Fear festers following outbreak of tuberculosis at Grant

In the shadows of Grant Union High School, The 3 B’s barbershop hosts Little League sign-ups, fundraising carwashes and community association meetings.

These days, the red stucco shop is where people come to talk about tuberculosis.

Shannon Daniel, who works at the barbershop, lamented that his son was one of 120 students and employees diagnosed with a noninfectious form of the disease. “As a parent, I’m frustrated that my kid contracted something from school,” Daniel said as he ran his clippers through a child’s hair last week.

Del Paso Heights residents have been on edge since a Grant student attended school in February with active tuberculosis. She had the more serious form that attacks the lungs and can be fatal. Many have complained that school and county officials were slow to release information and that the health department waited too long to offer free schoolwide testing that they feel might have slowed the contagion. A community meeting for them to air their concerns is scheduled for Thursday.

Those concerns were amplified last month when health officials announced that nine people, including five students, had contracted active TB, enough to be considered an official outbreak.

In the neighborhood around Grant Union High School, where more than 90 percent of students come from low-income households, parents wonder openly whether they have been given short shrift because of their socioeconomic condition.

“If this were anywhere else, they would bring out the (testing) buses,” said Amber Leslie, who was signing in her son and grandchildren at the Our Kids Community Breakfast Club last week. “People are feeling like nobody really cares about our kids.”

Del Paso Heights residents said they believe the outbreak would have been dealt with differently in a more affluent neighborhood.

“If this happened at Jesuit, what steps would be taken?” said Laurence Lambus, referring to the private Carmichael high school, as he waited for his son’s hair to be cut at 3 B’s.

People with active TB can spread the disease through the air when they cough, laugh, sneeze or sing, but not through hand-shaking or touching objects such as doorknobs or railings.

Since February, the health department has tested nearly 500 Grant students and school employees at the 2,200-student school. The testing was selective at first, with free county testing and treatment offered only to students who attended the same classes as the “index patient.”

The large number of cases found in the first screening prompted county health officials to broaden testing to students whose classrooms were connected to the same ventilation system as rooms used by the infected student..

“We had to look at who is the most at risk,” said Olivia Kasirye, Sacramento County’s public health officer. “That is what we focused on initially.”

Parents pushed for a screening of the entire school population in June. The health department agreed and set up testing for two days after the school year ended. Some parents thought that timing limited the number of students who could access the screenings. Kasirye said the school asked to hold the test then because of the large number of year-end activities, including graduation.

Officials from the California Department of Public Health said the timing and the decision to start with only a select group of students were consistent with state protocol.

The TB tests made the end of the school year stressful for students at Grant, said Dorrell Fore.

Fore, an incoming senior, sat near the infected student during his Advanced Placement statistics class. He was in the first group of students offered free testing by the county.

He saw his private doctor instead of standing in a long line. People were afraid and “trying to be tested,” Fore said.

He isn’t worried about returning to school next month. Parents are more worried than the kids, Fore said. “They worry about their child’s safety,” he said.

Dresden Vogt, who will be a junior, said students hid their fear by joking. She heard freshmen say, “When I signed up for Grant, I didn’t sign up for tuberculosis.”

Students, though, supported the student first diagnosed with active TB upon the student’s return after treatment, Fore said.

Neither summer nor a TB outbreak has stopped activity on the Grant campus. Here, an electronic sign on the lawn flashes “Pacer,” then “Pride.” Last week, the Pacers football team practiced on the field. Junior Destiny Tobeck watched nearby.

She said she thought people have overreacted and that the lingering stigma was unfortunate. “Now,” she said, “that’s what Grant’s known for.”

All told, health officials have found five Grant students with active tuberculosis. All have been treated and are no longer infectious. Four more people, mostly adult relatives of the student who initially tested positive, were diagnosed with active TB. Scientists consider three or more related cases of TB an outbreak.

Last week, a middle school student at Rio Tierra Junior High, 3 miles away, was diagnosed with latent tuberculosis, the noninfectious form. The health department hasn’t found a connection to the Grant case. Latent TB can become active after a long period of dormancy.

Thirty of the students who tested positive for TB have not undergone chest X-rays and other evaluations necessary to determine if they have active cases. Kasirye said those students will not be allowed to register for classes unless they are cleared.

All Grant High students are eligible for free TB screening through the county health department. But mandatory testing is atypical in California, Kasirye said.

She pointed to the low number of positive tests during a third screening as an indication the outbreak has been contained. Two of the 75 students in that group tested positive for TB, typical of the number found in the general population.

But fears remain. One relative of a Grant student with latent TB wondered whether he should be tested. Some parents wanted food service employees to be tested before they could work in the cafeteria. Other parents wanted to know why students had not been inoculated against the disease, though TB vaccines are rarely used in the U.S., according to the Centers for Disease Control and Prevention.

“I think the people lack a real knowledge of what tuberculosis is,” said Derrell Roberts of the Roberts Family Development Center in North Sacramento. “If you don’t know something, you become fearful. The more people become educated, the less fearful they are.”

During a break in a Twin Rivers Unified school board meeting this month, Francisco Garcia said, “I’m praying that things get better.”

Garcia is the father of two Grant High students. He said he is fearful and anxious but doesn’t blame the school or the district. “If we don’t get a handle on this, we’re going to be in a lot of trouble,” he said.

Other parents were uneasy about sending their children back to school. Sascha Vogt said she won’t commit to sending her daughter to Grant until she gets more information from the district about how the disease will be contained. Daniel said he doesn’t want to send his daughter back, but she is intent on returning.

Teachers also want more communication from the district. Teachers want to know what they should do if a student in their class is diagnosed with tuberculosis, said Kristen Finney, president of Twin Rivers United Educators.

“People want as much communication as possible,” she said. “They want more information. What are the supports in place? The protocol? What happens if?”

Superintendent Steven Martinez said the district is hiring a consultant to help it deal with the disease. The school board expects to have a plan to present at its Aug. 5 meeting. He said he hopes to start a public health campaign to raise awareness of the disease. “I know it’s bigger than Grant,” he said.

“Misinformation, particularly in a community like ours, can do some damage,”’ City Councilman Allen Warren said. “Equally as important, we want to make sure this doesn’t turn out to be a health issue that gets out of control. We don’t want it to turn it into something that becomes an epidemic in our community.”

Editor’s note: Councilman Allen Warren’s first name was added to this story on July 21.

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