Tuberculosis Case Tests Health Department’s Incident Response Systems

More than 100 students were tested for infection last week

By Justin Franz

A single active case of tuberculosis last week tested the Flathead City-County Health Department’s emergency response systems, as local medical officials rushed to ensure the infection did not spread into the wider community.

Hillary Hanson, county health officer, said so far the department has successfully ensured that the infection has not spread beyond a single student at Flathead High School. That student is currently isolated at home recovering from the infection.

TB is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs but can attack any part of the body, such as the kidney, spine and brain.

TB is spread through the air by coughing, laughing, singing and sneezing. The only way to contract the disease is by close contact (several hours a day) with someone who has the disease. It cannot be spread by contact with someone’s clothing, drinking glass, eating utensils, handshake, toilet or other surfaces. Symptoms of TB can include a cough of longer than three weeks, unexplained weight loss, night sweats, chills, fever and coughing up blood.

Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection (LTBI) and active TB disease. If not treated properly, TB can be fatal.

Upon learning about the active TB infection, the health department and School District 5 notified all parents of known students who had been in close contact with the patient. Those students, about 200, have been or will be tested for TB. The students will be tested again in May to ensure they did not pick up the infection.

Hanson said the success of the response was due in large part to the coordination between the school district and Kalispell Regional Healthcare, which lent the expertise of doctors while investigating the incident.

Whenever the health department is facing an outbreak of an infection or a relatively rare sickness like TB (Montana only had three active cases of the infection in 2017), it launches an epidemiology team, which includes public health officers, public information officers, pubic health nurses and registered sanitarians. The team is structured much like an incident command team that fights a wildfire.

Hanson said the epidemiology team has been deployed a number of times in recent years, including for influenza outbreaks. It was even launched in 2015 when a wildfire near Essex threatened to burn down a railroad snow shed treated with creosote. Health officials were concerned that if the large structure caught fire it could release toxins in the air. To prepare for that possibility, they staged air-quality monitors that could be deployed in the area.

“We prepared for something that never happened, but we were ready,” she said.

Although it appears TB has not spread to anyone beyond that single Flathead student, Hanson said the epidemiology team would remain mobilized through May, meeting once or twice a day to ensure the community is safe.

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