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Delaware County reports a tuberculosis case in a middle school

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Delaware County health officials said Monday that they had identified a case of tuberculosis in a person who attends Penn Wood Middle School in Darby.

Tuberculosis bacteria spread through the air when an infected person coughs, speaks, or sings, according to the Centers for Disease Control and Prevention. Known as "TB," the disease is not as contagious as a cold or the flu, county officials said in a news release. To catch it, a person would have to spend at least 15 hours in close contact with an infected person, officials said.

"There is not a risk to the general public at this time," said Melissa Lyon, the county's public health director. She added that the department is confident it will be able to trace the patient's close contacts and test them for tuberculosis as well.

TB does not spread by shaking hands, sharing food or drinks, touching bed linens or toilet seats, sharing toothbrushes, or kissing, according to the CDC.

"People with TB disease are most likely to spread it to people they spend time with every day," the agency writes in an online explainer. "This includes family members, friends, and coworkers or schoolmates."

When someone breathes in TB bacteria, they can settle in the lungs and potentially spread to other parts of the body, including the kidneys and spine, the CDC says. Outside of the lung, TB bacteria are usually not infectious.

A person's risk for contracting tuberculosis depends on the level of contact with a person who is infected.

"There's a higher risk depending on time and what they're expelling into the air," said Eric Sachinwalla, the medical director for infection prevention and control for Einstein Healthcare Network, which is part of Jefferson Health. "If you're standing right next to someone who's actively coughing, that's higher risk. If you're in the room where someone is actively coughing, there's less risk, and even lower risk if the person isn't actively coughing."

Few details were released about the case identified in Delaware County. Lyon would not specify whether the person infected with tuberculosis was a student, a teacher, or another staffer at the school.

Lyon said officials learned about the case through "regular reporting from a healthcare setting." Tuberculosis is one of about 75 diseases required to be reported to public health officials when diagnosed.

Lyon said her department is working to identify potential exposures, looking through classroom and bus seating charts and extracurricular activities, and setting up testing for people who came into close contact with the person infected. The number of close contacts may be smaller than expected, Lyon said. Classes at Penn Wood last about 80 minutes, and students spend about six hours in a given classroom per week.

"Whether it's a teacher or a student, that's still not quite the 15 hours," she said.

Health officials stressed that not everyone exposed to tuberculosis becomes sick and that students and staff can continue to attend school.

Tuberculosis can exist in the body without symptoms, a condition called latent TB infection. People infected with latent TB can't spread the bacteria to others but usually will test positive for TB and might develop the disease later if not given treatment, the CDC says. The case at Penn Wood is not latent, Lyon said.

Sachinwalla said it's uncommon for people to show symptoms of tuberculosis after an exposure, but it is possible. Symptoms include unexplained fevers, night sweats or chills at night, or a new or worsening cough.

Treatment for active tuberculosis requires about six months of antibiotics, and patients with an active infection are isolated until they can no longer spread the bacteria to others.

"It depends on how severe the original infection was," Sachinwalla said. "It can take weeks or sometimes much faster."

Questions about testing and exposure can be directed to the Delaware County Health Department Wellness hotline, Monday through Friday between 8:30 a.m. to 4:30 p.m., by phone at 484-276-2100 or by email at DelcoWellness@co.delaware.pa.us.

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