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TB Scare Rocks Tiny Alabama College

Officials find 48 infected after grad student dies

THURSDAY, Jan. 17, 2002 (HealthDayNews) -- Health officials are working to prevent panic at a tiny Alabama college where 48 people have tested positive for tuberculosis after a foreign student died of the uncommon lung disease in late December.

So far, no one else at Mobile's Spring Hill College has become ill with tuberculosis (TB), which develops into full-blown disease in just a small percentage of people who get infected. But to be sure, health officials are sending infected people to radiologists for chest X-rays and making plans for distribution of medication.

"As each day passes, it seems that more and more news comes out. The awareness [of the possible infections] is increasing on a daily basis," said Joseph Jablecki, director of TB control in the Mobile region, which is at the southern tip of Alabama near the Florida panhandle.

Spring Hill College, a Roman Catholic institution run by Jesuits, has about 1,500 students. Benedict Lenjo, a 28-year-old graduate student from Kenya, died on Dec. 28 in his room at the college. According to the school, he was allowed to stay on campus during the holiday break because he could not easily go home.

Lenjo, who had been seeking a master's degree in liberal arts, had been in the United States since mid-August, according to a college statement. His fellow students noticed that he seemed very ill and had a bad cough, according to the statement. However, he did not visit a doctor, and was seen only after another student alerted campus security.

Health officials tested 491 people last week. Of those, 384 returned to get results; 48 showed signs of infection, also known as latent TB, Jablecki said. Officials are waiting for results of tests of about 150 people this week.

The infected people won't be given medication to destroy the TB germs until it's clear that they don't have the full-blown disease. If they don't, typical medical treatment -- the standard preventive is a drug called isoniazid -- lasts for six to nine months. Anyone with active TB would be given a battery of drugs to make sure the bacteria are killed.

Many of those tested do not know much about TB. "For the most part, they are calm, but there have been a few exceptions," Jablecki said.

TB, a common scourge through much of American history, is no longer a common disease. Alabama, home to 4.4 million people, reported just 265 cases in 2001, down from 310 in 2000. About 16,000 cases were reported in the United States in 2000, according to the Centers for Disease Control and Prevention (CDC). However, TB is still a problem in the developing world, including nations like Kenya: Nearly one-fifth of the 8 million cases reported worldwide each year occur in sub-Saharan Africa, says the World Health Organization.

TB is spread only through the air.

"You don't transmit it by eating, drinking or kissing someone who has TB," said Nancy Keenon, director of TB control with the Alabama Health Department. "It has to get into the body through the lungs."

While TB is contagious, most people have strong immune systems that can fight off infection and subsequent full-blown disease, she said. But between 5 percent and 10 percent of people exposed to TB germs do become infected.

Without treatment, about 5 percent of those infected will come down with the disease at some point in their lives, she said.

Those who have only infection are not a danger. "There's a lot of confusion between having TB infection and the disease," Keenon said. "Infection cannot be transmitted from one person to another. If I have it in my body and I'm not sick with it, I'm not going to transmit that to anyone else. It's only those who have active TB who can transmit it to others."

While treatment of full-blown TB is 95 percent effective, the disease can fool doctors and go undiagnosed, she said. TB is known as the "great mimic" because it imitates other diseases like respiratory ailments and cancer, she said.

"For the most part, if you're not looking for it, you don't find it."

The college said only people who spent a "considerable" amount of time with Lenjo -- four hours in the same room over a weeklong period -- should be concerned.

What To Do

Learn the basics about TB from this fact sheet from the New Jersey Medical School or the CDC.

If you're a doctor, the Johns Hopkins Center for Tuberculosis Research offers this online resource center.

SOURCES: Interviews with Nancy Keenon, M.P.H., director, division of TB control, Alabama Health Department, Montgomery; Joseph Jablecki, M.P.H., director of TB control, Mobile, Ala.; Spring Hill College statement; Centers for Disease Control and Prevention; World Health Organization
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