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Report: Almost 60 test positive for tuberculosis after outbreak

Almost 60 people linked to a deadly tuberculosis outbreak have tested positive for the disease since the summer, according to the Southern Nevada Health District.

That is about 6 percent of the nearly 1,000 tested, a health district report made public Monday says. Of those who tested positive, only two were considered contagious. The other three people who were contagious, a mother and her two daughters, had already died.

Health district specialists linked the Clark County cluster of cases to the death of Las Vegas resident Vanessa White, 25, and her premature twins, Emma and Abigail. White’s symptoms were treated at Summerlin Hospital Medical Center, but she wasn’t diagnosed with tuberculosis until after she died at a California medical facility.

Following incidences of certain diseases such as tuberculosis, the county health agency backtracks to figure out who may have come in contact with a contagious patient in an attempt to stop further infection. Usually a doctor reports the initial diagnosis to the health district, as required by state law, then the investigation starts.

But this case was different since no local physican determined Vanessa White had TB. An autopsy showed the disease killed her.

The health district report reminded doctors to keep tuberculosis in mind.

“It would be a great help if physicians throughout the valley would consider tuberculosis as a diagnosis,” said Dr. Joe Iser, chief medical officer with the Southern Nevada Health District. “If one round of antibiotics doesn’t help, then test for TB.”

It worked that way in another Las Vegas tuberculosis investigation, Iser said.

About 325 students and staff at Coronado High School were tested after a doctor reported a case of tuberculosis.

“That helped to prevent a much larger investigation and cluster than what we have,” Iser said.

The health district has not said whether the person who had TB was a student or employee.

Abigail White, one of the premature twins, died Aug. 1 after testing positive from tuberculosis. She contracted it from her mother.

Her sister, Emma White, died June 1. She wasn’t tested for TB. But the latest TB report from the Southern Nevada Health District counts Emma among the five confirmed cases of active, or contagious, cases of TB linked to this cluster. The other two people who were contagious included a hospital staffer and someone the health district considers a “personal contact” of Vanessa White.

The 54 others who tested positive have a latent, or dormant, form of tuberculosis. They received medication to help keep the disease at bay.

The day after Vanessa White’s July 1 death, the health district started its investigation to determine who might have been exposed to TB. White had visited her babies in Summerlin’s Neonatal Intensive Care Unit, and health district officials started with testing hospital staff and visitors to the NICU.

In August, the health district sent letters to parents of about 140 babies who were in the NICU when White had been there, saying TB tests were not recommended. But by October, those parents received a second letter saying their children should get the tests since a NICU staffer had tested positive for tuberculosis.

None of the babies tested positive for TB. The health district recommends additional rounds of testing and medication because infants’ immune systems are not fully developed.

A state report released in November said Summerlin Hospital didn’t take basic precautions, which can prevent infection in others, when White was sick and visited her daughters. Hospital staff allowed White to enter the NICU while she had a 103-degree temperature, and documentation lacked evidence staff required her to wear a mask, which can stop the spread of airborne diseases such as TB.

In its response to the state report, hospital adminstration said it would update visitor policies and retrain staff about wearing proper protective gear.

Summerlin Hospital’s parent company, The Valley Health System, released a statement Monday saying it has cooperated with the Health District throughout its investigation, emphasizing only one person who contracted contagious TB was directly connected to hospital, with the other being a personal contact of Vanessa White.

Lawyers for White’s husband in November announced plans to sue Summerlin Hospital and possibly others in the deaths of his wife and daughters. Ruben White said his wife went to the Summerlin emergency room three times with symptoms including a persistent cough, fever and delirium, but she was never screened for tuberculosis.

“It’s illustrative of, again, a perfect storm of failure in the system where Vanessa White was never tested and treated for a curable disease,” attorney Ryann Dennett said Monday. “And there’s three fatalities as a result.”

A group of employees, former patients and visitors filed suit against Summerlin Hospital in November, saying they were exposed to tuberculosis when White and her babies were being treated there.

Nevada recorded 84 tuberculosis cases in 2012, according to statistics from the state Health Division.

Contact reporter Adam Kealoha Causey at acausey@reviewjournal.com or 702-383-0361. Follow on Twitter @akcausey.

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