Tuberculosis Outbreak Warning Issued for Those Who Work or Volunteer in Homeless Shelters in Downtown Atlanta

8/5/2014

August 4, 2014
Today we received a letter from the Georgia Department  of Public Health for any of you who work with homeless shelters; we know that many of you do. The letter has some important questions and answers appended.   
Ethel Ware Carter, Regional Council of Churches of Atlanta

To Churches with Volunteers that serve in Homeless Shelter Ministries Re:  Tuberculosis Outbreak in downtown Atlanta Homeless Shelters

This is to alert volunteers in your church who may work in homeless ministries that there is an on-going outbreak of drug-resistant tuberculosis (TB) associated with staying or volunteering at homeless shelters in downtown Atlanta. The TB outbreak strain is resistant to the drug isoniazid, but is curable with the use of other anti-TB medications. Twenty-eight outbreak-related TB cases have been reported to public health authorities since January- July 2014. Two of these cases occurred in volunteers who served at downtown Atlanta homeless shelters. Please inform your homeless ministry volunteers about this outbreak and ask them to get screened for TB at their local county health department or private physician.

Sincerely,
Dr. Rose-Marie Sales, Director, Tuberculosis Program, Georgia Department of Public Health
 


Questions asked by volunteers at downtown Atlanta homeless shelters:

Are there recommendations for high-risk individuals versus low -risk individuals? A high-risk individual is someone who may have spent several hours in close proximity to an individual with active tuberculosis. These individuals should be tested. All other individuals are low-risk individuals and do not need testing.  It is understandable if low-risk individuals still want to be tested and county health departments  can provide that service, or volunteers may have this done by their provider.

 Do I need to get an X-ray if I have had a positive TB skin test? If an individual was in close contact for several hours with a client of the shelter who had tuberculosis it is recommended he get an X-ray if he has a previously positive TB test.  If he did not have several hours of close contact with a client from the shelter he is at low-risk and it is not recommended that he be tested. That said it is recognized that volunteers who have had previously positive TB tests still may want testing and if this is their desire, a screening chest X-ray would be the next step.

Is there a window of vulnerability associated with TB?  Can it lie dormant for a long time in your system or after so many months are you good to go?
• A person may become infected with TB and not become sick with active TB disease, a condition called latent TB infection.  In this case it can lie “dormant” in the body.  However, this condition still needs to be treated to prevent development of active TB disease.
• A TB test is needed to determine if an individual has been infected to TB and needs treatment.
• More information to answer this question can be found at: http://www.cdc.gov/tb/topic/basics/default.htm.   The link describes latent TB infection, a condition where an individual acquired TB infection but did not become sick.  Persons with latent TB infection need to be treated to prevent active TB disease.

Do I need to be concerned about infecting my family? The only way to know if you have tuberculosis or know if you have been exposed in the past is to have a TB test.  Tuberculosis is an airborne     infectious disease caused by the bacteria called Mycobacterium tuberculosis.  This bacteria most commonly infects the lungs, however TB bacteria can attack any part of the body such as the kidney, spine, and brain.  TB is spread through the air from one person to another.  The bactetuberculosis are most likely to spread the infection to people they spend time with every day.  This includes family members, friends, and coworkers or schoolmates especially where there is prolonged close contact, typically several hours and usually in a poorly ventilated area.

Where can I be tested?  You can be tested for TB at the county health department in the county you reside in.  Please inform them that you are seeking testing because you worked at one of the shelter that cases of tuberculosis stayed at.

If I go to my private provider will I be charged for the TB test? If you go to a private physician you will be charged for the TB test.

Basic TB Facts:
  • What is Tuberculosis (TB)? TB is an airborne infectious disease caused by the bacteria called Mycobacterium tuberculosis. This bacteria most commonly infects the lungs, however TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, tuberculosis can be fatal.
  • How is TB spread? TB is spread through the air from one person to another. The bacteria are put in the air when a person with TB disease of the lungs coughs, sneezes, or speaks. People with pulmonary and laryngeal tuberculosis are most likely to spread the infection to people they spend time with every day. This includes family members, friends, and coworkers or schoolmates especially where there is prolonged close contact, typically several hours and usually in a poorly ventilated area.
  • There is good news. People with TB disease can be treated if they seek medical help.


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