Attacking the Disease of Panic : Hit by four TB cases, Orange County school district rises magnificently to the occasion

The resurgence of tuberculosis in the United States in the last few years, especially in Eastern cities, is serious enough that health officials have considered rewriting quarantine laws and reopening sanitariums. Moreover, nativist fears have been fueled along the way because in some instances immigrants have carried the contagious disease.

So when the Garden Grove school district was hit with a tuberculosis scare recently, much could have gone wrong. But the district and Orange County health officials responded magnificently, establishing a model of how to handle parental fears.

Last spring, private physicians notified Orange County officials that they had found four cases of active tuberculosis among students at the district’s La Quinta High School in Westminster. The school and county workers then offered free skin tests to 466 students likely to have come in contact with the bacteria. Unfortunately, the parents of only 220 of the students signed the permission forms.

When school resumed last month, teachers and school officials wisely pressed their campaign for TB testing. They prepared messages and permission forms in English, Vietnamese and Spanish, in keeping with the diverse population at the school. The school offered the same carrot--free tests--and added a stick--refusal to be tested could result in suspension. The combination clearly worked: Nearly 1,300 students and teachers took the skin tests this time.

Equally heartening were the results: Fewer than 20% of those screened had positive skin tests. Doctors said that was about the percentage expected, and cautioned that a positive test did not indicate the presence of tuberculosis. It signaled only that the person had at some time been exposed and would require further testing.

The need for careful explanation and testing was underscored by panicky telephone calls to the school from parents who had heard unfounded rumors that various diseases were sweeping La Quinta. Once thought to be on the road to extinction in the United States, tuberculosis has made a comeback. Health officials blame increased homelessness, fewer testing programs and intravenous drug users as well as infected foreign nationals.

The number of active TB cases has increased in Southern California since the late 1980s, though at far lower levels than in New York City and elsewhere. Vigilance is needed, and so are proper methods of alerting those at risk, as was shown in Orange County.