NICU Visitor May Have Exposed Nearly 50 People to TB in Ohio

A visitor to Akron City Children’s Hospital (ACCH)’s neonatal intensive care unit (NICU) in Akron, Ohio, may have inadvertently exposed nearly 50 people to tuberculosis (TB) during the months of November and December of 2016. Those exposed included infants, other visitors, and hospital staff. The Summit County resident who was infected with TB may not have been experiencing any symptoms at the time of exposure as the resident was not diagnosed until January 3, 2017.

Upon learning of the diagnosis, the hospital set up a clinic to preventatively treat the NICU patients and their families with the hopes of preventing infection. Tuberculosis is known to be particularly troublesome in pediatric and neonatal patients.

The Summit County Health Department warned in a news release that, “TB in infants may be more difficult to diagnose at first because they may initially have few symptoms or symptoms that appear like common viral infections.” In addition, infants are at risk of life-threatening complications as the infection develops.

Akron City Hospital notified all parents of infants potentially exposed to the illness as well as any staff or visitors who may have been exposed. “We are contacting people who need to be tested,” a spokesperson said in the release.

Margo Erme, MD, Summit County’s medical director, noted in a public health alert that individuals who might have been visiting the neonatal unit in November and December should be tested for TB toward the end of February. “This would be about 10 to 12 weeks after the last potential exposure,” she explained, adding that this time period will give patients’ bodies time to develop a response to the bacteria and enable doctors to diagnose any infection.

Summa Health, of which the ACCH is a part, stated that Akron City Hospital patients and other individuals who were not in the facility’s NICU at the times when the infected person visited “have not been found to be at increased risk for exposure to TB.”

Tuberculosis is considered one of the world’s deadliest diseases and the Centers for Disease Control and Prevention estimate that about one-third of the world’s population are infected. Many of these infections go undiagnosed as individuals can be infected without showing any symptoms. With this latent form of the infection, individuals cannot spread TB bacteria to others, although a latent infection may become active and cause hard coughing, chest pain, and expulsion of blood and sputum.

Tuberculosis bacteria spread when a person with active TB coughs, sneezes, or talks, but the TB bacteria die upon hitting a hard surface like a floor or counter and cannot be spread by hand-to-hand contact or even sharing silverware. In the United States, TB infection rates have steadily declined for more than two decades thanks to heightened levels of awareness and effective treatments. Patients with compromised immune systems are more likely to become ill from TB and suffer potentially life-threatening complications.

Akron City Hospital itself emphasized via a public statement from pediatric infectious disease specialist John Bower, MD, that “infants who were in the NICU at the Akron Children’s Hospital campus were not at risk of exposure.” Dr. Bower went on to say that the hospital would evaluate all infants in the NICU during the times that the infected individual visited and “begin them on a protective antibiotic…at no cost to our patient families.”

At time of publication, no additional cases of TB had been diagnosed, although some patients are still within the window during which the body might be developing a response to the infection.