Tuberculosis in Genesee County

Facts About Tuberculosis (TB)

Tuberculosis Investigations at Genesee County Health Department (GCHD)

TB Data for Genesee County

Flint Central Academy Tuberculosis Investigation

Flint Central Academy Tuberculosis Investigation - Timeline of Events

Current Tuberculosis activity in Genesee County

Facts About Tuberculosis (TB) (Back to top)

Tuberculosis is a disease caused by a bacteria that usually infects the lungs, but may infect other organs
There are different kinds of Tuberculosis (TB) infection
Persons with Latent TB infection are those who are infected but have no signs or symptoms of the disease in their body
- People with this form have the bacteria in their body but the bacteria are not active (the bacteria are lying dormant)
- Someone with Latent TB infection do not expel TB bacteria from their lungs and cannot infect other people
Persons with Active TB disease are those who are infected and are showing signs of the disease in their body
- Only some forms of Active TB disease can be transmitted to another person
- There are different kinds of Active TB disease
  - Active TB disease that is in an early stage (sometimes referred to as Primary TB)
    - People with this form are showing signs of progression from Latent TB infection to Active TB disease
    - People with this form of TB disease do not expel TB bacteria from their lungs and cannot infect other people
  - Active TB disease that is infectious
    - Persons with this form have active TB bacteria in their lungs
    - Those with this form of the disease may show symptoms including: cough, fever, night sweats, and weight loss
    - Persons with this form of the disease expel TB bacteria from their lungs and can infect other people
    - Infection can be transmitted through the air when someone with this form of the disease coughs or sneezes
    - Prolonged and repeated exposure to an infectious case is usually necessary to lead to infection of contacts
  - Active TB disease that is extrapulmonary (not in the lungs, but in another organ)
    - This form of TB is not common
    - Persons with this form have active TB bacteria in another organ of their body
    - People with this form of TB disease do not expel TB bacteria and cannot infect other people (except for rare situations where there is a draining sinus or the TB bacteria have infected the larynx)
A TB skin test is the standard method of determining whether a person is infected with TB (Fact Sheet on TB skin testing)
- Persons with either Latent TB infection or Active TB disease will test positive with a skin test
- A positive skin test does not necessarily mean a person is infectious
- Further evaluation of a person with a positive skin test by a physician along with a chest x-ray is necessary to identify the kind of TB infection
In the majority of cases, all the different kinds of Tuberculosis can be cured by antibiotics
- The exception is Extensively Drug Resistant Tuberculosis, or XDR-TB, which is resistant to almost all the drugs used to treat the different kinds of TB (see the fact sheet for XDR-TB)
- XDR-TB causes the same symptoms as drug-susceptible (regular) TB and is spread the same way
- There are treatments for XDR-TB, including antibiotics, but they are often less effective and have worse treatment outcomes
- Genesee County has never had a case of XDR-TB
Primary care physicians and clinics, including the Health Department Clinics, can provide routine TB testing

Tuberculosis Investigations at GCHD (Back to top)

Physicians, hospitals, and laboratories are required by law to report cases of Active TB Disease to the local health department
When GCHD receives a report of a case of Active TB Disease GCHD nurses who specialize in TB will speak with the physician
GCHD TB nurses will gather medical information such as copies of the chest x-ray, skin test results, and prescribed medications
GCHD TB nurses will then contact the patient to ensure the patient has access to a physician and is able to obtain medications
Patients with no health insurance are referred to the GCHD's TB physician for evaluations and medications
GCHD TB nurses arrange a schedule for Directly Observed Therapy, also know as DOT, based on what medication schedule the doctor prescribes (see here for an explanation of DOT)
GCHD nurses will begin contact tracing and TB skin testing of close contacts to the patient
In all cases of Active TB disease GCHD will attempt to contact and test everyone who was at risk of exposure from that patient
A skin test is done as soon as possible after a potential exposure to detect infection
Those with negative initial skin tests are given a second skin test 8-10 weeks later because it may take that long to detect recent infection
Those who have an initial test 8-10 weeks after exposure only need one test to detect infection
Contacts who test positive will be sent for a chest x-ray and be evaluated by a physician

Current Tuberculosis Activity in Genesee County (Back to top)

Tuberculosis is not uncommon in Genesee County (Genesee County TB Data)
From January 1, 2007 to date there have been 16 people in Genesee County identified with Active TB Disease
Of those 16, 14 have been associated with the recent cluster of cases, which included the person associated with Central Academy
Only 2 of the 14 were considered infectious at the time of diagnosis
Among the others, 11 were showing progression from Latent TB Disease to Active TB Disease and were not infectious and one is a case of extrapulmonary TB who is not infectious (see Facts about Tuberculosis)
Genesee County Health Department staff is identifying and attempting to contact and skin test those people who had close contact with the cases of infectious Active TB Disease
All people identified with Active TB Disease have been evaluated by a physician and are currently undergoing treatment
Currently, NONE of the people identified with Active TB Disease in Genesee County is infectious
It is safe for Genesee County children to go to school

Last update: 09/20/2010