By NANCY WEST, InDepthNH.org
An adult who was recently diagnosed with tuberculosis spent time in a childcare center in Manchester while infectious, according to a statement from the state Department of Health and Human Services.
The statement Saturday doesn’t say which center, but did say the individual is no longer in the childcare environment and all staff and families of students who may have had contact with the individual have been notified.
The statement was released Saturday after InDepthNH.org asked about a health alert issued by the NH Health Alert Network to healthcare providers Friday.
DHHS and the Manchester Health Department are also working to identify others who may have had prolonged exposure to the infectious individual, according to the statement.
DHHS will make available any further information about this investigation that may have an impact on the public’s health, according to the statement.
“Individuals exposed to the bacteria that causes TB will need follow-up with their healthcare providers to be evaluated for TB infection. In addition, children under the age of 5 and people with weakened immune systems may need proactive treatment to prevent the progression of TB,” according to the statement.
“DHHS has informed healthcare providers of patient monitoring and treatment protocols to ensure proper care of any child who may have been exposed. Any families with concerns about their child’s exposure should contact their child’s healthcare provider.”
DHHS and MHD have not identified any related TB infections to date.
“All families of students who may have had contact with the individual have been notified, so if a family hasn’t received a notification, their child does not attend the impacted childcare facility. We are not releasing the name of the childcare facility to protect the privacy of the individual and the families who have been impacted,” DHHS said.
The infectious individual is receiving voluntary in-patient care, DHHS said.
A letter from Dr. Ben Chan, state epidemiologist, and Elizabeth Talbot, MD, deputy epidemiologist, to healthcare providers dated Aug. 16 contained more details.
The letter said the person had been present in a Manchester, NH childcare facility during their infectious period from March 1 – Aug. 6, 2024. The letter was distributed to healthcare professionals through the NH Health Alert Network.
“All children who attended and staff who worked at this facility during this period are considered exposed and being notified by NH DPHS to seek care with their primary care provider,” the letter said.
“We are requesting that you evaluate this child as soon as possible to rule out active disease, determine if infection has occurred, and consider window prophylaxis for those who qualify. Window prophylaxis is appropriate for all asymptomatic children who are younger than 5 years of age, and any person who is immunocompromised who do not have evidence of active TB disease and while waiting for latent TB infection test results.
“This window prophylaxis is important because these persons are at high risk for developing active TB disease and disseminated infection,” the letter said.
Window prophylaxis is treatment given to people even if they have a negative TB blood test or TB skin test result, according to the CDC. Treatment is given because it can take 2 to 8 weeks after TB infection for the body’s immune system to be able to produce a response to a TB blood test or TB skin test.
According to the Department of Health and Human Services website, New Hampshire is one of the lowest incidence states for TB in the nation, averaging 20 cases of active disease annually.
The highest risk factor for a TB diagnosis in New Hampshire is having been born in a foreign country where TB is commonly seen.
CDC Materials for Providers: https://www.cdc.gov/tb/hcp/clinical-overview/index.html
For questions about this situation, please contact the NH Division of Public Health Services (DPHS) at 603-271-4496 (after hours 603-271-5300), according to the health alert to healthcare providers.
According to the Centers for Disease Control, tuberculosis (TB) is caused by a bacterium (or germ) called Mycobacterium tuberculosis.
TB usually affects the lungs. TB can also affect other parts of the body, such as the brain, the kidneys, or the spine. TB can also affect multiple parts of the body at the same time. For example, TB can affect both the lungs and lymph nodes.
Not everyone infected with TB germs becomes sick. As a result, two TB-related conditions exist: inactive TB (or latent TB infection) and active TB disease.
If not treated properly, TB disease can be fatal, according to the CDC.
TB is spread through the air from one person to another. The TB germs are put into the air when a person with active TB disease of the lungs or throat coughs, speaks, or sings.
