Tuberculosis Updates

Wilkes County Health Department Investigating Tuberculosis Cases at NC Department of Correction, Wilkes Correctional Center.

January 11, 2011
Contact: Ann Absher (336) 651-7450

WILKESBORO – Inmates and employees of the Wilkes Correctional Center have been tested for tuberculosis (TB) after two cases of the disease were confirmed at the facility.  The Wilkes County Health Department has been working with the center to contact those individuals who may have been exposed and to ensure that they receive appropriate testing and treatment. As of Tuesday, January 11, no additional cases had been identified.

“We believe all inmates with any symptoms have been identified and are being treated or observed,” said Wilkes County Health Director Beth Lovette. “Staff and any outside contacts with the cases are being notified and will be carefully screened and offered appropriate follow-up.”

The first case was diagnosed in early November.  Testing and notifications began immediately.  Both of the infected individuals have been transferred to Central Prison in Raleigh for medical observation and treatment.  While it is important for the community to be aware of this exposure, health officials believe the potential for exposure is limited and that no one is at immediate risk of any health problems. 

“Tuberculosis infection may not be detected by a skin test until up to two months after exposure, so our standard procedure is to repeat skin tests in eight weeks on all employees and inmates to determine if those persons may have been infected.  ,” said Dr. Jason Stout, medical director of the N.C. Tuberculosis Control Program at the N.C. Division of Public Health. “Most infected persons are not sick and not contagious, and can take medicine to prevent getting sick in the future."

Tuberculosis a disease that often affects the lungs. It is transmitted when a sick person coughs, sneezes, or speaks.  The germs are expelled into the air, and if a nearby person breathes them in, that person can become infected with TB.  Tuberculosis is curable with medications.  For more information on TB, visit the N.C. Tuberculosis Control Program website at http://www.epi.state.nc.us/epi/tb/

For more information, call the Wilkes County Health Department at 336-651-7450 or visit the website www.wilkeshealth.com

Wilkes County TB Exposure Talking Points for Wilkes Co. Health Department
01/11/11

• Two inmates from the Wilkes Correctional Center have been confirmed to have tuberculosis disease.  Both patients have been relocated to Central Prison in Raleigh, where they are on respiratory isolation to minimize the risk of transmission to others.
•  Wilkes County Health Department, staff from the N.C. Division of Public Health and medical staff from the Department of Correction have been actively involved in this investigation from the onset.  We have worked collaboratively to coordinate identification of testing of inmates and staff.
• This exposure does not represent any immediate risk to the public’s health.
• The health department staff is working with Wilkes Correctional Center to determine any additional potential exposures in visitors to the facility and/or inmate work details or visits outside the facility. Anyone who may have been exposed to the disease would be notified and evaluated for signs of infection or disease, according to state communicable disease guidelines.
• TB is transmitted when a sick person coughs, sneezes, or speaks.  The germs are expelled into the air, and if a nearby person breathes them in, that person can become infected with TB.
• TB is NOT spread by shaking someone’s hand, sharing food or drink, touching bed linens or toilet seats, sharing toothbrushes, or kissing.
• TB is killed relatively quickly by sunlight, so usually transmission occurs indoors. Because of the close quarters in a prison or jail setting, inmates are at very high risk for communicable diseases. 
• TB is a disease that often affects the lungs.  People who are sick with TB often have one or more of the following symptoms:

1. Cough lasting over 3 weeks
2. Coughing up blood
3. Fever
4. Profuse sweating at night, often soaking the bed sheets
5. Unintentional weight loss
6. Poor appetite
7. Chest pain or discomfort
8. Difficulty breathing

•  TB infection is diagnosed by either a skin test or a blood test. 

1. For the skin test, a small amount of liquid is injected under the skin of the arm.  A healthcare worker examines this arm 2-3 days later.  If the area where the liquid was injected swells up, this indicates that the person has been exposed to the TB germ at some point during her/his lifetime. 
2. The blood test requires a single blood draw, and tests whether the person’s immune system recognizes the TB germ.
3. A positive skin test or blood test does not mean that a person is sick with TB.

•  If the TB skin/blood test is positive or if a healthcare provider is concerned about any symptoms a patient is experiencing, a chest x-ray may be performed to check for any signs of TB illness.
• It can take up to two months after exposure for the TB skin test or blood test to turn positive.  Standard procedure is to test exposed persons at the time that the exposure is discovered, and then to repeat the same test 2 months or more later if it is negative the first time.
• Once a person has been exposed to TB and has a positive skin test/blood test, that person may become ill with TB in the future.  The risk of becoming ill depends on that person’s immune system; persons with weak immune systems are more likely to become ill than persons with normal immune systems.
• One can reduce the risk to become sick with TB in the future by taking medicine.  The standard course of medicine is one pill every day for 9 months, and this reduces the risk to get sick in the future by about 80 percent.