still to be tested, it’s too early to draw conclusions, but the current rate of 3 percent is definitely low.”

A transmission rate closer to 10 percent typically would cause public health officials to expand the pool of people potentially at risk.

Officials said those individuals previously told they need testing still can and should come for testing at the county health department at 4520 Reading Road until July 14. A second round of testing at the high school, to make sure the infection has not shown up since the first testing and to catch it in those not previously tested, will be held Aug. 3. It can take the infection as long as three months to become detectable in blood samples.

228 people tested

The county health department announced the TB cluster at the 2,200-student high school two weeks ago. At the time, officials would only confirm two individuals had been infected, at least one of whom was contagious. It was not clear whether the cases were related or occurred independently of each other.

Reynolds on Wednesday disclosed results from last week’s testing of 228 students and staffers and confirmed there were four cases initially. It remains unclear if the cases were related, though Starke acknowledged that four people randomly getting the disease at the same time would be unusual.

The investigation is continuing.

In addition to the six new positive tests, seven individuals must take retake tests because their results were invalid or inconclusive, Reynolds said.

The testing at George Bush Aug. 3 is only for students and staff who previously were notified they are at risk.

todd.ackerman@chron.com twitter.com/ChronMed