About 200 Flathead High School students' parents and school staff members were notified Tuesday morning that they may have been exposed to a student who has tuberculosis.
A “handful” of non-school people who may have had contact with the ill student also were contacted, said Hillary Hanson, the Flathead City-County Health Department officer. She added that they’re working closely with the Montana Department of Public Health and Human Services and the Kalispell Regional Medical Center to manage the care of the student.
The student, about whom Hanson declined to give any information, is complying with isolation precautions and is taking medication to treat the illness.
“The student is doing well on the medications, and we expect to see improvements,” Hanson said. “There’s no reason not to expect a full recovery.”
Tuberculosis is a potentially serious infectious disease that mainly affects peoples’ lungs, but also can attack the kidney, spine and brain. The bacteria is spread through the air by coughing, laughing, singing and sneezing, but it typically takes close contact — which Hanson described as being in close proximity in a shared space for several hours a day — to become infected.
She noted that it can’t be spread by coming in contact with someone’s clothing, drinking glasses, eating utensils or a handshake.
Symptoms include a cough lasting longer than three weeks, unexplained weight loss, night sweats, chills, fever and coughing up blood. If not treated, tuberculosis can be fatal.
In recent years, doctors have seen an increase in drug-resistant strains of the tuberculosis bacterium. Antibiotics were first used to fight TB more than 60 years ago, and since then some of the germs have developed the ability to survive. Drug-resistant strains also are created if an antibiotic fails to kill all of the bacteria, which is why the treatment lasts for six to nine months.
However, a person with tuberculosis becomes non-contagious within a few days to weeks of effective treatment and can return to normal activities without posing a risk to others while completing treatment, Hanson said.
It has two forms, latent and active. Latent tuberculosis isn’t contagious, and the bacteria can remain in a person’s body while they’re asymptomatic. It can, however, turn into active tuberculosis at any time. The Mayo Clinic’s website estimates that about 2 billion people have latent TB.
"The majority of people don't develop an active infection. In some people, the bacteria gets in the lungs and the immune system fights that bacteria," said Dr. Jeff Tjaden, an infectious disease physician in Kalispell.
The health department is offering to test those who may have been exposed, either Wednesday at the high school or at the county health department.
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“We are going to do as many tests as we can,” Hanson said. “We are trying to make sure folks have the option of being tested before spring break, which is next week. We will test the ones that want to tomorrow, so we can read the tests by Friday. If they can’t do it tomorrow and wait until after spring break, we’ll do the tests the first week of April.”
Tjaden said the test involves inserting a small needle into the skin, and within 48 to 72 hours they'll know whether the person has been exposed to tuberculosis.
"If they have been, there are medications we can use to treat that person so they never have an active case of tuberculosis," Tjaden said.
A second round of testing typically takes place eight to 10 weeks later.
Hanson said she doesn’t know where the student contracted tuberculosis, but the student had been traveling internationally to multiple places recently, and believes that’s where the disease was picked up. The student wasn’t traveling as part of a school function.
“We’re not certain of the exact timeline,” Hanson said. “We are estimating the coughing began in mid-January.”
Tuberculosis protocol requires identifying and contacting people who may have been around the infected person three months before the symptoms began.
Hanson said the school was prepared to be “inundated” with calls from parents, but that hadn’t happened as of noon. Two community meetings will be held — one at 4 p.m. Tuesday, March 20, the other at 5:30 p.m. Wednesday, March 21 — in the Flathead High School auditorium.
“Identifying and screening contacts is an essential intervention, as is ensuring treatment of the ill individual,” Hanson said. “We have both these interventions in place to prevent the spread.”
Superintendent Mark Flatau said the school sent emails to more than 7,000 families members and staff Tuesday morning in grades kindergarten through 12 explaining what was discovered and the actions they're taking. That was followed up with another email to the families of students that may have been exposed.
"We will continue to share information in whatever form that takes so our families can be informed and make appropriate decisions," Flatau added.