Castle Heights Middle School TB Investigation

Investigation Updates

January 19, 2017

The S.C. Department of Health and Environmental Control (DHEC) has provided the following update to a tuberculosis (TB) contact investigation involving Castle Heights Middle School in York County.

Of the individuals tested for TB, there are currently no test results indicating active TB disease.

As of this update, the testing totals associated with the school stand as follows:

• There were 135 individuals who received testing from January 4 through January 17.
• Results were mailed to individuals January 17.
• As of today, DHEC has identified three individuals with a positive TB screening test. Further testing was performed on the individuals to confirm that they did not have active TB disease.
• At this time no additional cases of active disease have been identified.

Information resulting from this investigation will be provided as it is confirmed, and in accordance with state and federal law.

To learn more about TB, visit http://www.cdc.gov/tb .

December 30, 2016 update

DHEC has confirmed a case of tuberculosis (TB) in someone associated with the Castle Heights Middle School in Rock Hill. DHEC is working closely with school leaders to identify members of the school community who may have been exposed and need TB testing. This process is called a "TB contact investigation". DHEC has communicated this information to parents and staff and will continue to keep the school community updated on next steps.

DHEC is evaluating the school layout and routine activities of the case to determine the level of risk for classrooms, lunchrooms and other areas where the students and staff congregate.

A TB contact investigation is a fluid process that is completed based on CDC (Centers for Disease Control and Prevention) guidance. Information gathered during the investigation is used to make specific testing recommendations to individuals. As the contact investigation progresses, additional people may be recommended for testing.

It is important to note that TB can be treated with antibiotics. DHEC will update this web page throughout the investigation as information becomes available.

Facts about TB

What is TB?

Tuberculosis (TB) is a bacterial disease that can be spread through the air from person to person. There is a difference between active TB disease and latent TB infection .

• When a person is exposed to the TB germ, they may become infected. Not everyone infected, though, will become sick.
• Latent TB infection is when someone is infected with the TB germ but their body's immune system is able to keep the infection from progressing to active TB disease.
• People with latent TB infection are not sick and cannot spread the TB germ to others.
• Many people who have latent TB infection never develop active TB disease, but some will at some point in their life. Most frequently that happens within two years of becoming infected.
• People with latent TB infection can take medicine to prevent developing active TB disease.
• Some people develop active TB disease soon after becoming infected, but most do not, instead they develop latent TB infection.
• Only people who have active TB disease are sick and infectious.
• Active TB disease can be treated.

• Tuberculosis information from DHEC ( en Espanol )
• Tuberculosis information from CDC
• Latent TB Infection vs TB Disease (click image to view PDF)
  

Can TB be treated?

Yes, TB can be treated with antibiotics. TB disease can be treated by taking several drugs for six to 12 months. It is very important that people who have TB disease finish the medicine and take the drugs exactly as prescribed. If you stop taking the drugs too soon, you can become sick again. If you do not take the drugs correctly, the germs that are still alive may become resistant to those drugs.

Is it safe for kids and staff to return to school next week? What steps are being taken to make sure it is safe for kids and staff?

Yes, it is safe for kids, parents and staff to return to school next week. The single most critical step that has been taken to protect this school community is the identification and exclusion of an individual with active tuberculosis. TB is passed person-to-person by droplets that are suspended in the air. These droplets settle and the bacteria die within approximately four hours. TB is not spread like many viruses, e.g. influenza, which can be picked up from surfaces on hands and inoculated into eyes, mouth or nose. There is no on-going environmental threat to anyone in the school.

Since TB is spread person-to-person, anyone coming back to school with symptoms of prolonged cough (greater than three weeks), chest pains, or coughing up blood or sputum from deep in their chest needs to be excluded from school and evaluated by their physician, relaying that they may have been exposed to TB. If students and staff have no symptoms and they are not sick, there is no risk to anyone else in the school, even if a TB test comes back positive.

FAQs about DHEC TB Investigations

DHEC follows up on all reported cases of active TB disease

• TB is a serious infectious disease and healthcare providers are required to report all cases to DHEC.
• DHEC ensures that patients with active TB disease are isolated when they are infectious and receive adequate treatment.
• During a TB investigation, DHEC identifies individuals who were exposed to someone with active TB disease, provides TB testing, and provides infected persons with preventive treatment if needed.

When a TB case occurs in a school setting, DHEC works closely with school leaders to identify individuals who were exposed and need to be tested for TB infection

• Individuals who have been around a person with active TB disease for an extended amount of time are at risk of becoming infected.
• DHEC works with the school to contact individuals who need testing.
• DHEC offers free testing for those that they identify as needing testing.

CDC only recommends TB testing for those who have an identified risk of exposure to TB

• TB tests can have false positive results so testing is not recommended for those who have not been exposed.
• Not everyone exposed to TB becomes infected.
• Individuals who have a positive TB test need further evaluation to determine whether they have "latent TB Infection" or "active TB disease".
• Most people who become infected don't develop active TB disease.
• Medicine is available that people who are infected can take to reduce their risk of developing active TB disease.

TB Statistics

How many TB cases do we typically see each year in South Carolina?

In South Carolina we had 104 active TB disease cases in 2015, 79 in 2014, and 112 in 2013.