University of Missouri Health Care officials today (Monday, June 8) announced that they have identified a health care worker with an active case of tuberculosis and have begun taking steps to notify persons who had prolonged, close exposure to the worker.
The worker’s active TB was diagnosed Thursday, June 4. The worker was identified through routine monitoring of test results conducted by MU Health Care’s infection control department. The employee has been removed from patient care duties and is receiving appropriate medical treatment.
MU Health Care officials immediately notified the Columbia/Boone County Department of Public Health and Human Services and the Missouri Department of Health and Senior Services when they learned that initial tests indicated a possible case of active TB. Representatives of those health agencies are assisting MU Health Care with the follow-up.
“We have already begun identifying and notifying any patients or health providers with recent significant contact with this individual,” said Les Hall, M.D. chief medical officer at MU Health Care. “Although the risk to most in this case is low, patients with any significant risk will be contacted to arrange for appropriate testing. We will be following procedures established by the federal Centers for Disease Control and Prevention, beginning the investigation with those persons who have experienced the most frequent or prolonged exposure to the individual. By taking this proactive approach, we are confident that we can identify and manage the risks to patients and staff who may have come in contact with this worker.”
“Tuberculosis is a bacterial infection that is usually spread by the inhalation of infected airborne droplets,” Michael Cooperstock, M.D., medical director of infection control for University Hospitals and Clinics, said. “In most cases, the disease is spread following a prolonged period of contact with an individual who has an active case of tuberculosis.”
According to the CDC, one-third of the world’s population is infected with tuberculosis.
“Although many advances have been made in the diagnosis, treatment and prevention of tuberculosis in recent decades, this case serves as a reminder that this condition continues to be present at low levels in most communities in the United States,” Cooperstock said. “Ongoing public health initiatives, involving cooperation between health systems and public health departments, represent the best opportunity to decrease incidence of this infection in the population."
In the early stages, tuberculosis can be difficult to diagnose because it mimics many conditions that are far more common, Cooperstock said. Initial symptoms include a bad cough that lasts three weeks or longer, coughing up blood, unexplained weight loss, night sweats and fatigue.
“Most individuals infected with the TB bacteria have no symptoms,” he said. “These individuals are not contagious and have normal chest X-rays. This is called latent TB infection. Individuals are not sick, and they do not spread TB. However, individuals with latent TB infection may at some point develop active TB disease and become contagious.”
Treatment for individuals with latent TB infection generally includes a nine-month course of an anti-tuberculosis drug, isoniazid. Persons with active TB disease usually require a multi-drug regimen for a minimum of six months.
At MU Health Care, all employees are required to have TB skin tests at regular intervals. If a skin test is positive, employees will be given a chest X-ray and a blood test. If a chest X-ray is positive or active infection is found elsewhere in the body, the TB is considered active.
If a worker tests positive as a carrier of TB, he or she is counseled about risks of developing active TB, offered treatment options and monitored annually by the MU Health Care’s staff health department.
In the case of individuals who have had close contact with the health care worker, MU Health Care will be offering tests approved by the Food and Drug Administration and recommended by the CDC.
Individuals with questions or concerns should contact MU Health Care at (573) 884-2401 or visit www.muhealth.org.