From Cayman Islands Department of Health

Tuberculosis at Hospital

The Public Health Department advises the public that four patients are receiving treatment for tuberculosis (TB) at the Cayman Islands Hospital.

Since the beginning of 2015 there have been seven cases. Officials are investigating persons with whom patients may have come into contact to determine the possibility of exposure and to test those individuals as soon as possible.

“Tuberculosis is an airborne disease caused by germs that are spread from person to person. It usually affects the lungs, but can also affect other parts of the body, such as the brain, the kidneys, or the spine. TB germs become airborne when a person who has the disease in the lungs or throat coughs, sneezes, speaks, or sings. Persons who have close contact for a prolonged period of time with an infectious patient (i.e. household members, coworkers in enclosed areas, etc.,) are at higher risk of contagion,” said Acting Medical Officer of Health, Dr Williams-Rodriguez.

Patients who have received adequate* treatment with regular anti-TB medications for two weeks are usually no longer infectious. In fact, if a patient is improving clinically with medication, the possibility of infecting other persons is “very low”, according to the Pan American Health Organisation (PAHO) and the World Health Organisation (WHO).

Reassuring the public, Dr Williams-Rodriguez said: “We are following international standards in responding to these cases and are working assiduously to prevent transmission of tuberculosis in the Cayman Islands. All findings will be communicated accordingly’’.

Dr Williams-Rodriguez expressed full confidence in the medical team in charge of the care of these patients, and expects patients will have a prompt and complete recovery.

Expanded Programme on Immunisation Manager, Nurse Angela Graham, stressed the importance of vaccination to mitigate infections or transmission.

“One vaccine approved by WHO to combat tuberculosis infection is already routinely given in the Cayman Islands as part of the immunisation schedule. The combined Bacillus Calmette-Guerin (BCG) vaccine is part of the routine Childhood Immunisation Schedule, and is offered at six weeks. When given under one year, it provides protection for children against the most severe forms of TB”

The Public Health Department maintains adequate stocks of the vaccine and parents/guardians are asked to check the records of their child or children to ensure appropriate vaccination.

Since 2010 there have been 23 confirmed cases of TB. Twenty one of these were pulmonary, and two were extra pulmonary. Of the 23 cases eight nationalities were identified.

Officials say people can protect themselves from TB by understanding what TB is and how it is spread. Persons who think they may have been exposed to someone with TB should contact their doctor or the Public Health Department.

Symptoms of tuberculosis include weakness, weight loss, night sweats, sneezing, a severe cough (usually for more than three weeks), spitting up phlegm and blood and a high fever for three or more days. Anyone who presents with these symptoms is asked to contact their doctor immediately so that care and contact tracing can be further pursued.

For information regarding immunisations, contact your private doctor or the following district health centres:-

Public Health Department (George Town): 244-2648

West Bay Health Centre: 949-3439

Bodden Town Health Centre: 947-2299

East End Health Centre: 947-7440

North Side Health Centre: 947-9525

Faith Hospital, Cayman Brac: 948-2243

Little Cayman Clinic: 948-0072

Further information on TB may be sought by accessing the following link http://www.cdc.gov/tb/publications/faqs/pdfs/qa.pdf

Patient Information: Tuberculosis (The Basics)

What is tuberculosis? — Tuberculosis is an infection that usually affects the lungs. It is not very common in the United States. But in other parts of the world, tuberculosis is still a serious problem. Tuberculosis is sometimes called “TB.”

How does TB spread? — You can catch tuberculosis from anyone who is sick with TB. The germ that causes TB can travel in the tiny drops of fluid that spray when a person coughs or sneezes. If you inhale those drops, you can get infected.

What happens if I get infected with TB? — If you get infected with TB, you probably will not get sick right away. Instead one of two things might happen:

• Your body’s infection fighting system, called the immune system, might kill off the germs that cause TB. If that happens, you will not get sick with TB.

Your body’s immune system might be able to control the germs but not completely kill them off. This is called “latent TB.” People with latent TB do not get sick right away, but they can get sick later on.

People who are sick with TB have what doctors call “active TB.”

What are the symptoms of active TB? — The symptoms of active TB can include:

●A cough that lasts a long time

●Fever

●Sweating at night

●Losing weight without trying to

Should I see a doctor or nurse? — See your doctor or nurse if:

●You have been near someone who was sick with TB

●You have a cough that has lasted longer than three or four weeks and does not seem to be getting better

●You have other symptoms of TB, such as fever, sweating at night, and unexpected weight loss

Is there a test for TB? — Yes. Your doctor or nurse can test you for TB by giving you a shot that contains tiny pieces of the dead TB germ. You will get the shot in the arm. Then, two or three days later, your doctor or nurse will need to look at the spot where you got the shot to see if you form a bump, and to see how big the bump is. Only a doctor or nurse can tell whether the bump from a TB test is positive or negative.

There is also a blood test for TB. But that test is not available everywhere.

What if my TB test is positive? — If your TB test is positive, you will probably need treatment. But the treatment will differ depending on whether you are sick.

People who are not sick and have latent TB must take medicine every day for three to nine months. People who are sick with active TB must take four different medicines every day for at least two months. After that, some people can go down to two medicines, but all people must keep taking some medicines for another four months. That means that treatment for active TB lasts at least six months total.

If your doctor or nurse gives you medicine to treat TB, it is very important that you take it all. It is hard to take medicine day after day for months. But if you do not take all your medicine, you could get sick with TB, or the medicine could lose its effect. If the medicine loses its effect, the infection can become even harder to treat.

TB is a serious disease. It can lead to death. That’s why it’s so important that you take treatment very seriously.

Patient information: Tuberculosis (Beyond the Basics)

All topics are updated as new evidence becomes available and our peer review process is complete.

This topic retrieved from UpToDate on: Sep 30, 2015.

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