Officials at the DeKalb County Board of Health have new information about the tuberculosis (TB) skin tests administered at Tucker High School. The skin tests were performed because an active case of TB disease was identified in a member of the school community. This person has been receiving treatment and is showing steady improvement. None of the nearly 500 students and staff who were tested had active TB disease.

However, recent laboratory results about the active case identify a multidrug-resistant strain of TB bacteria. TB bacteria are considered multidrug-resistant if they do not respond to two or more of the commonly prescribed medications used to treat the disease. Multidrug-resistant TB can be effectively treated, but the drugs must be taken longer and have more side effects than normal treatment. As a result, this case requires greater attention for control and prevention efforts.

As the Board of Health expected, a small percentage (approximately four percent) of the individuals tested at Tucker High School had a positive skin test indicating TB infection. As part of the routine TB investigation, the Board of Health has evaluated these individuals and ruled out active TB disease. Further follow up with these individuals may include treatment for TB infection.

"Physicians need to be more aware of the possibility of TB infection. TB should be suspected in persons with a cough that lasts more than two weeks, particularly if it is associated with fever, weight loss, night sweats, coughing up blood or prolonged illness," said Dr. Stuart Brown, medical director of Personal Health Services at DeKalb County Board of Health.

In the past five years, the overall trend in reported TB cases has declined in metropolitan Atlanta, as well as in Georgia and the U.S. However, it is present throughout the U.S., so the diagnosis of TB among high-school age persons is not unexpected.

"For every case of TB, we investigate to determine the source of infection and identify others to whom infection may have been spread from the same source. Our testing at Tucker High School is part of this type of investigation. We will continue our work with the Tucker High School community and others to investigate this case," added Dr. Brown. "We're doing so with the cooperation of the school and the parents, as well as the support of our public health partners at the Georgia Department of Human Resources and the Centers for Disease Control and Prevention."

"Most Americans think of TB as a disease of the past, but that isn't the case," says Dr. Brown. "With multidrug-resistant strains of TB and our highly mobile society, public health is facing challenges our predecessors never had to confront. Fortunately, TB treatments and the public health system's ability to identify and track the disease have also evolved. TB remains a manageable medical condition, even in the face of drug resistance."

The only way to determine if you have TB infection is through a skin test, in which a small amount of TB-detecting fluid is placed under the skin of your arm. Your skin's reaction to the test reveals whether or not you have been infected with the TB bacteria.

TB infection is not the same as TB disease. Persons with latent TB infection have the bacteria that causes TB in their body, but it is inactive. Brown adds, "It is important to emphasize that the positive skin tests indicate TB infection and not necessarily TB disease. TB bacteria can only be spread to others by persons with active TB disease."

One of the benefits of testing is that those who test positive for TB infection can be given medication to prevent their infection from developing into TB disease and becoming contagious to others.

The Board of Health will repeat the Tucker High School skin tests in January to follow up on its investigation.

For more information about the DeKalb County Board of Health's tuberculosis services, call (404) 508-7857.

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