Was their child exposed? What symptoms should they be looking for?
These are among the concerns that likely arose when parents of Vista Murrieta High School students were alerted Thursday that a student had tested positive for active tuberculosis.
“I have been more than a bit on edge since getting the email…As a parent, there is nothing more stressful than the idea that your child may have been exposed to this terrible disease,” said Christy Reichenbach, whose daughter attends the high school and son is a 2013 graduate.
But Reichenbach was also grateful for the notification.
“While the likelihood of transmission is very low it is imperative that it be regarded with our highest concern,” Reichenbach said. “As a community we should be grateful to the school district’s prompt and thorough communications with us all regarding this very serious matter.”
The Vista Murrieta case was the second reported in the city this year. In June, an employee of Rancho Springs Medical Center was diagnosed with tuberculosis.
Abbreviated as TB, tuberculosis is a bacterial disease that attacks the lungs but can also infect other body parts such as the kidney, spine and brain, according to the Centers for Disease Control and Prevention. If not treated properly, it can result in death.
TB bacteria is spread through the air when the infected person coughs or sneezes. It can also be spread when they talk or sing.
The infected person will have symptoms that include a bad cough that lasts for more than three weeks, pain in the chest, coughing up blood or mucus, weakness or faintness, loss of appetite, weight loss, chills, fever and night sweats.
Although there have been no Riverside County deaths attributed to TB in recent years, the County of Riverside Department of Public Health closely monitors the disease.
Thus far in 2013, Riverside County Department of Public Health Director of Disease Control Barbara Cole said there have been 42 cases reported countywide. In 2012, there were 56 reported cases, in 2011, 68, and in 2010, 74, Cole said.
Physicians and laboratories are required to report positive TB tests to the department, she said.
Then, as was the protocol when the Rancho Springs employee was diagnosed in June, county officials and the Murrieta Valley Unified School District were required to notify anyone who may have been exposed to the disease and require that they be tested.
No additional active cases came as a result of the Rancho Springs case, she said.
Cole said the department was notified of the Vista Murrieta case on Oct. 29, and in turn notified the Murrieta Valley Unified School District.
“There is no outbreak,” Cole said. “We have an individual case right now and the reason for informing people is so they can be aware of the situation...We don’t want them to hear it secondhand.”
Officials did not provide the identity of the infected student, citing confidentiality reasons. The student has not been in school since last week, is being treated and will not be allowed to return to campus until they are medically cleared to do so, officials with the district and county said in a joint statement.
There is a total enrollment at the high school of 3,460. Of those, calls went out Friday to parents of 261 students who may have been exposed to the disease, notifying them of an upcoming TB clinic.
“At this point in time, 261 students have been identified,” MVUSD Spokeswoman Karen Parris said late Friday afternoon. According to Parris, that includes those who have classes with the infected student.
Vista Murrieta parent Lisa Baker told Patch she was among the parents who received that notification Friday. She said she wished for a speedy recovery for the ill student, and was hopeful everyone else on campus will turn up healthy.
“I think very highly of our school and our school district and have confidence that they will take all precautionary measures that any student or staff member will be tested,” Baker said. “The school notified me that the incubation period is 2-10 weeks which is why the students will not be tested until the 19th. I'm not sure if my daughter is at risk because she had a class with the ill student or because she is a cheerleader and is in a lot of our schools activities. I have notified my daughter’s doctor of this and will have her tested at the school come November 19th.”
The clinic will be held during school hours, Cole said. Students whose parents were notified of their risk of exposure will be asked to take a skin test. From there, students whose skin tests positive will be asked to take a chest X-ray. If they show no outer symptoms but their X-ray comes back positive, Cole said that means they have a dormant case of TB.
“If they are not sick or contagious, we would be offering treatment so they wouldn’t go on to develop active TB,” Cole said.
Reichenbach was not one of those parents to receive a second phone call, but she sympathizes with those who have.
“I have it on good authority that any students who are at risk will likely be contacted today, and I know many parents are holding their breath hoping and praying that they do not receive such a dreadful call,” Reichenbach said. “I hope as a tight knit community of Broncos we can try and be supportive and kind and not inject the bitter hostility and judgment often seen on many of the comment sections of these articles. It doesn't help ease the worried minds of the many wondering 'what if.’”
Citing an active case that was reported at Vista Del Lago High School in Moreno Valley last year, Cole stressed that there is a low risk that any Vista Murrieta students exposed to this case of TB will contract an active case themselves. Out of all the students tested at Vista Del Lago, Cole said there were no other active cases that came as a result.
“It is not something that happens every year,” Cole said. “But we want to document that every child is OK, and if by chance someone does end up with a positive skin test then there is a process.”
Although the county and district require students to have various immunizations, one for tuberculosis is not among those and is generally not recommended in the U.S., according to the Centers for Disease Control and Prevention.
Previously, the county did require that students who enroll in public schools provide evidence of a negative TB skin test. However, in 2010, that mandate was lifted.
“We did have a mandate that required all first-time entrants to a Riverside County school—K-12, private and public—to have a clearance,” Cole said. “However, after multiple years of doing that...we found that it did not address individuals who were already in school or moving from somewhere else in Riverside County.
“It was not effective. Even though we were identifying people who had a latent skin test, we weren’t really finding active disease through that process. But we still monitor and follow up quickly with any reports from doctors or laboratories.”
For peace of mind, Cole encouraged parents who did not receive a second notification from the district but want to rule out any possibility of the disease to contact their health care provider and request a skin test for their student.