FAQ: Tuberculosis Exposure and Steps to Take

What is happening?

An individual at Lane Middle School was recently found to have tuberculosis (TB) of the lung. This means some staff and students may have been exposed to TB. 

Multnomah County Health Department (MCHD) is working closely with School District leadership to notify potentially exposed individuals and recommend testing.

What is TB? What are the risks and concerns with TB?

TB is caused by a bacteria. It is spread through the air from one person to another when someone who is sick with TB coughs, speaks or sings. People who breathe the germs into their lungs can become infected. Most people who have been exposed to TB will not become infected. A safe and simple skin or blood test can tell whether a person has been infected. TB disease can be treated and prevented with antibiotics.

How contagious is TB? What is the risk level to other students, staff, and families?

The risk to the Lane Middle School community is very low. TB is rarely spread in schools. People usually get infected as a result of close face-to-face contact for several hours with someone who has the disease – typically daily contact for weeks or months. You are not likely to get TB from someone walking in the hallway or from a brief conversation. Tuberculosis is not spread by sharing clothing, dishes, or drinking glasses. TB does not live on surfaces and is not spread through contact like shaking hands.

What happens if I was exposed?

Fortunately, most people who have had contact with a TB patient will not become infected. Also, people who have had contact can easily be tested to see if they have been infected. Potentially exposed individuals have been contacted by the Health Department via an emailed letter from the school.

Families or staff with questions have been advised to call the Multnomah County Health Department Tuberculosis Clinic at 503-988-3406. The Health Department will be providing free blood tests to the school community in the coming weeks. In the meantime, you may also see your personal healthcare provider for TB testing and/or treatment. Please call the Multnomah County Health Department Tuberculosis Clinic at 503-988-3406 if you plan to do a TB test with your personal healthcare provider.

Do I need to cancel travel or stay away from family?

No. TB is a slow-moving disease. It takes months to years to become ill with TB and be potentially infectious to others. Exposed students and staff are very unlikely to pose a risk to their families, friends, or coworkers.  

What does a TB test involve?

TB can be diagnosed with a skin test or a blood test. The blood test is used for all people in most cases. 

The blood test is done like any other routine blood test and also looks for the body’s immune response to proteins that look like the TB bacteria. The results are available a few days after the blood sample is taken.

The Health Department will be providing free blood tests to the school community in the coming weeks. In the meantime, you may also see your personal healthcare provider for TB testing and/or treatment. Please call the Multnomah County Health Department Tuberculosis Clinic at 503-988-3406 if you plan to do a TB test with your personal healthcare provider. 

Why is the Health Department recommending a second TB test later?

It can take up to eight weeks for the body’s immune system to respond to the TB infection and show up as a positive skin or blood test. If the first test is negative, a second TB test is done eight weeks after the sick person was last at the school to make sure the results of people exposed are truly negative for TB infection.  

What if I am infected?

If you have a positive blood or skin test, you will be sent for a routine chest x-ray and asked about TB symptoms to look for early TB disease. If you are feeling well and your chest x-ray is normal, you will be offered preventive antibiotics for latent TB infection to lower your chances of ever becoming sick with active TB. You can take treatment for the non-active or “latent” TB infection. That is your choice. The treatment lasts anywhere from three months to one year depending on a person’s medical history and other factors. 

I have tested positive and/or been treated for TB before and was told I was exposed. What do I do now?

Please call the Multnomah County Health Department Tuberculosis Clinic at (503) 988-3406. Health Department staff will review your TB testing history in detail, make sure you do not have any symptoms of active TB disease, and make other recommendations based on your individual circumstances.

What is the difference between latent and active TB?

TB infection is diagnosed by a simple blood test or skin test. If the test is positive the next step is a chest x-ray to make sure there are no early signs of TB disease. Anyone with a positive TB test and a normal chest x-ray has latent (non-active) TB. They are not sick and cannot spread the disease to others. Most people with the latent form of TB will never become sick. For the few that do, it usually takes months or years to become ill and potentially spread TB to others. Taking antibiotics can lower the chances that someone with latent TB will ever become sick with TB.

Active TB develops in about 10 percent of people with latent TB. When someone has active TB, they feel sick and have symptoms. TB can affect any organ in the body, but it most often affects the lungs (pulmonary TB). The symptoms of active pulmonary TB are typically fever, cough, night sweats and weight loss. People with active pulmonary TB can spread the infection to others, usually the people they spend the most time with. People with active TB in other parts of their body outside the lungs cannot spread the disease to others.

People with latent TB are more likely to develop active TB if they have a weakened immune system or other medical conditions like diabetes or kidney disease. 

I’m expecting a child. How will this affect me?

TB testing is safe during pregnancy. Antibiotics to treat TB are also considered safe during pregnancy. But sometimes pregnant women choose to wait until after delivery to be treated. Transmission of TB from mother to child during pregnancy is extremely rare. Talk to your health care provider and let them know they can call the Health Department at 503-988-3406 for consultation. 

Who is the source of the TB exposure?

Information about the sick person is protected by medical privacy laws.

If I haven't been asked to come in for TB testing, does that mean I'm not at risk? 

If you do not receive a letter from the Health Department asking you to get a TB test, the risk of infection is likely very low. However, if you are concerned or develop any TB symptoms (persistent cough, fever, night sweats, unexplained weight loss), please consult your healthcare provider.

What is being done to make sure this doesn’t happen again?

Whenever groups of people spend time together there is a risk of disease transmission.  Health Department staff carefully look at each situation to see if anything can be done differently in the future to prevent the spread of a disease. The Multnomah County Health Department works with up to 30 cases of tuberculosis a year.

Who is in charge?

The overall public health investigation is being led by Zoe Rettell, TB Nurse Case Manager in collaboration with Dr. Paul Lewis, Multnomah County Health Department TB Clinic Medical Director. They are working closely with Multnomah Education Service District and Portland School District leadership.

What is the Multnomah County Health Department Communicable Disease Services Program, and what does it do?

Communicable Disease Services works to stop the spread of contagious diseases like TB. This is part of their core public health work, and it is something they do every day. The program includes the Communicable Disease Services Clinic, which works on TB disease investigations, provides case management and treatment of people with active TB, and contacts people who have been exposed to TB. 

Where can I get more information about TB? 

You can find more information on the Multnomah County Health Department Tuberculosis Clinic website and on the Centers for Disease Control and Prevention (CDC) TB website.

We understand that this news may be concerning, and we are committed to keeping you informed and taking all necessary precautions to ensure the health and safety of our school community and families. Please do not hesitate to reach out if you have any questions about this FAQ or TB in general, please call the TB Case Management team at 503-988-3406.