Editor’s note: The following was released by the Delaware Division of Public Health after a News Journal report on tuberculosis)
As a reminder, Delaware has strict privacy laws related to TB, therefore DPH will not be confirming or sharing any information related to a specific case.
As part of the Tuberculosis (TB) Elimination Program’s routine investigation into a case of TB disease in a Delaware resident, staff learned in August 2019, that the case was related to seven others having the same genotype*. The eight cases were identified in Delaware between 2018 and 2019. The state typically sees one or two cases per year with the same genotype.
This grouping of TB disease cases is referred to as a cluster. It is not considered an outbreak as the number of cases of TB disease diagnosed in Delaware this year is no higher than at this time last year. The numbers are also consistent with previous years. There have been 16 cases of TB disease in 2019, including some of the eight associated with the cluster.
As part of its investigation into this cluster, which involves tracing any exposures the individuals may have had during their infectious period, DPH identified Bayhealth Hospital, Kent Campus, as a location in which people may have been exposed to an individual from the cluster investigation. As a result, with collaboration from Bayhealth, DPH has since identified approximately 200 individuals that were potentially exposed to TB at the health care facility between February and August of this year, and has begun making contact with them to recommend that they be tested for TB disease.
We want to strongly emphasize that the risk to the general public is minimal, and currently, there is no evidence of uncontrolled spread of the bacteria. There is no risk to current patients at the hospital as a result of this exposure.
DPH continues to work closely with Bayhealth to identify and contact all individuals considered at higher risk for exposure. If you do not receive a letter from the Division of Public Health regarding potential exposure, you are not considered to be at risk and should not be concerned at this point. If DPH determined that there was increased risk to the public, officials would have initiated broader outreach efforts such as a press release to notify the public about the potential need for testing. The medical facility is not the only place where exposures from persons in the identified cluster occurred, and the majority of individuals in the original cluster were not linked to Bayhealth. Per normal procedure, DPH TB program staff have reached out to those who may have been exposed to members of the original cluster in other locations, including residences, and encouraged them to get tested.
“I applaud Bayhealth for their partnership during this investigation and the concern they have shown in protecting the health of their patients and staff,” said DPH Medical Director Dr. Rick Hong. “We appreciate how they stepped up to work with us during the investigation to contain the spread of the disease.”
“This is a routine part of the important work that our TB program, clinic, and infectious disease epidemiology staff do every day,” said DPH Director Dr. Karyl Rattay. “Individuals who have been patients at the hospital during the identified time frame will be understandably concerned. We have a hard-working team of highly-trained individuals and the public can have complete confidence, as I do, that they are more than capable of managing this investigation and connecting at-risk individuals to the testing and treatment they need.”
To protect medical privacy, no additional information will be provided regarding the source of the infection or the individuals who need testing. This is an ongoing investigation.
Tuberculosis is caused by a bacterium that typically attacks the lungs. It is spread when someone with TB disease coughs, speaks, or sings, and a person in close proximity breathes in the bacteria. Not everyone infected with TB bacteria becomes sick.
There are two TB-related conditions: latent TB infection and TB disease.
People with latent TB infection have TB germs in their bodies, but they are not sick because the germs are not active. These people do not have symptoms and cannot spread the germs to others. However, the infection may progress to TB disease in the future if individuals do not get treatment. Persons with latent TB infection are often prescribed medication for approximately 12 weeks to prevent it from progressing to TB disease.
People with TB disease are sick from TB germs that are active, meaning that they are multiplying and destroying tissue in their body. They usually have symptoms such as a bad cough that lasts three weeks or longer, chest pain, and coughing up blood or phlegm. People with TB disease can spread germs to others and require treatment to kill the germs. People with TB disease are most likely to spread it to people they have close contact with every day. This includes family members, friends, and coworkers or schoolmates.
TB disease is NOT spread by shaking hands, sharing food or drink, sharing toothbrushes or kissing. TB disease is treatable and curable, usually by taking several medications for six to nine months.
For more information about Tuberculosis, visit: https://www.dhss.delaware.gov/dhss/dph/files/tbfaq.pdf.
*TB genotyping is a laboratory-based approach used to analyze the genetic material (e.g., DNA) of Mycobacterium tuberculosis, the bacteria that cause TB disease. The total genetic content is referred to as the genome. Specific sections of the M. tuberculosis genome form distinct genetic patterns that help distinguish different strains of M. tuberculosis.