The Delaware Division of Public Health (DPH) announced this week that over 600 individuals may have been exposed to someone with active tuberculosis (TB) at the ManorCare Health Services Foulk Road facility in Wilmington during a nine-month period in 2017.

Mycobacterium tuberculosis bacteria/CDC
Mycobacterium tuberculosis bacteria/CDC

Consistent with routine Division TB protocols, the agency is sending out letters to former residents and staff of the facility who may have been exposed to the infected individual between January and September 2017. DPH is also following up with phone calls to provide information on free testing and treatment at one of its three clinics in Newark, Dover, and Georgetown.

While the risk of transmission is usually not high, DPH is recommending that those who have been exposed, and test positive after a TB skin or blood test, receive further medical evaluation and treatment so they do not develop complications from TB disease. The Division is providing free screenings and treatment to former residents and employees of the facility receiving the letters. The facility is providing testing and treatment to current staff and residents who may have been exposed during January and September 2017.

To enable staff to reach the large number of individuals who may have been exposed, DPH is opening a call center at its State Health Operations Center in Smyrna. The call center staff will begin making follow-up calls and taking questions from concerned former residents and staff of the facility at 9 a.m. on Tuesday, May 29, 2018. Hours of operation will be 9 a.m. to 4 p.m. The call center will remain open until the bulk of concerns and questions have been addressed. Hours may be adjusted to accommodate for peak volume. Any changes will be communicated through press release and social media communications.

The call center number is 1-866-408-1899.

“This is an all hands-on-deck approach for us,” said DPH Director Dr. Karyl Rattay. “The most important thing we want people to know is that TB is treatable. That’s why it’s so important for us to reach out to all former residents and staff, to encourage them to get tested as soon as possible. Manor house leadership is working closely with the DPH and taking every measure necessary to protecting the health of its residents and staff.”

DPH will offer three open testing days at its clinic at the Hudson State Service Center (HSSC), 501 Ogletown Road, Newark, as the overwhelming majority of former staff and residents live in New Castle County. The open testing dates are June 4, 5 and 6, 2018, from 8:30 a.m. to 11:30 a.m. and 1 p.m. to 3:30 p.m. Testing is for walk-ins only on these days.

Anyone who cannot come to one of the open testing dates should call the DPH Call Center at 1-866-408-1899. Additionally, former staff and residents who live in Kent or Sussex counties are also asked to contact the Call Center, and provide their contact information to staff. Residents in Kent County will receive a call back from Williams State Service Center staff in Dover to schedule an appointment there. Residents in Sussex will receive a call back from Adams State Service Center staff in Georgetown to schedule an appointment there.

Residents in all three counties are asked to bring the letter they received from DPH when they arrive at any site for testing. Any former resident whose mobility makes getting to the clinic sites a challenge, is also asked to call the DPH Call Center to discuss testing options.

Thirty-five former staff and residents are currently living in seven other states. In addition to sending these individuals letters, DPH is coordinating with the states’ public health agencies to ensure the individuals are provided information on the closest public health testing clinic to them.

TB is generally on the decline throughout the country – with 9,557 cases nationwide in 2015 – but vigilance is important. Delaware had 22 cases of TB disease (also known as “active TB”) in 2015, 16 in 2016, 16 in 2017, and seven to date in 2018. As opposed to the latent kind, TB disease cases are defined as having the symptoms of the illness and potentially being able to spread it to others.

TB is a bacterium that can be inhaled into the lungs of others when a nearby person with the active disease coughs, sneezes, sings or laughs. People with TB disease are most likely to spread the disease to people they spend time with every day, such as family or other household members, close friends and coworkers. Signs and symptoms of TB may include a progressively worsening cough that lasts more than two weeks, fatigue, weakness, weight loss, night sweats, fever, chills and chest pain. TB can affect any bodily organ but is infectious to others only when it occurs in the lungs or larynx (voice box).

Only people with TB symptoms can spread the disease. TB is not spread by casual or brief contact such as shaking hands, touching, sharing food or drink, utensils, bed linens or toilet seats, sharing toothbrushes or saliva from kissing.

TB disease is treatable and curable, usually by taking several medications for six to nine months. About 5 percent to 10 percent of persons infected with TB if untreated will develop the disease at some time in their lives; most within the first two years after the infection occurs.

In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. The bacteria become inactive, but they remain alive in the body and can become active later. This is called latent TB infection. People with latent TB infection cannot spread TB bacteria to others. People who have latent TB infection can be treated to prevent TB disease from developing.