Gwinnett Medical patients possibly exposed to TB

Print Friendly and PDF By: Andy Miller Published: Jun 18, 2013

More than 100 patients at Gwinnett Medical Center are being urged to get screened for tuberculosis after potentially being exposed to a hospital employee with an active case of the disease.

Officials at the Lawrenceville hospital said Tuesday that 133 patients were certain or likely to have had contact with the employee from Feb. 1 through May 10.

The patients have been sent letters urging them to contact the county health department to have a free skin test to determine whether they are at risk of developing TB.

“We want to emphasize that the risk of contracting TB from casual exposure is low, but it is important to do everything possible to rule out the possibility that any individual may have had a significant exposure,’’ Dr. Alan Bier, Gwinnett Medical Center’s chief medical officer, told a news conference at the hospital.

The hospital employee was diagnosed with active TB in May. The worker had previously tested negative for the disease during regular hospital testing in 2011 and 2012. The hospital, citing privacy concerns, did not identify the employee nor the unit where that person worked.

Gwinnett Medical said that since the TB was discovered, a number of other employees have been tested, and that all those tests so far have been negative.

A similar exposure occurred two years ago at Emory University Hospital, when 680 patients were encouraged to get tested for tuberculosis after possibly being exposed to the disease by an infected employee.

An additional 100 Emory hospital workers were also exposed by a respiratory technician who unknowingly carried the disease.

Bier said Gwinnett Medical Center leaders had decided to disclose information about the exposure to the public after weighing various courses of action.

“At the end of the day . . . we arrived at a judgment that informing the public with the facts was the best possible course of action,” he said. “This is the kind of situation where word inevitably gets around, where rumor and speculation take over, and the next thing you know, you really are dealing with public confusion and unwarranted concern — not to mention public reports that may not be well-grounded in the facts.’’

TB is spread through the air from one person to another. The TB bacteria are dispersed into the air when a person with the disease of the lungs or throat coughs, sneezes, speaks or sings. People nearby may breathe in these bacteria and become infected.

The disease usually affect the lungs, but can also affect the brain, kidneys, spine and other parts of the body.

Symptoms of tuberculosis disease include a bad cough that lasts three weeks or longer; pain in the chest; coughing up blood or sputum; weakness or fatigue; weight loss; fever; and night sweats.

TB is a massive killer worldwide, accounting for 2 million deaths annually. And it’s the leading cause of death for people infected with HIV, including in the United States.

The U.S. rate of TB has been declining. A total of 10,528 cases were reported in the United States in 2011, an incidence of 3.4 cases per 100,000 people. That’s the lowest rate recorded since national reporting began in 1953, the CDC says.

But Georgia’s tuberculosis rate, though dropping, is still higher than the national average. Georgia reported 347 TB cases (3.5 cases per 100,000 population) in 2011, a 16 percent decrease from 2010. Georgia in 2011 had the eleventh-highest TB rate among the 50 states.

In Georgia, the disease is largely centered in three metro Atlanta counties — DeKalb (where Emory is located), Fulton and Gwinnett. Most infections become latent TB, which is non-contagious and has no symptoms. One in 10 of those cases, though, develop into active TB disease, which is contagious and has symptoms.

In Gwinnett, as well as nationally, the disease hits foreign-born residents disproportionately hard.

Alana Sulka, director of epidemiology for the Gwinnett, Newton and Rockdale public health district, told GHN last year that many TB patients “come from areas [of the world] that are high in TB.’’

There is also a higher incidence in prisons and jails, Sulka said.

If people have active symptoms, they are confined for four to six weeks in a quarantine-like situation. In Augusta, a man was jailed recently after refusing to cooperate in his TB treatment.

The primary cost of the public health TB response is due to increased staff workload and time. Public health officials manage active cases by using “direct observed therapy,’’ in which staffers must watch patients take their medications. Failure to take medication can not only harm a patient but even contribute to development of drug-resistant infections.

This need for one-on-one monitoring has strained public health budgets. “There’s not enough public health personnel to deal with the situation,’’ Sulka said last year.

Gwinnett’s rate has dipped, Sulka said, but it remains about double the national rate.

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