05/17/2019
DPH Coordinating with Local Health Department on Response to TB Exposure in Windham Public Schools
DPH Epidemiologist Lead Author of Updated National Recommendations Released Today for TB Screening, Testing and Treatment of Health Care Workers
The Connecticut Department of Public Health (DPH) is coordinating a response together with the North Central Health District and Windham Public Schools on identifying persons who may have been recently exposed to tuberculosis (TB) at the CH Barrows Stem Academy in Windham. As a letter from school officials to parents stated yesterday, there was a recent TB exposure in the school.“Together with local health officials, we have determined that currently there is no ongoing TB exposure at the school,” said Dr. Lynn Sosa, the TB Program Coordinator and Deputy State Epidemiologist for DPH. “More information will be provided to parents next week specifically addressing priority individuals who are recommended to be tested for the disease. School and health officials will also be offering parents an informational meeting to address any questions or concerns they have, including when testing will be provided. There are very few reported cases of Tuberculosis every year, but it is a public health issue we take very seriously in conjunction with our local health frontline partners.”
TB is a bacterial infection that is spread through the air by someone who is already sick with the disease in their lungs either coughing, speaking, sneezing or singing. Infection with TB usually requires prolonged exposure to someone who is sick; most healthy people will not be infected even if they are exposed. Of those infected, most will have what is called Latent Tuberculosis Infection (LTBI). Individuals with LTBI are not sick and cannot spread TB to anyone else. Anyone with LTBI can take treatment to prevent them from ever getting sick with TB or spreading it to others.
For more information about tuberculosis, please visit:
Federal CDC: https://www.cdc.gov/tb/topic/basics/default.htm
Connecticut DPH Tuberculosis Control Program:
https://portal.ct.gov/DPH/Infectious-Diseases/Tuberculosis/Tuberculosis-Control-Program
Dr. Sosa also served as the primary author of an updated set of recommendations for the TB screening, testing and treatment of health care personnel released today by the National TB Controller’s Association and the Centers for Disease Control and Prevention. Sosa helped lead the national workgroup that brought together public health, occupational health, infection control and academic partners to develop these recommendations. A link to those recommendations is here:
https://www.cdc.gov/mmwr/volumes/68/wr/mm6819a3.htm?s_cid=mm6819a3_e
The new recommendations include:
1. TB screening with an individual risk assessment and symptom evaluation at baseline (pre-placement)
2. TB testing with an interferon-gamma release assay (IGRA) or a tuberculin skin test (TST) for persons without documented prior TB disease or LTBI
3. No routine serial TB testing at any interval after baseline in the absence of a known exposure or ongoing transmission
4. Encouragement of treatment for all health care personnel with untreated LTBI, unless treatment is contraindicated
5. Annual symptom screening for health care personnel with untreated LTBI
6. Annual TB education of all health care personnel
The updated recommendations shift the focus away from annual TB testing in health care settings to the importance of identifying and treating health care personnel with LTBI.
Dr. Sosa states, “testing health care personnel for TB does not prevent TB transmission in health care settings; treating more health care personnel with LTBI before they get sick will decrease future spread of TB.”
A companion statement that provides guidance on implementing the updated recommendations is expected to be published in the next few weeks.