USA TODAY International Edition
500 kids exposed in Omaha TB outbreak
YMCA day care a focus after case is identified
Officials in Nebraska were testing more than 500 children and staff at an Omaha- area YMCA drop- in day care center for possible exposure to tuberculosis after a case at the site prompted a public health emergency.
Douglas County Health Director Lindsay Huse declared an emergency Thursday citing the risk of the infectious disease spreading at the Westview YMCA in the Omaha suburbs. Exposures would have happened between May and late October. The incubation period for tuberculosis is between two and 10 weeks.
The infected patient has been isolating at home and was undergoing treatment, Huse said. Officials would not say if the person was an adult or child, or identify a gender, but they confirmed the person tested positive Nov. 6. A contact investigation prompted the person or relatives to contact the Westview YMCA Childwatch, a day care where gym members can drop off their children for up to two hours. The fact that the person was in this day care has made the count of possible exposures especially high. The current estimate was about 500, but it is subject to change as families and siblings are identified and in some cases ruled out.
“It’s not so unusual to find an active TB case,” Huse told USA TODAY. “But what is unusual is just the size of exposure.”
The infected person was linked to an onset date of symptoms Aug. 21, requiring health officials to look back to May to fully capture anyone who may have experienced symptoms they hadn’t thought of as tuberculosis. This makes tracing more difficult, given the number of people coming in and out of the day care center.
“Just by nature of that, you have a whole lot more exposures that can happen if there is someone in that room that has active disease,” Huse said.
Omaha clinics work to contain spread
Exposure to a disease such as TB requires being in a small, enclosed area for an extended period, Huse said. In a letter to health providers throughout the county, Huse wrote that people can be infected after someone with tuberculosis germs in their lungs or throat coughs, sneezes, speaks or sings, causing germs to float in the air that others then breathe.
Over the weekend, Children’s Nebraska, a pediatric hospital in Omaha planned to hold held clinics to test about 250 children 4 and younger who could have been exposed in the past 10 weeks. Young children are considered high risk because they can become ill quickly, prompting the need for attention sooner than an adult would require, Huse said.
Along with a baseline skin test to look for the disease, hospital staff planned to administer window prophylaxis, a therapy to treat tuberculosis even as a preventive treatment to keep people from getting the disease. In about 10 weeks, the same cohort will get another skin test to confirm infection.
In the coming days, the county is expected to have clinics at the Westview YMCA to test another 350 people using skin and blood tests. Officials will look for latent infection as well, and treat it with medication to ensure it doesn’t become active.
In emailed responses, the YMCA of Greater Omaha said the Westview Childwatch maintains electronic records of check- ins, which helped officials conduct contact tracing for possible exposures. They wrote that there is no longer a risk of exposure to TB at the center, according to the Health Department, though the Westview YMCA planned to remain for several days to give support staff a chance to conduct testing and to have their children tested.
“This was an unfortunate, isolated incident,” Rebecca Deterding, the local YMCA’s president and CEO, said in a statement. “Everyone who has been exposed at the YMCA has been identified and instructed with next steps for testing.”
In 2022, county health officials reported 15 confirmed tuberculosis cases, and 15 through September 2023. The Centers for Disease Control and Prevention reported 8,300 cases across the U. S. in 2022.
Tuberculosis, formerly called consumption, historically had high mortality rates in the U. S. Deaths and cases have declined dramatically in the past century as a result of rigorous public health efforts.
“This is one of the vintage public health diseases,” Huse said. “We have a lot of experience working on the prevention of spread and case investigations around this.”