Grand Forks businesses require employees to get TB test

While hundreds of Grand Forks County residents have been tested for tuberculosis since the outbreak last month, some were already tested because their employers required it.

Many have jobs that require prolonged contact to the public, including workers at the Grand Forks County jail, Northlands Rescue Mission and Comfort Keepers, which provide in-home care for seniors.

Recently, county jail employees were tested again because one of the 10 people known to be infected with TB had a connection to an employee. None of the tests were positive, according to Public Health Director Don Shields.

More than 400 county residents exposed to the 10 TB cases have been tested since Oct. 23, he said. “We are erring on the side of safety and preventing the spread of this disease, so we will be screening more than normal.”

Including Grand Forks County, there are 18 TB cases statewide. Historically, the incidence of TB has been rare in North Dakota. In the past five years, the state has reported less than 10 cases each year except for 2010, where there were 11, according to the state Health Department.

The homeless

At Northlands Rescue Mission, a homeless shelter in downtown Grand Forks, all clients and the staff of 20 must be tested for tuberculosis.

However, the ability to detect clients who have the disease has been challenging, according to Executive Director David Sena. Many of the clients are alcoholics, and even if they’ve tested and started a medicine regime, they don’t always follow through.

“The medicine doesn’t always mix well with alcohol,” he said. “And we don’t always have the staffing to follow through on making sure they’ve completed the regime. We really rely on the medical community to say, ‘This person is done.’”

The initial outbreak of tuberculosis has been linked to homeless visitors who spread the disease to a family they stayed with, but Sena said he’s not sure if the visitors passed through the shelter.

Northlands, which sees around 800 homeless people a year, no longer allows those with TB to stay.

In the past, a client with TB might have been allowed to stay, “depending on the situation.” Sena said. For example, a year ago, a client who faithfully took medication stayed for a few months, he said. The Public Health Department also reassured Northlands that the client was not contagious, he said.

But, as more and more people are attracted by North Dakota’s low unemployment rate, the shelter has seen the number of residents grow from 70 to 120 per day in the past five years.

Sena said the shelter has had to become more selective about who can stay, based on testing. “Ninety-nine percent of the time we’re not allowing people in because we test for it,” he said.

Inmates get tested

At the Grand Forks County jail, inmates are screened for TB upon admission, and if found to be infected, are sent to the hospital.

Inmates infected while in jail, are also allowed by the court to be treated at a hospital before returning to jail, said Administrator Bret Burkholder. The amount of time they’re sick “typically doesn’t count toward the time they’re serving,” he said.

The inmate population is currently around 180.

One way the county is trying to prevent diseases from spreading among inmates is by building two cells with sepa-rate air flow from the other cells. The County Commission approved the project last week.

If any of the inmates has the flu, Burkholder said, “you want to keep them as separate as you can.”

The County Commission and the Public Health Department are also considering a screening program that includes other diseases for jail employees and would-be employees, said Shields.

Care for seniors

Senior citizens are among those most susceptible to tuberculosis.

Comfort Keepers, which has 30 employees overseeing 100 clients, requires employees to complete a questionnaire each year to ensure they haven’t contracted the disease, said Office Manager Mary Beth Martin.

Foreign-born employees, who apply weekly at Comfort Keepers, must have proof of further testing before being hired.

James Hargreaves, infectious specialist at Altru Health Systems, said some foreign-born may have received a vac-cine that causes a false positive result.

“The vaccine is used in the developing world, and it seems to help lower the chance of a baby developing dissem-inated TB in the brain, but it really doesn’t have much impact on preventing pulmonary or other related strains due to TB,” he said. “That’s why it’s seldom used in the United States.”

A follow-up blood test can determine if the person is truly infected with TB, which takes awhile to make itself known.

Hargreaves said the general public is not likely to catch TB on the street. Once the disease gets in the air, he said, the ultraviolet rays kill it quickly and it doesn’t survive in the environment well.

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