Nebraska officials are testing more than 500 children and staff members at an Omaha-area YMCA daycare for possible exposure to tuberculosis after a case at the site sparked a public health emergency.
Douglas County Health Director Lindsay Huse declared a state of emergency on Thursday, citing the risk of spreading the infectious disease at the Westview YMCA in suburban Omaha. The exposures would have occurred between May and the end of October. The incubation period for tuberculosis is two to ten weeks.
The patient is in isolation at home and undergoing treatment, Huse said. Authorities would not say whether the person was an adult or a child, or identify their gender, but they confirmed the person tested positive Monday, and a contact investigation prompted the person or their loved ones to contact the Westview YMCA Childwatch, a daycare where gym members can drop off their children for up to two hours. The fact that the person was at this daycare made the number of possible exposures particularly high. The current estimate is around 500, but is subject to change as families and siblings are identified and, in some cases, excluded.
“It’s not that unusual to find a case of active tuberculosis,” Huse told USA TODAY. “But what’s unusual is just the scale of the exposure.”
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The infected person was linked to a symptom onset date of August 21, forcing health officials to go back to May to fully capture anyone who may have had symptoms in previous months. she hadn’t considered it tuberculosis. This makes tracing more difficult, given the number of people coming in and out of the daycare.
“By its nature, you risk a lot more exposures if there’s someone in that room who has an active disease,” Huse said.
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Exposure to a disease like tuberculosis requires staying in a small, enclosed space for an extended period of time, Huse said. In a letter to health care providers across the county, Huse wrote that people can become infected after a person with TB germs in their lungs or throat coughs, sneezes, talks or sings, causing bacilli or germs in the air that others then breathe. .
Symptoms of tuberculosis include:
- a cough lasting several weeks;
- chest pain;
- coughing up blood or sputum;
- weakness or fatigue;
- chills, fever or night sweats;
- weight loss or lack of appetite.
On Saturday and Sunday, Children’s Nebraska, a pediatric hospital in Omaha, planned to hold clinics to test about 250 children ages 4 and younger who may have been exposed in the past 10 weeks. Young children are considered high risk because they can get sick quickly, requiring earlier attention than an adult would need, Huse said.
In addition to a basic skin test to look for the disease, hospital staff plan to administer window prophylaxis, therapy to treat tuberculosis, or even as a preventative measure to prevent people from contracting the disease. In approximately 10 weeks, the same cohort will undergo another skin test to confirm infection.
In the coming days, the county is expected to open clinics at the Westview YMCA to test 350 more people using skin and blood tests. Authorities will also look for a latent infection and treat it with medication to ensure it does not become active.
In emailed responses, the YMCA of Greater Omaha said the Westview Childwatch keeps electronic records of the recordings, which helped officials with contact tracing for possible exposures. There is no longer a risk of exposure to tuberculosis at the center, according to the Department of Health, the email said, although the Westview YMCA was closed Thursday and the facility planned to remain open for several days to give support staff a chance to get tested and to get their children tested.
“This is an unfortunate and isolated incident,” Rebecca Deterding, president and CEO of the local YMCA, said in a statement. “All those who were exposed at the YMCA have been identified and informed of next steps for testing.”
In 2022, county health officials reported 15 confirmed cases of tuberculosis, and 15 through September 2023. The Centers for Disease Control and Prevention reported 8,300 cases across the United States in 2022.
Tuberculosis, formerly called tuberculosis, historically had high mortality rates in the United States. Deaths and cases have declined significantly over the past century thanks to rigorous public health efforts.
“It’s one of the oldest public health diseases,” Huse said. “We have a lot of experience in preventing the spread and investigating cases on this. »
Eduardo Cuevas covers health and breaking news for USA TODAY. He can be contacted at [email protected].