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Department of Health and University of Hawaii at Hilo Notify Students and Staff of TB Exposure at Hilo Campus

Clinic to be held on campus in April

The Hawaii State Department of Health (DOH) and University of Hawaii at Hilo are notifying approximately 120 students and staff members of their recent possible exposure to a person with active tuberculosis (TB) at the Hilo campus. All students and staff will be receiving a notice describing the situation and whether testing is recommended. A clinic for TB testing will be held on campus this month and DOH will be testing only those persons with regular close contact to the patient.

“The University of Hawaii Hilo campus activities and all classes can be held as scheduled with no safety concerns related to the past possible exposure,” said Health Director Dr. Virginia Pressler. “We don’t expect to find more individuals with infectious TB disease, but we hope to identify individuals who may have had recent exposure, are not contagious, and could benefit from preventative medication.”

“Tuberculosis usually requires many hours of close indoor person-to-person contact to spread it to others,” said Dr. Elizabeth MacNeill, chief of the TB Control Branch. “Most of the students and staff are not at risk, and our investigation to date has found no related active TB cases and no spread of the disease at the university or in the community.”

DOH conducted an extensive investigation and evaluation of potential contacts and possible exposure immediately after being notified of the active TB case. The individual is receiving treatment and is no longer infectious. Further Information on the individual and their case is confidential and protected by law.

TB is a disease that is commonly seen in the lungs and can only be spread from person-to- person through the air. When a person with active TB disease in the lung or throat coughs, sneezes, speaks, or sings, tiny drops containing M. tuberculosis may be spread into the air. If another person inhales these drops there is a chance that they will become infected with TB.  Two forms of TB exist, both of which are treatable and curable:

  1. Latent TB infection – when a person has TB bacteria in their body but the body’s immune system is protecting them and they are not sick. Someone with latent TB infection cannot spread the infection to other people.
  2. Active TB disease – when a person becomes sick with TB because their immune system can no longer protect them. It usually takes many months or years from having infection to developing the disease and most people (90 percent) will never become ill. Someone with active TB disease may be able to spread the disease to other people.

For more information on tuberculosis, please call the State of Hawaii Tuberculosis Control Program at 832-5731 or visit the Department of Health website at www.hawaii.gov/health/tb.

State Temporarily Suspends Tuberculosis (TB) Clearance Requirements Due to Nationwide Shortage of Testing Solution

The Hawaii State Department of Health (DOH) is announcing the state’s temporary suspension of tuberculosis (TB) clearance requirements that are mandated in Hawaii Administrative Rules, Title 11, Chapter 164, for school personnel, students, food handlers, and workers in health care, domiciliary care, daycare, and residential care facilities. Beginning today, the state will not restrict attendance at work or school due to the absence of a TB clearance. The suspension is in response to a nationwide shortage of testing solution required for tuberculin skin testing.

Department of Health“With limited supplies of testing solution available due to nationwide production delays that began late last year, we anticipate people may have some difficulty getting tested for TB at this time,” said Dr. Richard Brostrom, TB Control Branch Chief. “TB clearance requirements will be suspended until further notice, and our state TB clinics will be limiting testing to specific high-risk groups to prioritize and extend current supplies.”

Because of the shortage of Tubersol® and Aplisol® purified protein derivative (PPD) solution, DOH is limiting TB testing available at state clinics to specific high-risk groups until further notice. These groups include:
• Persons with signs and symptoms of active TB disease
• Contacts exposed to an infectious case of TB
• High-risk immigrants referred from the Honolulu Quarantine Station
• Persons with immunodeficiencies
• Persons who require TB screening due to medical treatment

All other individuals seeking a TB clearance are advised to contact their private health care provider or health center.

DOH services related to the evaluation and treatment of persons suspected or confirmed to have active TB disease are not affected by the PPD shortage; these services will continue without change.

Manufacturers of the PPD have been experiencing delays in production since November 2012. It is estimated that adequate supplies of PPD solution will be available several months from now. DOH anticipates the temporary suspension of state TB clearance requirements may be in effect for up to 120 days or until the PPD shortage has ended. Public notice will be issued when the suspension is lifted and a grace period or catch-up date will be announced for individuals whose TB clearance was postponed to meet their requirement.

Hospitals and medical providers in Hawaii have received detailed recommendations from DOH on steps to take during the PPD shortage. For more information on tuberculosis or TB testing, the public may call the Hawaii TB Control Program at (808) 832-5731 or go to www.hawaii.gov/health/tb.

The DOH TB Control Branch provides effective prevention, detection, treatment, and educational services to reduce the incidence of TB in Hawaii. Program activities include diagnosis, treatment, case investigation, preventive therapy for persons at high risk, and direct testing services. Each year, DOH conducts roughly 50,000 tuberculosis skin tests, and provides treatment to approximately 120 individuals identified with TB.

 

 

Department of Health Completes TB Contact Investigation at HPU and KCC

The Hawai‘i State Department of Health (DOH) has completed its contact investigation for tuberculosis (TB) that began in March after a student attending Hawai‘i Pacific University (HPU) and Kapiolani Community College (KCC) was diagnosed with active TB disease.

As of today, no new related cases of active TB disease have been identified. Two students were found to have latent TB infection, which is the inactive (dormant) and noncontagious form of TB. Both students were offered treatment.

According to Dr. Richard Brostrom, Chief of the DOH Tuberculosis Control Branch, “Our investigation has shown that this patient was not highly infectious. We appreciate the cooperation of the students and faculty that were potentially exposed, as well as our successful collaboration with the two colleges.”

Both HPU and KCC worked very closely with the DOH to provide notification and follow-up to those who may have been exposed. Emails were sent immediately to a total of 210 students and faculty who shared the same classroom with the ill student to inform them of the exposure and the need to be tested for TB. Of those, 108 reported for evaluation.

The DOH conducted a total of eight days of testing on-campus at both institutions at no cost to those exposed. Reminder phone calls were made prior to the testing events. Persons who did not take advantage of the testing on-campus received another phone call and a letter (by postal mail or delivered in class) with instructions to report to the DOH for TB testing.

Those notified who have not completed their evaluation, but still want to be screened, should call 832-3539 to make arrangements for TB testing at no cost at the DOH TB Control Branch located at the Lanakila Health Center.

The DOH TB Control Program works to reduce the incidence of TB in the state by providing effective prevention, detection, treatment, and educational services. Program activities include diagnosis and treatment; identification and investigation of cases; providing treatment of latent TB infection in high risk patients including contacts of active TB cases, those who are HIV positive, and those with evidence of untreated TB; conducting direct services including chest xray, sputum smear and culture, tuberculin skin testing, anti-tuberculosis therapy, and directly observed therapy through various clinics locations. For more information on TB go to http://hawaii.gov/health/family-child-health/contagious-disease/tb/faq.html