Clark County public health officials will be sending out letters this week to a select group of parents in Vancouver, urging them to have their children tested for tuberculosis.
The county plans to set up at a screening clinic, said Dr. Alan Melnick, Clark County public health official.
Last week, health authorities told families with students at Wy'East Middle School that they had identified a case of tuberculosis at the school. They have not named that person and have declined to say whether it involved a student or staff member to protect that person's privacy, Melnick said.
"There's a stigma attached to it," he said.
He said the general public has no reason to worry.
"It's not very contagious," Melnick said, "that's why the public isn't at risk."
Only staff and students in a few classes at the school might have been exposed, Melnick said. They're the ones public health officials are concerned about.
"The people who should get tested are those at the highest risk," Melnick said.
Anyone who tests positive for the bacteria -- even if they have a latent form -- will be treated.
The bacteria can stay dormant in the body for years. Cases of latent TB are not contagious. The disease is spread through the air by coughing, but the bug doesn't live long in the environment, unlike influenza or measles.
"It's not that contagious," Melnick said.
Clark County health officials are currently following about 10 cases, including the one at Wy'East, he said.
All of the patients have been treated or are undergoing treatment, he said. He expects all of them to make a full recovery.
The person at Wy'East has either returned to school or will return shortly, he said.
There were nearly 9,300 cases in the U.S. last year. They included eight patients in Clark County, with a total of 205 in Washington state as a whole. That compares with 70 cases in Oregon, including 25 in Multnomah County.
Animals can get TB, too. Early this year, Packy, the much-loved elephant at the Oregon Zoo, was euthanized at 54 following recurring bouts with the disease.
People usually become infected abroad. Tuberculosis is still a problem in developing countries. Those with the most cases include Afghanistan, Bangladesh, Brazil, Cambodia, China, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Kenya, Mozambique, Myanmar, Nigeria, Pakistan, the Philippines, the Russian Federation, South Africa, the United Republic of Tanzania, Thailand, Uganda, Viet Nam and Zimbabwe, according to the World Health Organization. Every year yearly 2 million die.
There's a vaccine but it isn't very effective, Melnick said.
The bug is very slow growing and can affect any part of the body. Melnick has seen cases of infection in the eye, spine and skin. People are only contagious when they get tuberculosis in the lung and start coughing. Other symptoms include fever, night sweats and weight loss.
Tuberculosis is treated with four antibiotics that have to be taken for up to nine months. It's important to take them for the full course to kill all the germs, Melnick said. If not, any surviving bacteria can mutate and become resistant to one or more antibiotics.
There have been cases of multi-drug resistant tuberculosis in Clark County, Melnick said. All of those people have been cured.
He's seen cases involving elderly people on hospice. He said they were treated, cured and came off hospice.
Health officials will follow all cases, to ensure that people are isolated when they're contagious and take the antibiotics for the full course. They'll also be continually tested to see whether they're still contagious.
Usually people are not contagious after taking antibiotics for a few weeks, Melnick said.
-- Lynne Terry