Infected Nurse May Have Exposed More than 1,000 People to Tuberculosis

More than 1,000 people, including 350 infants, may have been exposed to tuberculosis (TB) in the maternity wing of a hospital in California, hospital officials say.

The Santa Clara Valley Medical Center in San Jose, California, said it was notified in mid-November that an employee who worked “in the area of the newborn nursery” had been diagnosed with TB, with the potential to infect hospital staff and patients, including the newborns, the New York Times reports. The potential exposure occurred between August and November, the hospital said.

Hospital officials said that as many as 1,026 people may have been exposed to the disease: 350 infants, 308 employees and 368 parents, primarily mothers of the newborns. Hospital officials said they had identified all patients, staff members and visitors who might have been exposed, and were contacting each one.

Dr. Stephen Harris, the hospital’s chairman of pediatrics, said that the risk of infection remained low but that “the consequences of a tuberculosis infection in infants can be severe.” He said the hospital would begin offering preventive treatment to the exposed infants “as soon as possible.” Such treatments include diagnostic testing and a daily dose of isoniazid, an antibiotic that can prevent infants exposed to tuberculosis from developing the disease, the Times reports. Employees and other patients, including the mothers, will also be screened and receive treatment if needed, hospital officials said.

Screenings have begun and hospital spokeswoman Joy Alexiou said, so far, no one has tested positive for the disease, according to the Times. She described isoniazid as “very effective at keeping tuberculosis from taking hold,” but said the disease posed a special risk to them. “In infants that young, it doesn’t stay in the lungs like it does with older children or adults,” she said. “There is the potential for it to go into their bloodstream and then infect other organs.”

Isoniazid is used alone or with other drugs to treat tuberculosis and  prevent it in people who have had contact with tuberculosis bacteria, according to the U.S. National Library of Medicine of the National Institutes of Health. The drug eliminates only active bacteria. Since the bacteria may exist in a resting (nongrowing) state for long periods, therapy with isoniazid (and other antituberculosis drugs) must be continued for a long time (usually 6 to 12 months). Isoniazid may cause severe and sometimes fatal liver damage, the NIH warns.

Tuberculosis is an airborne disease that spreads when an infected person coughs, sneezes or spits, but only someone with an active case is contagious. Although it typically attacks the lungs, according to the Centers for Disease control and Prevention (CDC), TB can also attack other parts of the body, including the brain, spine and kidneys. If not properly treated, the disease can be fatal. The agency said there were 9,421 cases of tuberculosis in the United States in 2014. TB killed 555 people in the United States in 2013, the most recent year for which such data was available.

The hospital said the infected nurse tested negative for tuberculosis during an annual check in September. The diagnosis was made after her personal physician took an X-ray during a visit for an unrelated medical condition. The nurse has been placed on leave, the Times reports.


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