Tuberculosis on Campus
On November 26, 2007, Dr. Leslie Jaffe, college physician,
notified the Smith College community that a sophomore student
was being treated for probable tuberculosis. The following
is an update on the outreach, testing and education that
have taken place to date.
What is tuberculosis?
Tuberculosis or TB is a highly curable and preventable bacterial
disease, caused by a germ breathed into the lungs. It is
important to distinguish between “active tuberculosis” or “tuberculosis
disease,” which is characterized by abnormalities
in the lungs, and “latent” or “dormant” tuberculosis,
in which the patient experiences no symptoms and is not
contagious. Tuberculosis is spread through the air, via
repeated exposure to an active TB carrier’s coughing
How many Smith College students are confirmed to
have active tuberculosis?
One. The college physician learned of her probable case
of TB on Nov. 22 and notified the campus community as soon
as classes resumed after Thanksgiving break on Nov. 26.
The student is undergoing antibiotic treatment and will
be able to return to campus once it is determined she is
no longer contagious.
What are the clinical signs of tuberculosis?
The most common symptoms of TB disease are coughing, fever,
loss of appetite, weight loss, weakness, night sweats and
feeling very tired. No single symptom would be likely to
trigger the need for TB-specific testing. Rather, a clinician
would take into consideration a constellation of symptoms.
How is tuberculosis diagnosed and treated?
A skin test, known as a PPD test, can detect latent tuberculosis.
A chest x-ray is needed to diagnose active TB. Thus, a
positive skin test does not necessarily indicate active
TB. It can indicate exposure to TB or a previous TB vaccination.
Anyone with a positive PPD test needs to have a chest x-ray
to exclude the possibility of active tuberculosis. Further,
even if a chest x-ray confirms an individual doesn’t
have active TB, standard protocol recommends a six-to-nine-month
course of antibiotics as treatment for latent TB. The antibiotics
used to treat latent and active TB are covered by most
medical insurance plans.
Who is being screened for tuberculosis exposure?
Although TB is an infectious disease, the possibility of
spreading it through casual contact is low. Smith is following
the testing protocols of the Massachusetts Department of
Public Health, which has recommended that the college test
the student's close contacts, those in her classes, residents of her house,
and others with whom she had regular contact.
Of this group of 267,
263 have been screened, either through PPD skin
tests or chest x-rays. The remaining 4 individuals are not
on campus for unrelated reasons.
What are the test results to date?
A total of 32 individuals had positive PPD skin tests. Of these, many positive
results likely reflect previous vaccination with BCG (see below) and/or previous
positive PPD tests. Every individual with a positive skin test had
a normal chest x-ray. None
has active tuberculosis and none is contagious.
As stated above, even if a chest
x-ray confirms an individual does not have active TB, standard
protocol may recommend a six-to-nine-month course of antibiotics
to someone with a positive TB test. Dr.
Jaffe accompanied 13 students and one employee to Baystate
tuberculosis clinic, where they had the opportunity
to meet with a specialist to discuss antibiotic treatment.
Such treatment was recommended for 11 of these 14 individuals.
The Massachusetts Department
of Public Health recommends a final PPD screening test be
conducted approximately 10 weeks after the last possible
exposure to active tuberculosis. On February 12, from 10
a.m. to 2 p.m. at the Campus Center Carroll Room, the 231
contacts with a negative PPD will be retested.
Are Smith students screened for tuberculosis?
In order to matriculate, every Smith student must present
proof of tuberculosis screening, using forms and protocols
developed by the Massachusetts Department of Public Health.
Smith require a tuberculosis vaccine? Do other colleges?
While the bacille Calmette-Guérin (BCG) vaccine
is used in many countries with a high prevalence of TB,
it is not generally recommended for use in the United States
except for very select persons who meet specific criteria.
People who have had BCG vaccine can still get TB infection,
and many still get active TB disease. Some international
students who come to college in the United States have
been vaccinated but the majority of domestic students have
not. More information about the BCG vaccine is available
from the Centers for Disease Control.
How can I learn more about tuberculosis in the United
Last updated: Feb. 1, 2008