Officials in Nebraska are testing more than 500 children and staff at an Omaha area YMCA drop-in daycare center for possible exposure to tuberculosis after a case at the site prompted a public health emergency.
On Thursday, Douglas County Health Director Lindsay Huse declared an emergency citing the risk of the infectious disease spreading at the Westview YMCA, in the Omaha suburbs. Exposures would have happened between May and late October. The incubation period for tuberculosis is from two and 10 weeks.
The patient has been isolating at home and is undergoing treatment, Huse said. Officials would not say if the person was an adult or child, or identify a gender, but they confirmed the person tested positive on Monday, and a contact investigation prompted the person or relatives to contact the Westview YMCA Childwatch, a daycare where gym members can drop their children off for up to two hours. The fact that the person was in this daycare has made the count of possible exposures especially high. The current estimate is about 500, but the estimate is subject to change as families and siblings are identified and in some cases ruled out.
“It’s not so unusual to find an active TB case,” Huse told USA TODAY. “But what is unusual is just the size of exposure.”
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The infected person was linked to an onset date of symptoms on Aug. 21, requiring health officials to look back to May to fully capture anyone who may have experienced symptoms in prior months they hadn’t thought of as tuberculosis. This makes tracing more difficult, given the number of people coming in and out of the daycare center.
“Just by nature of that, you have a whole lot more exposures that can happen if there is someone in that room that has active disease,” Huse said.
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Exposure to a disease like TB requires being in a small, enclosed area for an extended period, Huse said. In a letter to health providers throughout the county, Huse wrote that people can get infected after someone with tuberculosis germs in their lungs or throat coughs, sneezes, speaks or sings, causing bacilli, or germs, to float in the air that others then breathe.
Tuberculosis symptoms include:
- a cough lasting multiple weeks;
- chest pain;
- coughing up blood or sputum;
- weakness or fatigue;
- chills, fever or night sweats;
- weight loss or no appetite.
On Saturday and Sunday, Children’s Nebraska, a pediatric hospital in Omaha, planned to hold clinics to test approximately 250 children 4 and younger who could have been exposed in the last 10 weeks. Young children are considered high risk because they can become ill quickly, prompting the need for attention sooner than an adult would require, Huse said.
Along with a baseline skin test to look for the disease, hospital staff plan to administer window prophylaxis, a therapy to treat tuberculosis even as a preventative treatment to keep people from getting the disease. In about 10 weeks, the same cohort will get another skin test to confirm infection.
In the coming days, the county is expected to have clinics at the Westview YMCA to test another 350 people using skin and blood tests. Officials will look for latent infection as well, and treat it with medication to ensure it doesn't become active.
In emailed responses, the YMCA of Greater Omaha said the Westview Childwatch maintains electronic records of check-ins, which helped officials conduct contact tracing for possible exposures. There is no longer a risk of exposure to TB at the center, according to the Health Department, the email said, though the Westview YMCA was closed Thursday and the facility planned to remain for several days to give support staff a chance to conduct testing and to get their children tested.
"This was an unfortunate, isolated incident," Rebecca Deterding, the local YMCA's president and CEO, said in a statement. "Everyone who has been exposed at the YMCA has been identified and instructed with next steps for testing."
In 2022, county health officials reported 15 confirmed tuberculosis cases, and 15 through September of 2023. The Centers for Disease Control and Prevention reported 8,300 cases across the U.S. in 2022.
Tuberculosis, formerly called consumption, historically had high mortality rates in the U.S. Deaths and cases have declined dramatically in the past century as a result of rigorous public health efforts.
“This is one of the vintage public health diseases,” Huse said. “We have a lot of experience working on the prevention of spread and case investigations around this.”
Eduardo Cuevas covers health and breaking news for USA TODAY. He can be reached at EMCuevas1@usatoday.com.
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