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Nurse at California Hospital May Have Exposed More than a Thousand People to Tuberculosis

Dec 15, 2015

The Santa Clara Valley Medical Center in San Jose, California says that more than one thousand people, including 350 infants, may have been exposed to tuberculosis (TB) by a nurse diagnosed with the disease.

The hospital was notified in mid-November that an employee who worked "in the area of the newborn nursery" had been diagnosed with TB and could potentially infect patients and staff, the New York Times reports. These exposures occurred between August and November, according to hospital officials.

As many as 1,026 people may have been exposed to tuberculosis; this includes 350 infants, 308 employees, and 368 parents, primarily the mothers of the infants. Hospital officials said they had identified all the people who might have been exposed and were contacting each adult and the parents of the babies.

Dr. Stephen Harris, chairman of pediatrics at the medical center, said that the risk of infection is low, but "the consequences of a tuberculosis infection in infants can be severe." Harris said the hospital will provide preventive treatment to the exposed infants "as soon as possible." The hospital will offer diagnostic testing and a daily dose of isoniazid, an antibiotic that can prevent infants exposed to tuberculosis from developing the disease, the Times reports. Hospital employees and other patients-including the infants’ mothers-will also be screened and receive any necessary treatment.

The screenings have begun and hospital spokeswoman Joy Alexiou said that thus far no one has tested positive for TB. Alexiou described isoniazid as "very effective at keeping tuberculosis from taking hold" in infants but explained that TB poses a special risk to infants, according to the Times. "In infants that young, it doesn’t stay in the lungs like it does with older children or adults." The disease has the potential to enter the bloodstream and then infect other organs.

According to the U.S. National Library of Medicine of the National Institutes of Health, Isoniazid is used alone or with other drugs to treat active tuberculosis and prevent it from developing in people who have had been exposed to the tuberculosis bacteria. But the drug eliminates only active bacteria and since the bacteria may remain in a nongrowing state for long periods, antituberculosis drugs must be continued for as long as six to 12 months. Isoniazid may cause severe and sometimes fatal liver damage, the NIH warns.

Tuberculosis is an airborne disease that was once a leading killer in the U.S. It spreads when an infected person coughs, sneezes or spits. Only someone with an active case is contagious. Although TB typically attacks the lungs, it can also affect other parts of the body, including the brain, spine and kidneys, according to the Centers for Disease control and Prevention (CDC). If not properly treated, TB can be fatal. The CDC reports that 9,421 cases of tuberculosis were reported in the United States in 2014. TB killed 555 people nationwide in 2013, the most recent year for which the numbers are available.

The hospital said the infected nurse had tested negative for tuberculosis during an annual screening in September. The diagnosis was made after an X-ray during a doctor’s visit for an unrelated condition. The Times reports that the nurse has been placed on leave.

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