A former client of a homeless shelter here is being treated in Georgia for tuberculosis and officials there are investigating whether the patient might have come into contact with other people – either en route to or in that state – who should be tested, according to Georgia’s health department.
Meanwhile, testing continues at the Myrtle Beach-based Street Reach shelter, where nurses with the S.C. Department of Health and Environmental Control are checking to see if staff, volunteers or shelter clients might have been exposed to the disease. Results of that testing, which continues from 7 a.m. to 5:30 p.m. Friday, are not yet known.
More than 100 people were tested at Street Reach on Thursday, according to Kathy Jenkins, executive director of New Directions of Horry County Inc., which operates the shelter.
“The response today at Street Reach has been phenomenal,” Jenkins said. “We are proactively reaching out to people who stayed here, ate with us and volunteered with us during the time in question. We have also posted flyers in area agencies where our clients receive other services.”
Thursday’s testing was limited to individuals connected with the shelter, according to DHEC spokeswoman Lindsey Evans. “In the event additional TB cases are identified, the scope of the contact investigation will be expanded for contacts of that case as necessary,” Evans said. “We have not identified any additional cases to date.”
A positive test does not necessarily mean someone has the disease, and further evaluation – such as a chest X-ray – is necessary. About 1 out of every 10 people who are infected with the germ get the disease, although it can take weeks or even years before the disease develops.
The infectious patient, who cannot be identified because of federal privacy laws, stayed at Street Reach between April 26 and May 17 and was admitted to a local hospital on May 27, when the patient was diagnosed with the infectious respiratory disease. The local hospital discharged the patient on June 4 and gave the patient a one-way bus ticket to Georgia, according to DHEC spokesman Mark Plowden, who would not identify the hospital.
While it usually takes between six months and nine months to treat TB, long hospital stays usually are not necessary because patients can take the drug therapy at home, according to the federal Centers for Disease Control. The CDC, however, advises such patients to avoid public transportation and limit contact with others.
Nancy Nydam, media relations specialist with the Georgia Department of Public Health, said the patient “is in Georgia and is undergoing TB treatment.” Nydam said none of the patient’s family has tested positive for the disease. She declined to say where in Georgia the patient is being treated or whether there are concerns that other passengers on the bus might have been exposed to the disease.
“A contact investigation is ongoing,” Nydam said.
Hospital officials say it is normal for their facilities to arrange transportation – including out-of-state travel on occasion – for patients who don’t have the resources to pay for the trip home or to another health care facility.
“Our discharge planners work with all patients to meet their discharge needs to find a safe and appropriate level of care following their discharge, either local or out of the area, or to help with the cost of medication, housing, etc.,” said Joan Carroza, spokeswoman for Grand Strand Regional Medical Center. Carroza said the hospital spent more than $121,077 on bus, taxi and ambulance transportation for patients as part of its charity program.
“Transportation of patients could be to their own home, or to relatives, a nursing home, rehabilitation etc.,” she said. “The discharge planners contact local charity agencies as well as agencies out of town to work on a plan for patients if they are in need. Out of town arrangements are more common here because of the number of tourists.”
Julie Rajotte, spokeswoman for Conway Medical Center, said that hospital also provides transportation for patients who cannot afford it after discharge, but does not see as many tourists as other area facilities and, therefore, rarely pays for out-of-state travel.
“If a patient is being discharged home and does not have the means of securing their own transportation, we do work with area resources to manage that,” Rajotte said. “Our case management department actively works to try to secure transportation home, however it needs to be provided.”
There were 122 cases of TB reported last year in South Carolina, including nine in Horry County. The statewide total is a decline from the average annual number of 153 reported cases. Preliminary reports show 28 reported cases of TB disease so far in 2013.
TB is spread through the air when people who have an active infection transmit respiratory fluids, usually by coughing or sneezing, according to the federal Centers for Disease Control.
Symptoms of TB include a bad cough that lasts three weeks or longer, pain in the chest, coughing up blood, fever, night sweats, fatigue and weight loss. People who have HIV or other immune system diseases, those with diabetes and those who abuse alcohol or drugs are more susceptible to the disease. TB usually affects the lungs but also can attack the kidney, spine and brain.
TB responds well to antibiotics, according to DHEC. Cases of extremely drug-resistant TB are rare.