Tuberculosis Testing Planned for Classes at 2 Middle Schools

Sixty schoolchildren and adults are set to bare their forearms Tuesday and prepare to be stuck with a needle to determine whether they have become infected with the bacteria that causes tuberculosis.

The students, ages 12 to 14, together with a handful of adults in classes at two intermediate schools were exposed to the disease by a classroom worker sometime before that person was diagnosed last month.

County Public Health Services workers say it is unlikely that any students and adults at Los Cerritos Intermediate School and Colina Middle School will actually become infected with the tubercular bacteria.

“We caught it at an early enough stage [in the infected classroom worker] that this is unlikely,” said Marilyn Billimek, supervisor of the county’s public health communicable disease program.

The rare classroom exposure comes as tuberculosis is again gaining a foothold in Ventura County and other Southern California communities. Nearly extinguished with medication and proper treatment, the contagious disease has begun appearing again in part because immigrants from countries with poor public health practices have reintroduced it to the population here.

The threat of the disease crops up in a Ventura County classroom only about once every five years, Billimek said.

Far more frequent is exposure and public health testing in hotels, restaurants, factories and other areas of employment in which many of the workers are foreign-born, she said.

Public health workers will be on the Los Cerritos and Colina campuses to inject a small amount of a protein solution derived from tubercular bacteria just beneath the surface of the forearm skin.

Workers will return to the campuses two days later to examine the skin for raised marks to determine whether those who came in contact with the infected person are infected themselves.

“As long as the tuberculosis bacteria can be coughed out, the person is contagious,” Billimek said.

“The idea is that they are sharing the same air,” Billimek said. “And when you share the same air day after day with an infected person, you’re sure to be exposed.”

Billimek said she did not know details about the personal habits of the infected classroom worker, or how that person might have become exposed and infected.

The worker had been coughing, Billimek said. “But some people cover their mouths when they cough and others don’t. Those that do give less exposure to other people.”

Tuberculosis, she added, is more difficult to transmit than a common cold. The tubercular bacteria must be breathed in, whereas a cold virus can be passed through a handshake with a person who has recently covered his mouth to cough or through other casual contact.

The children to be tested and others at the schools have been curious about the procedure, but do not seemed to be frightened or alarmed, said Los Cerritos Intermediate School Principal Pat Pelletier.

“It’s been handled extremely well” by the Public Health Department, Pelletier said. “This will possibly make the students and parents more comfortable. If I were a parent, I would want them to test as a precautionary measure.”

The classroom worker learned of the disease after seeing a private physician last month. The doctor reported the disease to the Public Health Department because tuberculosis is a communicable disease for which reporting is mandatory and because the patient worked in the schools, Billimek said.

The worker has been on health leave ever since, and will be on medication to treat the disease for at least six months. But the period of time the classroom worker is contagious should have passed now, Billimek said, and the worker is being retested.

People infected with tuberculosis form an ulcer inside their lungs, sometimes coughing up blood and infected mucus.

Before modern drugs, the disease was almost always fatal eventually, often clearing up and recurring throughout a person’s life. Now, the disease is treated with a combination of anti-bacterial drugs that knock out the disease in six months when no other complications exist, Billimek said.

However, the disease can still be fatal to people with compromised immune systems.

After the testing Tuesday and the follow-up examination for raised welts on the arm two days later, students who are determined positive for the bacteria will be referred for chest X-rays.

The students who test negative will be retested in three months. That is because it takes 10 to 12 weeks from the time of exposure until the bacteria can be detected through the skin test.

Depending on the time and duration of the classroom worker’s contagious period, results from the tests administered Tuesday may not show infection from the classroom worker.

“We’re getting a baseline now,” Billimek said. “If anyone has ever been infected [over their lifetime], it will show up now. If the test is negative now and positive in three months, we will know they were exposed by the school contact.”

Among the public at large, about three cases per year are reported in Thousand Oaks, compared to five each in Simi Valley, Ventura and Port Hueneme, and seven in Camarillo. In Oxnard, there were 24 cases reported in both 1994 and 1995 due to its large population of immigrants of Latin background, she said.

Many Latino residents of Ventura County become exposed through contacts with family members who they visit in Mexico or who come here to visit them, she said.

But in other communities with large Latino populations, such and Fillmore, Moorpark and Santa Paula, fewer than five cases were reported in each of those cities in the last two years.

Billimek said fewer cases are reported in those cities because its residents are either not seeking health care or are receiving health care in Mexico. She suspects that many more cases exist than are reported.

When a case is detected anywhere in the county, Ventura County Public Health workers track the infected people and the progress of their disease to ensure they are taking their medication for the entire six months, or until the tuberculosis is cleared up.

Refusal to take medication to control the communicable disease can be a misdemeanor and is enforceable by law, she said.