State, College testing community members to combat risk of tuberculosis

by Aleka Kroitzsh | 1/23/20 2:10am

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Dick's House is working with the state health department to test community members.

by Jason Romero / The Dartmouth

Since the Jan. 15 announcement that a Dartmouth community member has contracted an active case of tuberculosis, the College has begun testing individuals who have the highest risk of having contracted the disease. 

The New Hampshire Department of Health and Human Services has been working with Dick’s House to identify those who have shared airspace with the individual who has the active case of TB, according to New Hampshire deputy state epidemiologist Elizabeth Talbot. 

The potential risk is determined by the intersection of various factors, Talbot said. These include the patient’s condition, the “environment where the air was shared” — meaning whether it was a large open space or a small bedroom — how much time an individual spent around the infection and the immune systems of those who have been exposed.

Talbot said that the state is currently, and will continue to, contact those at risk in order of priority. 

“Every student identified at risk will be contacted directly by phone and directed to have screening and likely a blood test done at the Dick’s House,” Talbot said. She added that staff will also be contacted but will likely get tested at Dartmouth-Hitchcock Medical Center or by their own primary care provider.

Talbot added that if there are “conversions” — meaning individuals go from uninfected to an infected state — within the initial group that has been identified to be at-risk, the state will expand the group of people that are invited in for additional testing.

“If those who appear to be at highest risk of transmission have no infections among them, there is no reason to go further,” Talbot said. “This gives us valuable information that risk is low.”  

Talbot said that it usually takes eight weeks for the persons exposed to infection to test positive. 

The current testing is also being done to establish a “baseline” by identifying if those exposed have a preexisting risk for infection, such as growing up in a setting with high TB rates, she said.

“This testing will show if the bacteria has been transmitted, and then we offer treatment to prevent that person from progressing from latent, asymptomatic, non-contagious infection to active tuberculosis,” Talbot said. 

Although both the asymptomatic and active tuberculosis are treatable, the asymptomatic state is easier to treat, according to Talbot.

Talbot reiterated that TB is a “common event” and that the testing being done is routine. She added that there are approximately 10 to 20 active cases within New Hampshire and approximately 9,000 nationally. 

A community member who was called in for testing spoke to The Dartmouth on the condition of anonymity. He said that he was initially worried, but grew reassured after being contacted for testing. 

“I think at first I was like, ‘Oh no,’ like coughing blood TB — I think that can kill me,” he said. “When I got the call from the state, they weren’t super freaked out about it.”

He explained that the person who contacted him reassured him that TB was both widespread and highly treatable. 

“I was scared at first, but overall, if I have TB, I guess I have TB,” he said. “Getting a disease — you can’t really do anything about it, it just is.” 

After being contacted, the community member had a blood test and is currently waiting to hear back about results. 

College spokesperson Diana Lawrence wrote in an email that the College is satisfied with the outreach and communication to community members since announcement of the active case. Lawrence added that outreach has included communication with town officials, two public information forums and emails sent to parents.

“Judging by the modest number of complaints and inquiries, we believe the community feels informed,” Lawrence wrote. “We will continue to provide updates and respond to questions as needed.”

Talbot also expressed optimism about the case. 

“I do want to reassure the community that this is a common event, and there are standard approaches that are well-proven to protect the public health,” Talbot said. “We are enacting those, and there are very good indicators here that the various members of the communities are collaborating and cooperating well.”