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Seven Test Positive for Latent TB at Nebraska High School Where Active Case Was Diagnosed

Seven of 172 students, faculty, and staff at Benson Magnet High School in Omaha, Nebraska, who were given blood tests during the past two weeks have tested positive for latent tuberculosis (TB) infection.

WOWT in Omaha reported that 191 students, faculty, and staff were exposed to the disease by a student who was diagnosed with active TB at the school in November. Ten percent of those exposed, or 19 out of 191, did not submit to blood tests, so their TB status remains unknown.

“Two hundred thirty seven of Benson Magnet High School’s 1,273 students, or 18.6 percent, are refugees, according to Omaha Public School’s District English Language Learner/Refugee Report, 2015-16,” Breitbart News reported on December 9.

“Our thorough investigation revealed no further risk of exposure to active TB disease at Benson High School,” Dr. Adi Pour, Douglas County Public Health director, told WOWT.

“Seven individuals were positive for the TB bacteria, but they most likely have latent TB infections. They were contacted by phone and referred to their regular provider for antibiotic treatment to prevent development of TB disease,” Pour added.

“Families of students who had a negative TB test have been notified by mail. Those letters were expected to arrive yesterday,” WOWT reported: “After cross-checking records, it was determined that 191 people should have been screened for possible TB exposure. Of those, 90 percent participated in the free screening while others may have seen their own doctors.”

Pour did not say why the 19 people who were exposed to TB at the school but did not undergo blood tests had been determined to pose “no further risk of exposure to active TB disease.”

Nor did she explain whether the seven individuals who tested “positive for the TB bacteria … [and] most likely have latent TB infections” had been scheduled to undergo chest radiographs, which is the standard protocol in determining whether someone has active TB.

“Officials with the Nebraska Department of Health and Human Services and the Douglas County Public Health Department are withholding whether the student was foreign-born or American-born,” Breitbart News reported soon after the news broke that a student at Benson Magnet High School had been diagnosed with active TB.

A spokesperson for the Douglas County Public Health Department later told Breitbart News that 11 of the 13 cases of active TB diagnosed in Douglas County for the period beginning January 1, 2016, and ending December 10, 2016, were foreign-born.

That compares to 14 out of 16 in 2015 and 17 out of 18 in 2014.

Since January 1, 2014, 89 percent of all cases of TB diagnosed in Douglas County, or 42 out of 47, have been foreign-born. Only nine percent of the population of Douglas County is foreign-born.

This contrasts unfavorably with the country as a whole, where 66 percent of the 9,563 cases of active TB diagnosed in 2015 were foreign-born. It also is higher than the 82 percent rate of foreign-born TB cases reported for the entire state of Nebraska in 2014.

The Centers for Disease Control recommends that all foreign-born refugees who arrive in the United States should be tested for latent TB in an initial domestic medical screening that is supposed to be conducted within 90 days of their arrival. Participating in such an initial domestic medical screening is not legally required, though most states report that between 70 percent and 90 percent of arriving refugees do complete initial domestic medical screenings and are tested for latent TB.

Though not all states report the percentage of arriving refugees who complete their initial domestic medical screening who test positive for latent TB, Breitbart News has reported over the past year that in the eighteen states in which data is available, that percentage ranges from 11 percent in Florida to 35 percent in Vermont.

“Twenty-five percent of the 4,848 refugees who completed initial domestic medical screenings in Nebraska during this five-year period [between 2011 and 2015] tested positive for latent TB infection (LTBI),” the Nebraska Department of Health and Human Services told Breitbart News in August.

Under the Refugee Act of 1980, resettlement agencies are responsible for monitoring and treating arriving refugees who have health problems, and should ensure that arriving refugees who test positive for latent TB are treated with a standard drug regimen so that the condition does not deteriorate to active TB, which is the deadly infectious disease that, if untreated, can lead to death.

The state of Nebraska, however, was unable to tell Breitbart News how many of the arriving refugees there who tested positive for latent TB received this treatment.

Breitbart News asked both the Douglas County Public Health Department and the Nebraska Department of Health and Human Services how many of the 237 refugees who are currently students at Benson Magnet High School, where the active TB case was diagnosed, completed initial domestic medical screenings upon their arrival in the United States. We also asked how many of those students tested positive for latent TB in their initial domestic medical screenings, and how many of those who tested positive received treatment for the condition.

Neither the Douglas County Public Health Department nor the Nebraska Department of Health and Human Services responded to Breitbart News inquiries.

An estimated four percent of the general population tests positive for latent TB. Ten percent of that group develops active TB during the course of a lifetime.

As numerous medical studies have demonstrated, including a 2013 study conducted by the University of California at San Diego, high rates of latent TB among refugees pose a risk to the health of the general population in communities in which they are resettled.

Refugees with latent TB demonstrate a higher rate of activation than those in the general population of the United States with latent TB.

One possible explanation for this is that refugees are more likely to experience lower immune systems due to high stress, crowded environments.

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