500 may be exposed to tuberculosis at Omaha childcare center

The Douglas County Health Department was notified of the case Monday by the patient’s health care provider and learned of the childcare center’s involvement Tuesday, said Justin Frederick, the department’s deputy director. The patient tested positive for the bacterial infection over the weekend. 

The number of possible exposures and the fact that young children are involved — the center cares for children from 3 months to 12 years of age — has triggered a complex multi-agency response that came together over 48 hours, Frederick said. 

“Young children are at increased risk of severe disease,” he said. “So our goal and our mission is to prevent any additional cases of tuberculosis and to catch them quickly, and to be able to get them treated.” 

Possible exposures may have occurred from late May to Oct. 30. However, he said, health officials have determined that the patient likely was most infectious between mid-August through late October. 

The patient is isolating at home and undergoing treatment. The patient is believed to be doing well.

The health department worked with the YMCA and identified two groups: Those at highest risk of developing disease, who had potential exposures within roughly the last 10 weeks, and those at lesser risk, who had possible exposures from late May to Aug. 21. 

The YMCA, which is situated near 156th and Ida Streets south of Bennington, on Thursday sent emails to parents and guardians of children who used the center. Those with possible exposure were advised of the steps they need to take next. Those who were not believed to be exposed were told that they did not need to take action. Health officials estimated that about 50 people attended an informational meeting Thursday evening at the YMCA.

Brian Jeter, who has four children (ages 7, 5, 3 and 8 months) who have used the center, said after the session that health officials did a great job of explaining the situation.

“It’s really just trying to help the community make sure more folks don’t get TB,” he said.  

Jeter said he wanted to hear the recommendations regarding testing. He said he also appreciated the work put in by staff at the YMCA and others to pull records together and identify children who were potentially exposed. 

“Forty-eight hours is a pretty good turnaround,” he said. 

Lindsay Huse, Douglas County health director, said there is no concern about continued exposures at the facility now that the patient is no longer present.

Transmission requires close, prolonged contact, which includes being in the same room as an ill person but does not include brief exposures in a  hallway, restroom or gym. 

All children potentially exposed between May 30 and Oct. 30 should be tested for tuberculosis and receive treatment if they test positive, health officials said.

But children 4 years of age and younger who were exposed between Aug. 21 and Oct. 30 should also receive preventive treatment with antibiotics, Frederick said. Young children are more likely to progress more quickly to active disease than older children and adults, who may develop latent disease that may not become active for years, if ever. 

Children’s Nebraska will hold clinics Saturday and Sunday to test and evaluate the just more than 200 children ages 4 and younger believed to have been exposed during that recent 10-week period. 

The health department, he said, will hold clinics at the YMCA each day Wednesday through Friday, Nov. 15 to 17, to test more than 350 other children and staff members identified as having exposure.

Huse also planned to declare a public health emergency, which would allow the department to access additional resources. Such a measure is not the same as a directed health measure and will have no effect on others in the community. 

Frederick said health department officials have consulted with experts at the federal Centers for Disease Control and Prevention, who have called it the largest tuberculosis investigation in the Midwest.

“This in my opinion is a true public health emergency in the fact that it really could cause widespread illness,” he said.

Tuberculosis is a disease caused by airborne bacteria spread through coughing, sneezing or speaking, according to the Centers for Disease Control and Prevention. It can’t be spread through such things as kissing, shaking hands or sharing food and drink.

The bacteria usually affect the lungs but can attack any part of the body such as the kidney, spine, and brain.

Symptoms include a cough lasting three weeks or longer, chest pain and coughing up blood or mucus. Other symptoms include weakness or fatigue, weight loss, loss of appetite, chills and fever.

But Frederick stressed that tuberculosis is treatable. The department investigates all active cases reported in the county, Frederick said. Fifteen have been reported so far this year and 15 were reported last year. According to CDC, more than 8,300 cases were reported in the U.S. last year.

Parents or others with questions can call the health department’s information line at 402-444-3400.