Although testing has shown that more people – other than the original confirmed case of active tuberculosis in Homewood –have been exposed to the disease, the Jefferson County Health Department recommends concern – but not panic.
The exposure to disease does not mean that others have active TB, said Dr. Edward Khan, medical director for disease control at the JCDH.
“The investigation is still ongoing – it is largely complete. But we haven’t yet screened everybody. So far we have found no additional active cases of TB,” he said. “We have found that some people do have evidence of exposure to TB. Its premature to say whether they were exposed to the current case in question or they may have been exposed at some other time.”
On March 24, Homewood officials announced that a student, a freshman at Homewood High School, had contracted tuberculosis, and that the school, along with health officials, had made plans to test additional students, faculty members and others possibly exposed. The student with the confirmed case – who has not been identified – is “on treatment and doing well,” Khan said.
Although tuberculosis has a long and deadly history both here and abroad, Khan said the Homewood situation,with only one active case, is not out of control. “In situations like this it’s serious but it’s not a problem as long as the appropriate measures are taken. They’re all being taken, which is to test anybody who is at risk of exposure, and put them on appropriate treatment, either for active disease or preventative therapy, whichever the case may be,” he said.
“You basically take care of any problem before it happens. It’s really not a cause for concern. It’s just important that people do follow through with the appropriate testing. My overall message would be that nobody has to be alarmed or panicked about it,” Khan said. “This is something that, at the Health Department, we do pretty routinely. The most important thing is that parents make sure their kids get the appropriate testing as requested by the health department or by school officials and things will be fine.”
There is also no apparent threat to the wider community, Khan said, so no need for widespread testing based on the current situation in Homewood. “We have something now which we call targeted testing when it comes to TB…You really don’t need to test someone who has not at risk or has not been around someone with TB.”
Far from its days as the “great white plague” TB today is much more treatable, Khan noted. “I think,” Khan said, “the example of tuberculosis is something that demonstrates the great advances of public health by public health measures done through the past decade, over the last century or so.
“Tuberculosis is still a very endemic condition worldwide. In the United States since, I would say, the 1950s, but even going on before that, the numbers of cases of TB have dropped dramatically. I think around the 1950s or so — and I’m kind of quoting this off the top of my head — I think there were close to 100,000 cases of tuberculosis nationwide. Now, in the last year, 2014, we’re down to about 9,500 cases nationwide, so we’re seeing, basically, a tenfold drop in cases over the last 50 years.
“Our case rates, which used to be as high as 50 cases per 100,000 population, we are now down to about a national average of 3 cases per 100,000. And in the state of Alabama, our case rates are below the national average.”
Following the now established protocols regarding TB, Khan said control of the disease is manageable, and the trends prove it. “So again, identifying active cases as soon as possible, getting them on treatment, identifying potential contacts, getting them on treatment or preventative therapy — those measures have greatly reduced the TB cases over the last 50 to 60 years.”