NORTH COUNTY: Workers at Tri-City, Palomar exposed to tuberculosis patient
Officials say risk of outbreak is very low
By DAVID GARRICK - Staff Writer | ∞
NORTH COUNTY ---- A man diagnosed with tuberculosis came into contact with a dozen medical workers and some patients at Tri-City Medical Center on Sept. 8, according to a Tri-City spokesman.
But medical officials said it was unlikely that the exposure was long enough to spread the potentially deadly lung disease.
The man also came into contact with three medical workers at Palomar Medical Center and two ambulance paramedics when he was transferred from Tri-City to Palomar later that day, said Joyce Agorrilla, Palomar's manager of infection control.
No patients at Palomar were exposed because the man was taken directly to a private room, Agorrilla said.
Tests already have determined that the Palomar employees do not have tuberculosis, hospital spokesman Andy Hoang said.
Officials from the ambulance company did not return phone calls Monday.
It won't be determined until November whether the 12 employees at Tri-City have contracted the disease, because the hospital uses a less advanced testing method.
Tri-City's method takes eight to 10 weeks, while Palomar's takes one to two days, officials said.
The man spent about 4 1/2 hours in the Tri-City emergency room Sept. 8, hospital spokesman Jeff Segall said.
Segall said he was unsure how many patients might have come into contact with the man, but that concern was low, because they would have had much less close contact with the man.
While he was in the emergency room, hospital personnel did not diagnose him with tuberculosis despite performing an examination and taking a chest X-ray.
Dr. Gene Ma, director of Tri-City Medical Group, said the patient's X-ray showed no signs of the infection.
"The preliminary diagnosis was that it looked like pneumonia," Ma said.
He said diagnosing tuberculosis requires a series of three tests and generally takes longer than the time the man spent at Tri-City.
The man was then transferred from Tri-City to Palomar at the request of Kaiser Permanente, his insurance provider.
Once at Palomar, he was diagnosed with tuberculosis and warnings were issued to all medical personnel who came into contact with him, Hoang said.
The patient was in isolation during his stay at Palomar, which ended with a Sept. 28 discharge, Hoang said.
The typical symptoms of tuberculosis are a chronic cough, fever, night sweats, weight loss and coughing up blood.
According to the Centers for Disease Control in Atlanta, tuberculosis is usually spread through the air by sneezing or coughing.
A latent type of tuberculosis infection, when one shows no symptoms and does not feel sick, cannot be spread to others.
Jose Alvarez, a spokesman for the county's Health and Human Services Agency, said contracting tuberculosis typically takes eight to 16 hours of exposure to the disease.
Agorrilla, Palomar's infection control manager, said it usually takes many hours of exposure for someone to contract tuberculosis. She also said people can live in the same house with a tuberculosis patient and not get the disease.
Contact staff writer David Garrick at (760) 740-5468 or dgarrick@nctimes.com.
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Are You Kidding Me wrote on Oct 6, 2008 7:54 PM:Alrighty then, can anybody explain why Tri-City would use a testing method that takes eight to 10 weeks for a result, while Palomar's takes one to two days?
Where's the logic in that?
No worries wrote on Oct 6, 2008 11:01 PM:As long as they people were healthy there should be no problems.
web blogg wrote on Oct 7, 2008 2:57 AM:On the other hand, a negative test does not always mean that a person is free of tuberculosis. People who have been infected with TB may not have a positive skin test if their immune function is compromised by chronic medical conditions, cancer chemotherapy, or AIDS. Additionally, 10%-25% of people with newly diagnosed tuberculosis of the lungs will also have a negative result, possibly due to poor immune function, poor nutrition, accompanying viral infection, or steroid therapy. Over 50% of patients with widespread, disseminated TB (spread throughout the body, known as miliary TB) will also have a negative TB test.
from the medicinenet.com so in other words - the test on skin in two days can be a postive reading for something else and then :\ not really tb . and you dont want to X-ray a bunch of people either that are exspoed to xray alot. theres alot to those the artical could of come up with. please have a reporter explain these nest time.
CITIZEN AT RISK wrote on Oct 7, 2008 8:43 AM:Another gift that keeps on giving from South of the border - down Mxxico way.
Shame on NCT Staff Writer wrote on Oct 7, 2008 8:56 AM:The writer of this column should really do his homework prior to writing or making such slanderous statements against Tri City Medical Center. Facts are great...if you know how to report them! Mr. Garrick....God Bless you when you get sick next time and need taken care of at your local hospital.
Joan wrote on Oct 7, 2008 1:34 PM:The test that takes longer is cheaper. That's the reason. Also, Palomar Hospital is lying to the press. 100 employees have tested positive for a latent TB strain. They have to take a potentially liver destroying medication. TB is AIRBORNE. You can't contain it.
To Citizen at Risk wrote on Oct 7, 2008 3:07 PM:1. The patient was never identified.
2. If you think Tuberculosis only comes from Mexico you need to go back to school.
3. The man was insured by Kaiser Permanente
4. The only thing you're at risk for is continued ignorance.
Truth wrote on Oct 7, 2008 3:31 PM:You are wrong... the 100 people tested was at Tri City. They failed to pick up on the typical signs of TB so this patient sat in their facility for several hours exposing people there. When he arrived to Palomar, the staff noticed the signs and put him in isolation as a precaution and tested him for TB.
The other test is not cheaper, not as accurate and takes longer. The blood screen for TB is more efficient and effective.
Seems like Tri City is trying to spin and shift blame for the fact that they missed the typical TB signs in this patient.
Why is it that Tri City always seems to be years behind in health care? Everytihng from TB testing, to trying to pass a bond measure to having quality leadership.
Quantiferon TB wrote on Oct 7, 2008 4:45 PM:Tri-City has the same blood test available. It's called Quantiferon TB Gold. You test right after exposure and then a second time eight to ten weeks later. You test the second time no matter if you use the blood or skin test. Check the CDC site. Palomar is wrong or mis-quoted.
Yes this is scary wrote on Oct 7, 2008 6:55 PM:I do believe being a border town we are at risk for other illnesses, however, go to Disneyland or Legoland. Look at all the tourist there from other countries. A simple cough is all it takes and it can spread like October wild fires. I don't think anyone does this on purpose of course, but it is happening.
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