Superintendent and health officials address parent concerns over confirmed tuberculosis case

Bill Cleveland, superintendent of Homewood City Schools, and officials from the Jefferson County Health Department spent an hour Wednesday night, March 25 answering questions from about 50 concerned parents about tuberculosis after a Homewood High School freshman was diagnosed with the potentially deadly, contagious respiratory disease.

 Some parents asked Cleveland and Dr. Ed Khan of the Jefferson County Department of Health whether it was safe to keep their kids enrolled in Homewood city schools while health department officials treat the unnamed victim and test students and employees of the school system. Khan assured parents it was OK to keep their kids in Homewood schools while his department treats the patient and tests students and employees to assure they aren't infected.

On Wednesday, about 960 of the 1,060 students at Homewood High School were tested for tuberculosis, about 85 percent of the student body, Cleveland said. Another 169 employees were also tested by the health department, he said.

"I will simply tell you for those of you who have a child or grandchild at Homewood High School, your students were phenomenal," Cleveland said. "Ive never seen a student tested for TB. I have seen flu shot tests. For a group to have an enjoyable time, some were tweeting out, they were a great group of students."

According to the Centers for Disease Control, tuberculosis is one of the world's most deadly diseases. In 2010, 8.8 million people fell ill with tuberculosis. Of the 1.4 million deaths, 95 percent occurred in developing countries. 

Tuberculosis is the world's most infectious disease killer in history, claiming an estimated billion lives over the past 200 years. Today, its death toll is second only to HIV.

Khan of the Jefferson County Department of Health said officials still don't know how the Homewood High student, whose name isn't being released, caught tuberculosis. He said the patient is being treated, and that county public health officials are researching people he might have been in contact with.

Carolyn Landers of the Alabama Department of Public Health, a pediatrician who is state medical director of the TB program, also spoke to parents in attendance. Khan said the most common question he hears is from folks who thought TB was gone. Thanks to advancements in treatment, tuberculosis cases are rare, but they do sometimes appear such as currently with the Homewood student, he said.

"The only way TB is transmitted is if someone has active TB in their lungs and then they cough, talk, sneeze, whatever, it gets in the air and then others within the vicinity of that person breathes in that air and then it gets in their lungs," Khan said. "This was recognized very early on."

Khan said the student is on a preventive medication. He said tuberculosis is a slow-developing disease. "You feel run down, you may be coughing or lose a little weight and might just pass it off as asthma or bronchitis. The good part about that is if we have time. You find out who is at risk, you get them in for symptom review, X-ray, test and make a decision."

Khan said it can take up to three months for symptoms to appear, meaning students and employees tested today aren't out of the woods yet. When told by Cleveland that Homewood city schools have eight weeks of school left, Khan said the Jefferson County Department of Public Health will retest students right before the school year ends in late May.

 Khan said county health officials don't know yet where the student caught tuberculosis. "Both the infected person and the person who gave them TB probably didn't know it was there," he said. "The majority of people do not know they have it. Sometimes you can learn risk factors based on where that person had been."

Khan acknowledged that some of the Homewood High student test results may come back as positive, but added they are OK as long as they don't have what he called "active disease.

"If there is active disease, we will observe to make sure person gets active treatment," Khan said. "If it is dormant, then we will give them medicine every month. That falls on parents to make sure their children get treatment."

Since tuberculosis is a federal priority, the department of health covers treatment costs, Khan said.

As part of their investigation, health officials will test the victim's family, and will alert people who might have been in contact with him, including church or any organizations or sporting teams the patient might have participated in.

Cleveland said school officials felt a sense of urgency to get the message out to parents. "Due to the calendar, with spring break coming upon us, there was a big sense to get this ball rolling despite the slow moving thing that tuberculosis is. I've heard lots of things as far as siblings of the student, should we be concerned. To our knowledge, there are no siblings of the student in our school system."

Khan said if parents have students at Homewood High, they should be alert for active coughing, abnormal chest X-ray or dramatic weight loss and other symptoms. He said one-third of world population has the tuberculosis germ in their body but don't get sick from it.

"That state cannot transfer the disease," he said. "There is no active transmitting of the disease. There is no active replication of the disease in the body. It's just dormant and contained by the immune system in the body.  That can't infect anybody else. it's only the one coughing, sick, losing weight. At the end of this, we are going to know who is latent, no symptoms, who is active."

One parent said her daughter is asking her what tuberculosis is. Cleveland said he is going to "to make this a teachable" moment. Our main focus has been on communicating to parents," he said, adding that he plans to invite the Jefferson County Department of Health to educate students and parents about the disease.