336 screened to find who is behind TB outbreak

AS many as 336 people have been screened for Tuberculosis, half of them twice, in an effort to identify who is behind an outbreak of the disease in a Cork primary school where 48 people have been infected.

Parents of the 217 children attending Scoil Iósaf Naomha, Crab Lane, Ballintemple, outside Cork city, yesterday received a letter from the Health Service Executive (HSE) confirming that active TB has not been detected in any adult linked either directly or indirectly to the school.

“This, despite screening of current staff, past staff and other adults who spent periods either within the school premises or in relation to school activities outside,” the letter said.

The source of infection is more likely to be an adult because children’s lungs, particularly those aged under 10, haven’t developed to the stage where they would cough up sputum (phlegm) containing the TB germ.

In addition to the pupils, 19 staff were screened and over 100 close contacts of the children. The HSE said a small amount of screening outside the school population remains outstanding.

While the HSE said they have not succeeded in identifying the source of infection since the first case was notified to public health officials on July 29 last, chair of the outbreak control team Dr Margaret O’Sullivan said they were “confident” that they could explain the “spread of infection”.

Dr O’Sullivan said in the letter that this confidence was based on “the main pattern of findings” within the school population, “in conjunction with findings from the wider population”. What this actually means was unclear and the HSE last night declined to provide any clarification.

Dr O’Sullivan, a consultant in public health medicine, also said the investigation had “revealed a very high degree of close interaction between many of the children/families in the community”.

Fortunately, the strain of TB involved has responded to first line TB drugs. To date, seven children at the school have full-blown or active TB, 37 have latent TB infection and five staff have latent TB, which is not contagious. All are on antibiotic treatment and, according to public health officials, are not infectious.

On foot of the outbreak, 104 children have been vaccinated against TB. All 170 children who took part in the second round screening were offered the BCG vaccine. The vaccine was not routinely available to newborns in Cork city until two years ago, at odds with national HSE policy.