MACOMB COUNTY, Mich. – The Michigan Department of Health and Human Services answered questions regarding tuberculosis after patients were potentially exposed to the illness over a nine month period at three Metro Detroit clinics.
An investigation started after the state was alerted that an individual had TB in November 2019. This led to testing of employees at the clinics, and the diagnosis of an ill employee.
The sick employee worked at Lakeview Pediatrics and its Ascension Medical Group Michigan locations in Macomb Township, Rochester and St. Clair Shores.
Ascension Medical Group Michigan has set up a call center for scheduling tests and responding to questions. The call center is open from 8 a.m. to 7 p.m., Monday through Friday, and from 9 a.m. to 1 p.m., Saturday. It can be reached by calling 855-757-4376.
Below are answers from Lynn Sutfin, with the Michigan Department of Health and Human Services, regarding the issue.
Local 4: Per the state press release, in 2018 there were 108 cases of TB reported in Michigan – yet we didn’t get 108 press releases. What is the usual threshold for broad notification of the public?
Sutfin: This was a large scale patient notification that was likely to result in questions from the public and the media. The press announcement was designed to acknowledge awareness of the situation and direct inquiries to appropriate parties. Also, it is common practice to send out news releases when the individual with TB is a healthcare worker who potentially sees individuals with weakened immune systems in multiple jurisdictions. We did so in February 2018.
Local 4: Talk about the process of tracing the contacts of a person that is found to have TB. I.e. what happens when a case of TB is reported to the state.
- Once a person is diagnosed with TB, this information is relayed to their local health department.
- The individual is interviewed by a health department staff member. They are asked about close contacts (family, friends co-workers who may have been exposed to TB) and where they have been since the initial onset of TB symptoms. This may require several conversations to gather information, as people will often remember additional information at a later date.
- The local health department then prioritizes these contacts in tiers, reaching out to those with the most and closest contact first (the first tier), offering TB testing.
- If people in the first tier have positive TB test results, the investigation may be expanded to include people in other locations or with less contact (second or third tiers).
- This process can take from a few weeks to a couple months depending on the number of contacts in each tier.
- There are two kinds to TB tests, skin and blood. In both cases results can be obtained in a couple days. In certain situations, TB testing may be repeated to verify the first result. Contacts who have a positive TB test result will generally receive a chest x-ray to check for signs of active TB disease in their lungs.
Local 4: What is the primary message you want to send to the patients of these practices?
Sutfin: That the threat to the public has been abated and notifications are going to out to potentially exposed persons to encourage testing and evaluation for TB.
Local 4: Was the health care worker’s case found through a routine annual test or as part of the investigation into the individual with TB?
Sutfin: During the investigation it was determined to screen and test associates at the clinic(s).
Local 4: Is it possible to definitively link the case outside of the practice to the healthcare worker?
Sutfin: We cannot definitively link the case outside of the practice to the healthcare worker.
Local 4: How long did it take for patients of those practices who were potentially exposed to be notified after the healthcare worker was confirmed to have TB? Why did it take that number of days?
Sutfin: Once the TB diagnosis was confirmed it was necessary for the health system to determine the work history of the impacted associate during the potential period of infectiousness and then connect that with patient records to best target persons who should receive notifications. This took several days. The news release was issued to amplify these notifications.
TB symptoms can include:
- A bad cough that lasts three weeks or longer
- Pain in the chest
- Coughing up blood or sputum (phlegm from deep inside the lungs)
- Weakness or fatigue
- Weight loss
- No appetite
- Sweating at night