Health Advisory
TUBERCULOSIS INVESTIGATION CONTINUES AT NURSING HOME

The Delaware Division of Public Health is investigating an increase in reported cases of Legionnaires' disease. At this time, the cases appear to be sporadic. No common source of exposure has been identified. DPH is continuing its investigation into these cases.

The following is content from a media release issued by the Division of Public Health on July 22, 2003. Questions about this advisory should be directed to 1-888-295-5156

Delaware's Division of Public Health (DPH) has not identified additional cases of tuberculosis (TB) as a result of its investigation of an employee with the disease at Gilpin Hall nursing home in Wilmington. To date, the investigation has not identified any risk of TB to other employees at the nursing home, residents, or the public.

DPH and Gilpin Hall have given TB skin tests to all 118 residents, and 24 adult daycare clients. In addition, 123 employees of the nursing facility were skin tested as part of this investigation or recently received a routine skin test.

Individuals with a positive skin test do not necessarily have TB disease. About 10-15 million people in the United States would be positive if skin tested. The vast majority of people with a positive skin test never develop TB disease and are never contagious to others. The following procedure is used to assure that people with a positive skin test do not have active TB disease:

• People with a positive skin test receive a chest x-ray and physical examination for evidence of active TB disease.
• Those with a suspect chest x-ray or physical examination submit a sample of sputum (mucous from deep in the lung), which is tested for evidence of TB. This test can be done quickly, but the results are considered preliminary. The TB bacterium is also cultured (grown) from the sputum. A positive culture confirms active TB disease, but the test takes two weeks or more.
• Those lacking evidence of active infection based on the chest x-ray and physical examination usually receive antibiotics to further reduce the likelihood that they will someday develop active TB disease.

Of the 265 people skin tested at Gilpin Hall, nine residents, five staff, and five adult daycare clients had positive skin test results. All nine residents had negative chest x-rays indicating that they do not have TB. The five positive staff members will remain out of work until DPH has evaluated their chest x-rays. The five adult daycare clients are also excluded from attending the facility until their chest x-rays indicate that they do not have active TB disease.

TB is a bacterium that is inhaled into the lungs after a TB-infected person coughs or sneezes. People with TB disease are most likely to spread it to people they spend time with every day, such as family members, friends and coworkers. Signs and symptoms of TB include a strong cough that lasts more than two weeks, coughing up blood or sputum (mucous), chest pain, weakness or fatigue, weight loss, appetite loss, chills, fever and night sweats.

Gilpin Hall has taken appropriate actions in response to this situation. The facility has been fully cooperative with the investigation. DPH will continue to monitor the progress of this effort.