Officials from the Denver Metro Tuberculosis Clinic have ordered all 1200 students and 120 faculty and staff members at Longmont High School to be tested for tuberculosis. The widespread testing was ordered after preliminary testing of 140 people revealed a stunning 40% infection rate. Those students and staff were tested because they were most closely exposed to a person with active TB, diagnosed in January.
So far, people who tested positive do not have active TB, but rather a latent form. Only the people with active TB can spread the disease. Bacteria spread into the air when an infected person coughs, and if someone breathes in a sufficient bacterial load, they could become infected, too. This is not a very efficient form of transmission, which is why the high infection rate is surprising.
TB typically attacks the lungs. Symptoms include:
- A bad cough that lasts 3 weeks or longer
- Weight loss
- Coughing up blood or mucus
- Weakness or fatigue
- Fever and chills
- Night sweats
Colorado has a fascinating historical connection to tuberculosis treatment. As settlers moved West, people suffering from consumption, as TB was known then, got better. While the reason wasn't clear, Colorado was thought to have a healthier climate. Sanitariums for TB treatment sprang up around the state. Patients were expected to spend lots of time outside everyday. In fact, current research suggests the explanation is at least partially due to Colorado's intense sunshine. Vitamin D, made in the skin in response to a narrow band of UV rays from sunlight, is now recognized to play an important role in TB resistance. Unfortunately, sunscreen turns off vitamin D production, and our modern indoor lifestyle, including sitting in cars, blocks the sun's rays.
According to the CDC, about 11 million people in the US have latent TB. While they cannot spread the disease, about 5-10% of those cases will progress to active disease. Compromised immunity, such as with HIV infection, makes progression more likely. In fact, TB is a leading killer of people infected with HIV worldwide.
So while latent TB cannot be spread, it must be treated. The CDC recently issued guidelines for a new simplified 12-dose treatment regimen. The standard treatment protocol involves 9 months of daily antibiotics. The new option is a once/week combination dose of antibiotics.
Fortunately, the one known infected person at Longmont High does not have a drug-resistant form of the disease. The skin test is a simple injection just under the skin; the injection site must be checked by a medical professional 2-3 days after injection. Testing at Longmont High School will begin next week. Dr. Randall Reves of the Denver Metro Buberculosis Clinic will speak at a parent meeting at LHS Monday evening, February 13th, at 6:30.
The CDC website has more information on tuberculosis.
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