County applauded for TB outbreak response

by Emmitt B. Feldner of The Review staff

SHEBOYGAN - The county’s response to a tuberculosis outbreak earlier this year will likely serve as a model for other localities who have to respond to a similar health crisis.

That was the summary presented to the County Board Tuesday by local health and emergency services officials who dealt with the cases of the disease which first were reported last spring.

"Calls have come in from around the country in terms of how we addressed the outbreak and what we learned," Public Health Nurse Jean Beinemann told the board.

"Others are going to look to Sheboygan County in the future for best practices," for similar public health situations, Emergency Management Director Steve Steinhardt added.

The first case of tuberculosis was confirmed in April, according to Beinemann, and by the time the last one was confirmed in August, there were a total of 10 cases of the disease. Although most people still carry the tuberculosis bacteria in their system, she added, it remains dormant for the vast majority and has largely been eradicated in the United States but is more prevalent worldwide.

"There are probably about 9 million people a year in the world who develop TB," Beinemann told the board. "In the state of Wisconsin, there are usually about seven cases a year. This year was an abnormality in Sheboygan County."

The first case in the outbreak was diagnosed in April at the Lakeshore Community Health Center after the patient was seen by several other doctors earlier who made other diagnoses. The case was confirmed as drug-resistant tuberculosis.

While tuberculosis is not highly contagious, it can be spread by close contact, Beinemann said. By early May, three adults and a child (a student at Sheboygan South High) in the original patient's extended family had also been diagnosed with TB.

"At that point we knew a number of businesses in the area were affected," Beinemann continued. "It affected two schools and two companies. We realized about a month in that we certainly had exceeded our local capability," to cope with the outbreak.

State and local agencies were brought in to help with the effort, including the federal Centers for Disease Control. By early June, according to Beinemann, "The CDC felt containment was met. They felt we had done a good job in containing the outbreak."

"This was a tremendous response, a well co-ordinated response," Steinhardt related. "It was a very dynamic event. Things were changing everyday."

In all roughly 450 people were tested for TB as part of the response, 40 people were treated in one way or another and two people confirmed with TB are still in isolation, Beinemann said.

"The average total cost is about $254,000 for medication alone for one patient," she noted. The county was able to get money allocated for the cost of the containment and treatment efforts, which ran into millions of dollars.

"That was a ground-breaking event, asking appropriations from state legislators," for the effort, Beinemann said.

"We truly have a very dedicated community, a very dedicated staff," she concluded. "People in Sheboygan County can rest assured that TB is not running rampant in our county."

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