Wider Tuberculosis Testing Ordered : Health: Rising incidence of disease, including La Quinta High School outbreak, prompts policy of tests for all students entering schools from outside county.

In response to an upsurge in tuberculosis cases in Orange County, health officials have ordered expanded testing of students this fall.

*

The new policy requires TB testing of students from outside Orange County who transfer into any public or private school in the county.

State law already requires TB testing of all students entering the first grade. The county’s new policy expands the testing to cover grades one through 12, if the student is moving into Orange County. Since 1985, Los Angeles County has had a similar policy for mandatory tuberculosis testing of transfer students.

“I’ve ordered this because I think it’s important for the health and well-being of the people of Orange County,” said Dr. Hugh Stallworth, the county’s director of public health. “It’s mandatory for public and private schools as of Sept. 1.”

Stallworth said Orange County’s new policy does not affect intra-county student transfers. But if the student is moving into Orange County from another county, another state or a foreign country, he or she must be tested for TB before being admitted, Stallworth said.

Los Angeles County has required that transfer students from outside the state or country be tested for tuberculosis, in addition to all first-grade students. Health officials in Los Angeles said that unlike the new Orange County policy, that of Los Angeles County does not require a TB test for a transfer student from another California county.

Stallworth said the new Orange County policy was “developed to deal with rising TB cases.” He added, “We’ve, of course, had a tuberculosis outbreak at La Quinta High (in Westminster), and we’ve also had some other cases in other high schools, middle schools, as well as some lower grades.”

A school-by-school breakdown of TB cases in Orange County was not available. County health officials, however, said that the number of TB cases countywide is rising this year. There were 162 TB cases diagnosed in the county from Jan. 1 to June 30 this year, compared to 148 cases during those six months last year. From 1990 through 1993, the number of new cases of tuberculosis in the county increased by 71%, from 258 to 440.

La Quinta High became the focal point for much of the county’s concern over rising tuberculosis infection after active cases of the disease were diagnosed in 17 students. In addition, 106 students and staff members at the high school tested positive for infection with the bacteria, meaning they might have the disease in the future.

The new order to expand TB testing has been transmitted to all school systems in Orange County, and the reception has been overwhelmingly favorable, Stallworth said.

“We’ve talked with school superintendents and parents, and we’ve gotten no significant resistance,” he said. The consensus of parents and educators, Stallworth added, is that expanded TB testing “is a win-win situation for everyone.”

*

One system, the Huntington Beach City School District, has enthusiastically backed the county’s new directive by adopting it as district policy.

“We think it’s a good idea to test all new students, as well as the first-grade students,” said school board member Trustee Shirley Carey.

Carey, who is a nursing consultant, said she wishes the required TB testing also included kindergarten students.

“State law doesn’t require testing of kindergarten students because kindergarten isn’t mandatory,” she said. But Carey added that she urges parents of kindergarten students to have them tested for TB before entering them into classes.

Sandra Landry, a registered nurse who is the administrator for health for the Orange County Department of Education, said “tuberculosis is something we’ve kind of minimized over recent years, but it’s something we do need to be concerned about.”

Landry said the skin test for tuberculosis is done with a needle “and doesn’t hurt any more than pinching.” She said parents who cannot afford to have the test by a private doctor can have it done at a community free clinic or the county Health Care Agency. The county clinic, at 1725 W. 17th St. in Santa Ana, offers free tuberculosis testing for school-age children on Mondays and Wednesdays from 7:30 a.m. to 4:30 p.m. and on Tuesdays from 10 a.m. to 5:30 p.m.

The skin test requires two clinic visits: one for the needle injection and a follow-up visit for the reading of the test.

Stallworth said TB is a bacterial disease “that can exist in any organ of the body, but most commonly is found in the lungs.” He said the disease is transmitted “by someone who has tuberculosis, coughing, sneezing or singing.”