Brentwood School District remains open; 5 TB cases are latent

Brentwood Borough School District will remain open as officials there and at the Allegheny County Health Department continue to investigate the presence of tuberculosis in a student and five employees.

Amy Burch, the school district’s superintendent, said an informational meeting with staff Nov. 9 went “extremely well.” The meeting came on the heels of the district’s discovery of latent tuberculosis in five employees following an active TB case in a student.

“As with any new situation, there is a fear of the unknown,” Burks said. “But now that (teachers) have the information, it’s up to them how they process that. But we see no reason for the schools to be closed.”

The five employees were tested and found to have latent TB, meaning they are not infectious, said Aaron Aupperlee, a county health department spokesman.

But that doesn’t mean the school and the health department will stop investigating for any other possible exposures or active cases. Burks said 118 students will be tested Nov. 16 and 17. It will take 10 days from then to get results back. Once those results are in, the school district and health department will host another informational meeting for parents of the district.

Aupperlee said more testing may be needed “depending on the results of these initial tests.” He said the health department does not know how large the investigation will be.

Tuberculosis is a rare disease in the U.S., said Briana DiSilvio, a pulmonologist at AGH Hospital. The doctor also works at the Allegheny County Health Department’s Pulmonary Center.

A 2017 report conducted by the Centers for Disease Control and Prevention said tuberculosis is “one of the most common infections in the world” with an estimated 2 billion people infected. With an average of 1.6 million deaths every year, the disease has been known as “the leading cause of death due to infectious disease in the world.”

Yet, in the U.S., the CDC reported only 8,916 cases in 2019 — the lowest number of cases on record since 1953, the first year the agency began nationwide reporting.

The case count gives the country a rate of 2.7 cases per 100,000 people.

But latent tuberculosis is more common, DiSilvio said, citing CDC data that estimates 13 million people in the U.S. have latent TB.

“So it’s not surprising that while contact tracing you come across latent TB because it is so much more prevalent,” she said. The five employees who tested positive for latent TB could have already been exposed earlier in life, DiSilvio said, or they could have been exposed to it by the student and their immune systems were strong enough to fight off clinical manifestations of the disease.

It would be surprising — and concerning — to have five additional active cases, she said. That’s because the initial active case was a student who is currently doing remote learning.

The pulmonologist said local spread among U.S.-born citizens tends to be in high-volume areas such as prisons, homeless shelters and other close-living quarters. The disease is spread by inhaling an infected droplet of liquid expelled into the air from a cough or a sneeze — or even through singing or talking. The disease cannot be spread through surfaces.

DiSilvio said most active cases in the U.S. are among foreign-born individuals. The most common among those cases is known as reactivation TB, where someone had exposure to the disease anywhere from one to 20 years prior but developed symptoms later in life because of a compromised immune system.

So the five employees with latent TB could later develop symptoms as they age or if their immune systems become compromised, she said.

The presence of latent TB at the school district makes even more sense with the current measures in place to curb the spread of covid-19.

“You have people wearing masks and shields. Some schools have desks with plastic shields between them. People are taking steps with limiting covid — those steps are effective in limiting the spread of TB, too,” DiSilvio said.

The school district has implemented a hybrid learning model for its students and teachers since Aug. 31. That means two separate groups attend schools just two days a week. All students engage in remote learning on Wednesdays.

According to the school district’s website, nine students have tested positive for covid-19 since Oct. 2, with the latest case reported Nov. 10.

The presence of tuberculosis in the school district does not mean everyone should scramble to get tested.

“No one should seek TB testing unless they have been contacted by the Health Department or the school district,” Aupperlee said, adding the health department will arrange to bring testing to them.

TB tests can be sought out through the health department’s Pulmonary Center for $25 or $35, depending on the type of test. But Aupperlee said it’s not recommended, again emphasizing people should get tested only if there is an indication they have been exposed.

Symptoms of TB can include a cough of longer than three weeks, unexplained weight loss, night sweats, chills, fever and coughing up blood. Symptoms for TB do not come and go; they become worse with time.

For details, call the TB clinic at 412-578-8162.