Concerned after seven cases of tuberculosis were found at La Quinta High School last spring, county health officials disclosed Friday that they will offer screening tests to everyone at the school who wants them, an effort they described as a “fairly massive undertaking.”
Dr. Gerald Wagner, Orange County’s chief health officer, said that in the spring, a private doctor notified the Orange County Health Care Agency that a teen-age girl who was a junior at La Quinta High had an active case of tuberculosis.
That report, relayed to school officials, prompted county health workers to test 225 students at the school in March and April, including the girl’s 11th-grade classmates and anyone else believed to have come into direct contact with her.
La Quinta High Principal Mitchell Thomas, reached at the school Friday evening, confirmed that “several rounds” of screening tests had been performed in the spring, including tests on 40 to 50 teachers. He said his school’s figures reflect a total of five cases of tuberculosis.
Penny C. Weismuller, who is tracking the outbreak for the County Health Agency, put the total number of cases at La Quinta at seven and said it is unusual to find that many cases in one school. All of them are members of the senior class, Wagner said.
Six of them have drug-resistant strains of the disease, which also is unusual. That is why the county wants to perform another round of tests, Wagner said.
All the students are back at school while receiving treatment, except the girl who first was discovered with the disease. She is hospitalized, Thomas said.
Wagner said that girl’s tuberculosis proved to be resistant to the “first line” of drugs used to combat the disease. Her treatment had been interrupted, Wagner said, which can promote the development of a mutant strain of tuberculosis that is resistant to one or more drugs. But it now appears that other combinations of drugs are proving effective.
Dr. Lauri Thrupp, chief of infection control at UCI Medical Center, where the girl is being held for evaluation, said doctors were concerned that her chest had not completely cleared, but her last culture was negative for active tuberculosis germs.
“We believe she is improved and non-contagious,” Thrupp said.
Thomas said that once the school was alerted to the first case in the spring, officials distributed flyers around campus, notified teachers and circulated the word in every way they could that anyone who might have had close contact with the ill girl should be tested.
Wagner said county health officers will meet with school officials Monday morning to compose a letter to be distributed to parents that afternoon, explaining the tuberculosis findings and informing them of the availability of skin tests for any of the 1,400 students who want them.
Wagner said that although arrangements have yet to be completed, testing will occur probably within the next week.
Any students who have positive results on skin tests, he said, will receive chest X-rays to see if the disease is active. Those with evidence of tuberculosis, he said, will receive treatment from the county. Those who have positive skin tests but no signs of active disease will receive preventive medication.
“The main thing we want to do is try to give information to people so they act responsibly and don’t have any irrational fears,” Wagner said.
Wagner said germ cultures from each infected student have been sent to the federal Centers for Disease Control in Atlanta to determine if they are related and if the students caught the disease from one another.
Joyce T. Johnson, president of the school board in Garden Grove Unified School District, which includes La Quinta High, said the board had not been notified of a cluster of tuberculosis cases at any school, but she did not find that unusual, since board members are not routinely notified if a matter is “something the school can handle on its own.”
Johnson recalled that there was a jump in the number of TB cases in the district some years ago that coincided with an influx of students from several Asian countries. But it was “handled nicely and easily taken care of,” she said.
Tuberculosis is a lung disease that can be transmitted when a contagious person coughs or speaks in enclosed places, sending the bacteria in phlegm into the air to be breathed in by another person. The presence of the illness is generally detected through a skin test, and a chest X-ray can confirm whether the infection is active--contagious--or dormant.
Because of the development of effective antibiotics and widespread testing, tuberculosis was considered a disease on the wane about a decade ago. But its numbers have soared in recent years due to the growing number of infected immigrants and the increased number of cases in which those infected with the AIDS virus have also contracted tuberculosis.
In Orange County, health officials have witnessed a dramatic rise in the number of tuberculosis cases, mostly among Southeast Asian immigrants. Last year, the number of new tuberculosis cases reported in the county jumped by 35% over 1991, from 305 to 411 cases--the greatest jump in a decade. Southeast Asians accounted for 58% of the new cases, Latinos 19% and Anglos 18%.
Garden Grove Unified School District has a large population of children of Asian immigrant.
In June of this year, a female inmate at Orange County Jail was diagnosed with tuberculosis and was isolated from other inmates. Hers was the fifth case of tuberculosis among inmates in the county jail system this year. In February, a security guard at MainPlace mall in Santa Ana was diagnosed with the disease as well.
According to the California Department of Health Services, Orange County in 1991 had the fourth-largest number of tuberculosis victims among 25 counties surveyed. Two of its cities, Santa Ana and Anaheim, were among the top 10 California cities for the rate of tuberculosis cases per 100,000 people.
Although 1.7 billion people worldwide are infected with dormant tuberculosis, 8 million people actually develop active cases of the highly contagious disease. In the United States, about 10 million each year are believed to be infected with the dormant disease.
Some areas of the country have been more susceptible to the disease than others. New York City, for example, has recorded nearly 4,000 cases of TB annually, an increase of 140% since 1980 and more than triple the number of known cases in the city of Los Angeles.
A report from the Centers for Disease Control and Prevention in Atlanta earlier this year showed an alarming increase of cases among children younger than 5.
Health officials say the rise in TB coincides with the growing number of cases involving the AIDS virus, in which the body is made more vulnerable to an infectious disease of any sort.
Times staff writer Mark Platte contributed to this report.