By Bobbi Mlynar
mlynar@emporiagazette.com
A Tyson worker who died Jan. 4 with an active case of tuberculosis had tested positive earlier for a latent TB infection, according to a state health official.
Information from a preliminary autopsy report, released publicly on Thursday, stated that active tuberculosis was a related factor in the death of the 20-year-old man, who originally was reported to have been in an industrial accident at the Emporia plant. The final autopsy report is not expected for six to eight weeks.
“The fact of the matter is that this is the first Somali case of (active) TB in Lyon County,” said Phil Griffin, director of the Kansas Tuberculosis Prevention and Control Program, Bureau of Epidemiology and Disease Prevention of the Kansas Department of Health and Environment.
Griffin said that the man, whom officials have not yet identified, was tested earlier and found to have a latent TB infection.
Because of health privacy laws, Griffin said he could not talk about the specifics of the deceased man’s care management before his death.
“We’re not trying to hide anything. ... Anything that we have to report, we will,” Griffin said.
Information provided this week was consistent with figures provided in September by the Lyon County Health Department.
In the Sept. 9 issue of The Gazette, Renee Hively of the health department said that the county had one active case of tuberculosis “and that is currently not in a Somalian. That person is on directly observed therapy.”
Latent tuberculosis can be treated with medication to prevent it from flaring into an active case.
Lougene Marsh, director of the Flint Hills Community Health Center, reiterated this week that the success of the treatment depends on the dedication of the patient.
The medication must be taken daily for nine months to be effective.
“Following the nine months, you would continue to be checked on intermittently,” Marsh said.
Active TB also can be treated with medication to prevent the patient from infecting other people. A primary difference in the way treatment is handled lies in monitoring.
“If someone has active disease, they are required by law to complete treatment,” Griffin said. “Every dose of that is observed. They are mandated by law to take those medications.”
No such law exists for people who have latent tuberculosis, he said.
“We don’t have any ability to require someone who has latent TB to take the medicine,” Griffin said.
The Tyson plant conducts TB screenings annually for the nursing staff and designated translators, according to Gary Mickelson, Tyson spokesman.
All new workers complete a health history questionnaire that asks questions about medical background, including whether they have tuberculosis or have been tested for the disease.
“In addition, when we learn of workers with latent TB or TB-related concerns, we connect them with the county health department, which can provide information, testing and help with follow-up care,” he said. Tyson encourages those with latent TB “to make sure they continue to take their medicine ...
“In light of the recent TB-related death, we plan to have additional discussions with county health officials about other possible measures.”
Griffin was not in favor of legislation to require latent TB patients to take medication, as is required of active TB patients.
“Someone with latent tuberculosis would not be a public health threat,” he said. “There’s no way for someone who’s latent to be able to infect someone else. That would be like us requiring monitoring people who have high blood pressure because they could have a stroke while they were driving. That’s how absurd it would start getting ... tomorrow they could be driving down the street and have a stroke and kill 15 people in the process.
“We can’t mandate or legislate every single condition, nor would anybody ever want that to happen.”
Although active cases of the disease must be reported to KDHE, until about three years ago, health-care workers were not required to report latent TB infections to the state, Griffin said.
“So by no means would I believe that we’re getting every latent case reported to us yet, just because there’s always a delay in people understanding that,” he said.
Statewide statistics for active TB cases totaled 81 in 2006.
“I can tell you only 16 percent of the cases in Kansas were Afro-American or black, which is where the Somalis would fall,” he said. “Sixty-two percent of our cases in 2006 were foreign-born and obviously that is widespread through a variety of backgrounds.”
Asians accounted for 21 percent of the total cases and 30 percent were Hispanic.
“Demographics have not changed dramatically at all,” Griffin said.
The state had a reported 3,500 latent TB infection cases in 2006, with approximately 267 of those in Lyon County. The figure is approximately 285 at this point in 2007.
A detailed breakdown of Lyon County cases is not available.
“The numbers are so small in Lyon County that I would have one or two cases a year in Lyon County,” Griffin said.
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Posted by create (anonymous) on December 3, 2007 at 10:35 a.m. (Suggest removal)
So therefore, when individuals who are being treated for latent TB during that 9-month period of time decide to move from one state to another, health records do not follow them and no one knows whether these individuals ever again go for treatment.
"The state had a reported 3,500 latent TB infection cases in 2006, with approximately 267 of those in Lyon County. The figure is approximately 285 at this point in 2007.
A detailed breakdown of Lyon County cases is not available."
I don't know what they mean by "detailed breakdown."
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