Case of tuberculosis at county agency spurs testing

By Marshall Allen

Wednesday, March 24, 2010 | 2 a.m.

An employee at the Clark County assessor’s office with an active case of tuberculosis may have infected colleagues, who are now being tested as part of an ongoing Southern Nevada Health District investigation.

Stephanie Bethel, spokeswoman for the Health District, said she does not think the public is at risk of contracting the disease, a bacterial infection usually focused in the lungs that can be transmitted through the air.

Bethel confirmed the investigation at the assessor’s office triggered by the case of tuberculosis, but said she could not elaborate. It is one of about 90 similar cases investigated annually in Southern Nevada.

The public has not been notified about the tuberculosis investigation because there is no indication that a large number of people are at risk, Bethel said.

Employees inside the assessor’s office question that assertion, a source familiar with the investigation told the Sun. About a half-dozen of the 60 employees tested for the disease in mid-February were positive, the source said.

Tuberculosis is present in its latent form, causing no symptoms or harm, in an estimated 9 million to 14 million people, the Centers for Disease Control and Prevention estimates. There were 11,540 active cases in the United States in 2009, according to the CDC. Tuberculosis is treated and cured with a nine-month regimen of antibiotics.

It’s impossible to know whether the employees picked up tuberculosis from their colleague with the active case, the source said. It’s believed that the person with active tuberculosis may have been contagious between October and February, the source said. The problem became obvious when the infected employee coughed up blood and lung tissue in the office, the source said.

At a February meeting to notify employees about the tuberculosis investigation, some workers were concerned that they were being told to keep the situation quiet, apparently to avoid media attention, the source said.

It’s doubtful the public is at risk, said Dr. William Schaffner, president-elect of the National Foundation for Infectious Diseases and professor of preventive medicine at Vanderbilt University School of Medicine. Schaffner, who has been involved in public health investigations in Tennessee, said tuberculosis is not readily transmitted. It requires prolonged and close contact in a closed environment, he said — though if the infected employee was coughing up blood and lung tissue, the case sounds severe.

Tuberculosis is tricky to diagnose because its symptoms are frequently mistaken for other ailments, Schaffner said.

Under the given circumstances, it would be unwise to notify the public about a possible tuberculosis infection because the health department could be swamped with “anxious but healthy” people looking for tests, Schaffner said, which could detract from the more important aspects of the investigation. It’s also important to maintain the privacy of the people who test positive for the disease as much as possible, he said.

Rocky Steele, assistant director of the assessor’s office, said the office was notified by the Health District about the case of active tuberculosis and has followed health officials’ lead in handling the matter.