NSW Health allays fears over ‘outbreak’ claim

Ten people are being monitored for tuberculosis after a Sydney man with TB was misdiagnosed with asthma and lung cancer for several months before he received appropriate treatment.
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But health authorities have moved to allay fears over the reported TB scare, declaring it is not an “outbreak”.

After several visits to a GP over three months a 23-year-old man was referred to the Royal Prince Alfred Hospital in October, where tests identified slightly drug-resistant TB, News Corp reported on Monday.

NSW Health director of communicable diseases Dr Vicky Sheppeard was adamant: “There was not an outbreak of Tuberculosis (TB) in October in Sydney”.

Ten people who were in close contact with the recent University of Sydney graduate were subsequently tested and found to have signs of TB infection, but not full-blown tuberculosis, NSW Health said.

Once the TB case was confirmed over five months ago, his close contacts (family, friends and work colleagues) were tested for the disease, in line with usual practice in such cases, Dr Sheppeard said in a statement.

“A public health alert is rarely necessary when cases of active TB disease occur as it is spread via close and prolonged contact, such as to others in the same household or close friends, not by brief, casual exposures,” she said.

People who have contracted the bacterium have a roughly 10 per cent chance of it progressing to TB at some stage in their lifetime, usually the first two years.

The patient said he likely contracted the infection while backpacking in Morocco, Vietnam, Cambodia, Bali and Thailand.

NSW has one of the lowest rates of tuberculosis in the world. Most confirmed cases were in people who grew up, or spent a considerable amount of time, in countries where TB was more prevalent.

There were 533 cases of TB in NSW in 2016, and 1300 new cases nationally. There were 99 reported cases of TB in NSW for far this year.

NSW health minister Brad Hazzard strongly rejected claims of an outbreak or that the case was a threat to public health.

“It was one GP presented with a diagnosis that was masked by other issues, including I understand asthma,” Mr Hazzard said. “This is not a disaster for the GP, the patient, or the health system.”

TB was a relatively small issue compared to influenza, which caused 3000 deaths in NSW between 2011 and 2012, Mr Hazzard said. TB was responsible for five deaths over the same period, he said.

Mr Hazzard said TB was a case of “be alert but not alarmed”. Call to educate GPs on TB diagnosis

It was not unusual for GPs to miss TB cases because they would so rarely see a presentation. NSW Health said it was not aware of any complaints concerning the treatment of patients with recently diagnosed TB.

NSW Opposition health spokesperson Walt Secord said the state government must review whether GPs and other health professionals needed further education to ensure they could identify TB.

Mr Secord pointed to government data showing almost half of TB cases in the state were in western Sydney. In 2016, Blacktown-Mount Druitt hospital has reported some of the highest notifications in the State.

“The NSW Government needs to ensure that they are properly educating GPs on how to identify TB symptoms.”

A University of Sydney spokesperson said the university was notified of the case soon after it was confirmed and worked closely with NSW Health on to appropriately notify and screen for TB, including telling staff and students who were most likely to be at risk of exposure.

“All such individuals were directed to the specialist TB health screening clinics for follow-up, and treatment where required,” the spokesperson said.

The patient – who has not been identified – was treated in an isolation unit at RPA for three weeks and spent another eight weeks in isolation at home, News Corp reported.

Symptoms include a cough that lasts more than three weeks, fever, unexplained weight loss, night sweats and tiredness.

It is usually treated with at least four antibiotics over at least six months.

The 10 people who tested positive for signs of TB have been offered follow up testing and treatment, as if appropriate for each individual, including chest x-rays as part of the state’s TB Program and network of free chest clinics.

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