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Ten Latent TB Cases Linked to Infected Doctor

Posted on: Friday, 22 July 2005, 18:01 CDT

Jul. 22--For the first time, public health authorities have linked the tuberculosis infection of a Boston Medical Center patient to a junior doctor who continued to treat people while she had an active case of the bacterial disease.

Nine healthcare workers at the hospital who tested positive for TB in recent weeks also probably contracted their infections from the physician, said Dr. Anita Barry, top disease tracker at the Boston Public Health Commission.

None of the 10 with positive skin tests has shown symptoms of the illness, which in most infected people remains dormant for years. TB can be spread only by patients suffering from the hallmark signs of the disease, including coughing and fever.

The patient and the medical employees have been advised to take a nine-month course of medication designed to eliminate their latent TB infections and to prevent them from becoming infectious, Barry said yesterday.

More than 3,900 doctors, nurses, and patients have been tested for tuberculosis so far at the three Boston hospitals where the surgeon-in-training rotated: Boston Medical Center and VA hospitals in West Roxbury and Jamaica Plain. Barry and other disease specialists said they were reassured that only 10 infections have been linked to the doctor.

"I would consider it still reassuringly low when you consider the number of people potentially exposed," said Dr. Alfred DeMaria, the state's director of communicable disease control. "You don't find a lot of transmission of tuberculosis today. It's not that 19th century situation where you find people exposed for years to somebody who's coughing."

A spokeswoman for Boston Medical Center, Ellen Berlin, said the hospital was "very concerned" about any infections caused by the doctor.

Federal records obtained last month by the Globe showed that a skin test first suggested that the junior doctor might be infected with TB last summer and that officials at Boston Medical Center then ordered the woman to get an X-ray for confirmation. But the federal memo said that the woman did not appear for her July 2004 X-ray, that she continued to treat patients, and that her infectious case of TB was not confirmed until last month. Public health authorities said they believe the doctor may have been infectious from Dec. 1 until June 2, when she was removed from treating patients.

Berlin said yesterday that the doctor has not returned to practice, but she would not provide further details of the doctor's status with Boston Medical Center.

Hospital and public health authorities have declined to identify the woman, citing federal laws designed to protect the privacy of patients.

A spokesman for the US Occupational Safety and Health Administration said that agency is continuing to investigate whether any of the hospitals where the doctor rotated violated workplace safety laws.

The physician also treated patients at Brockton Hospital and Cape Cod Hospital. No infections at those hospitals have been traced to the doctor.

Community activists last month criticized the hospitals -- particularly Boston Medical Center -- for allowing the physician to continue treating patients even after she skipped her July 2004 X-ray. The activists said the hospitals had demonstrated disregard for patient and worker safety.

Unions representing health-care workers either had no comment or said they were satisfied by the response from hospitals to the doctor's infection.

"It seemed like it was handled pretty much delicately," said David Schildmeier, spokesman for the Massachusetts Nurses Association, which represents some nurses at Boston Medical Center. "I didn't get any complaints about how it was being handled."

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Source: The Boston Globe

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