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Volunteers at homeless shelters urged to get testing for TB

8/15/2014, 6 a.m.

On Aug. 5, Ethel Ware Carter, associate director of the Regional Council of Churches of Atlanta, sent the following email to member churches in Atlanta.

“Friends, this is only the second time in 10 years that we have used our eNewsletter address list for something other than the newsletter. The first occasion was a plea for housing for families of patients being flown to Grady Hospital out of New Orleans at the start of the Katrina crisis.

“Today we have a letter from the Georgia Department of Public Health for any of you who work with homeless shelters; we know that many of you do.

“The letter has some important questions and answers appended.”

Ethel Ware Carter, Regional Council of Churches of Atlanta. 404-201-6448.

To: Churches with volunteers that serve in Homeless Shelter Ministries

Re: Tuberculosis Outbreak in downtown Atlanta Homeless Shelters

This is to alert volunteers in your church who may work in homeless ministries that there is an ongoing outbreak of drug-resistant tuberculosis (TB) associated with staying or volunteering at homeless shelters in downtown Atlanta.

The TB outbreak strain is resistant to the drug isoniazid, but is curable with the use of other anti-TB medications.

Twenty-eight outbreak-related TB cases have been reported to public health authorities since January-July 2014. Two of these cases occurred in volunteers who served at downtown Atlanta homeless shelters.

Please inform your homeless ministry volunteers about this outbreak and ask them to get screened for TB at their local county health department or private physician.

Sincerely,

Dr. Rose-Marie Sales, Director, Tuberculosis Program, Georgia Department of Public Health

Questions asked by volunteers

Are there recommendations for high-risk individuals versus low-risk individuals?

A high-risk individual is someone who may have spent several hours in close proximity to an individual with active tuberculosis. These individuals should be tested.

All other individuals are low-risk individuals and do not need testing. It is understandable if low-risk individuals still want to be tested and county health departments can provide that service, or volunteers may have this done by their provider.

Do I need to get an X-ray if I have had a positive TB skin test?

If an individual was in close contact for several hours with a client of the shelter who had tuberculosis, it is recommended he get an X-ray if he has a previously positive TB test. If he did not have several hours of close contact with a client from the shelter, he is at low-risk and it is not recommended that he be tested. That said, it is recognized that volunteers who have had previously positive TB tests still may want testing and if this is their desire, a screening chest X-ray would be the next step.

Is there a window of vulnerability associated with TB?

Can it lie dormant for a long time in your system or after so many months are you good to go?

  • A person may become infected with TB and not become sick with active TB disease, a condition called latent TB infection. In this case, it can lie “dormant” in the body. However, this condition still needs to be treated to prevent development of active TB disease.
  • A TB test is needed to determine if an individual has been infected with TB and needs treatment.
  • More information to answer this question can be found at http://www.cdc.gov/tb/topic/basics/default.htm. The link describes latent TB infection, a condition where an individual acquired TB infection but did not become sick. People with latent TB infection need to be treated to prevent active TB disease.