- Parents of 140 babies cared for at special unit called in for testing
- 25-year-old woman believed to have caught rare strain after eating unpasteurized food from abroad
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Loss: Vanessa White and her newborn babies died after she contracted TB meningitis
More than 100 babies and new mothers at a neonatal intensive care unit are to be tested for tuberculosis after a woman and her twins died and more than 26 people were infected in a Las Vegas hospital.
Vanessa White was taken to Summerlin Hospital Medical Center's neonatal unit after falling sick and going into premature labor in May.
After her death and that of one of her newborn twin girls was confirmed as TB, parents of more than 100 other children cared for at the same neonatal unit were called in for testing.
Health officials believe the 25-year-old from Las Vegas contracted a rare strain of TB after eating unpasteurized dairy products from abroad.
After her twin girls, Emma and Abigail, were born prematurely, Mrs White was moved to a hospital in southern California 'for a higher level of care', according to an August 22 health district report.
Emma died from respiratory problems on June 1, three weeks after being born on May 11, but she was never tested for TB, according to the Clark County coroner.
Her sister, Abigail, was moved to an isolation ward at Summerlin hospital, but died on August 1.
A post-mortem examination showed that Mrs White had tuberculosis meningitis. The delayed diagnosis may have come because the disease is relatively rare in the U.S.
Symptoms can often be overlooked because the first signs of infection include gentle aches and pains, that gradually become worse after eight weeks.
'TB can be very subtle, particularly as many doctors have not had much experience with TB these days,' Dr William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine, said.
Since her death on July 1, initial tests among hospital staff and friends and relatives of Mrs White's family, found 26 TB infections.
Parents of about 140 babies cared for at the neonatal unit between mid-May and mid-August have now been contacted by Nevada health officials, who have set up a temporary testing clinic.
The infection is spread through prolonged contact with a patient who is at the contagious stage, where symptoms include coughing and spluttering.
The call for testing came after at least one staff member on the ward tested positive for TB and was found to be contagious. It will be another week before it is known if any of the children have contracted the disease.
Outbreak: Families of babies born at Summerlin Hospital in Las Vegas are being tested for TB
Most of the new cases showed the disease to be latent, meaning the patients don't experience any symptoms and are not contagious, health spokesman Stephanie Bethel said.
The two active cases of TB involve one of Mrs White's relatives and a hospital employee. Both are expected to survive, officials told Fox 5.
Tuberculosis meningitis
TB meningitis is rare in the U.S. and is more deadly than other forms of TB.
Over a 12-year period, from 1993 to 2005, the Centers for Disease Control recorded 1,649 cases of TB meningitis in patients who had never previously suffered from TB.
Like more regular strains, TBM is passed on through prolonged contact with an infected person.
Earlier symptoms, such as fatigue and mild aches and pains that last for two to eight weeks, are often missed.
More severe symptoms, including vomiting, severe headaches, seizures and a dislike of bright lights, don't appear for several weeks.
Treatment can take up to a year after diagnosis, but in many cases patients suffer severe, long-lasting effects because of brain-tissue damage.
Over a 12-year period, from 1993 to 2005, the Centers for Disease Control recorded 1,649 cases of TB meningitis in patients who had never previously suffered from TB.
Like more regular strains, TBM is passed on through prolonged contact with an infected person.
Earlier symptoms, such as fatigue and mild aches and pains that last for two to eight weeks, are often missed.
More severe symptoms, including vomiting, severe headaches, seizures and a dislike of bright lights, don't appear for several weeks.
Treatment can take up to a year after diagnosis, but in many cases patients suffer severe, long-lasting effects because of brain-tissue damage.
Babies who may have been exposed to the disease are unlikely to catch it, according to chief medical officer Dr Joe Iser, but officials want widespread testing 'through an abundance of caution'.
'It's safer to expand the investigation,' Dr Iser said.
Health officials believe Mrs White, whose lifelong ambition was to be a mother, may have contracted TB through an unpasteurized dairy product from Latin America.
Interviews with Mrs White's husband, Ruben, and extended family, suggest that bacteria in cheese or milk from abroad caused the infection, Southern Nevada Health District’s chief health officer told Las Vegas Review Journal.
'We didn’t have a sample to test the product from the patient or the family,' Dr Iser said, adding that it was not known if Mrs White consumed the products at home or abroad.
An obituary for the member of the Church of Jesus Christ Latter Day Saints, who spent her whole life in Las Vegas, said she died surrounded by her family on July 1.
Families who had babies in the same hospital unit in Vegas were first informed of the investigation in August, but it wasn't until this week that the health district urged them to get tested.
Before that, health officials tested more than 200 hospital staff and 69 close family and friends.
'We did a full contact investigation and that helped us to determine her movements during the time she was not hospitalized but likely infectious, and we've followed up with all the contacts we know,' Dr Iser said.
Infected: An X-ray of a TB case shows the calcification damage to the lungs
Dr Schaffner said dairy cattle can sometimes carried the disease and pass it to people through unpasteurized milk, but he added that it was extremely rare, especially in the U.S.
Nearly all cases are transferred from person to person, he said, and TB occurs far more often in people who were born overseas.
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