Frequently Asked Questions:
Tuberculosis Case at AU, Contact Tracing, and Health Information
Have more questions? Please also see the video and Q & A with DC Department of Health on AU's case and what the community should know.
What is the background of the current case?
The DC Department of Health (DC Health) has informed American University that a residential undergraduate student was diagnosed with tuberculosis (TB) and is being treated. The person is currently undergoing medical treatment away from campus. Once the Health Department informed AU of the diagnosis, the AU community was immediately notified of the case in an email sent to students, faculty, staff, and families on November 1.
What is TB?
Tuberculosis (TB) is a bacterial infection that can be contagious if it becomes an active disease (TB disease). It can be active or latent. There are several testing options to detect TB infection and, if positive, additional evaluation is available to rule out or diagnose active tuberculosis disease.
How is TB transmitted?
The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can stay in the air for several hours, depending on the environment. Casual contact is generally not sufficient for transmission of the TB bacteria.
- TB is rarely spread to persons who spend brief amounts of time together. It requires extensive direct contact with a contagious person who has active TB disease.
- You cannot get TB from someone’s clothes, drinking glass, eating utensils, handshake, toilet, or other surfaces where someone with TB has been.
Have any other cases been reported on campus as a result of this exposure?
We have not identified any other individuals on our campus with active TB disease at this time.
How do I know if I’ve been exposed?
If you are identified as someone who needs to be tested, a separate letter will be sent to you by DC Health. DC Health is conducting a contact investigation to identify, evaluate, test, and (if necessary) treat individuals who may have been exposed. The University is cooperating with DC Health and following all protocols outlined by DC Health for handling a TB case.
Not everyone at the University will need to be tested as part of this contact investigation. Individuals who do not receive communication from DC Health are determined not to be closely exposed to this case and are not required to undergo evaluation for tuberculosis.
What is the difference between active and latent TB?
A person with active TB is sick from active TB germs. They usually have symptoms and can spread the bacteria to others.
A person with latent TB cannot spread the bacteria to others, does not feel sick, and does not have symptoms. and is not actively ill. However, they may later develop active TB disease.
Whether active or latent, TB is both curable and preventable. The Quantiferon-Gold blood test is used to detect infection with TB bacteria. If a person has latent TB, treatment is available prevent the progression to active TB disease. If diagnosed with active TB, treatment is also available to cure and treat the disease.
What are the symptoms of TB?
The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of a TB infection in the lungs also include coughing, chest pain, and the coughing up of blood.
What is the potential for acquiring the disease if exposed?
Most people who encounter an individual with TB will not develop the disease. First, they would need to be exposed sufficiently to become infected; then, the disease itself would need to become active.
As noted above, two TB-related conditions exist: latent TB infection (LTBI) and active TB disease. Even if a person encounters a contagious individual closely and is then infected with TB bacteria, the TB bacteria can live in the body without making you (or others) sick. This is called latent TB infection (LTBI). In most people, even if they breathe in TB bacteria and then become infected, the body is able to fight the bacteria and stop them from growing. TB bacteria, in this case, remains inactive for a lifetime without causing the disease and without the person becoming infectious.
However, people with latent TB infection - while they have no symptoms, do not feel sick, and cannot spread TB bacteria for others - can expect to test positive for TB. At that point, treatment would be pursued to keep any latent TB infection from becoming active in the future.
In contract, people with active and infectious TB disease typically display symptoms such as cough, fever, and weight loss. They are isolated as soon as possible after diagnosis and treated.
TB bacteria can remain inactive for months, years, or even a lifetime without causing the disease and without the person becoming infectious. Treatment is available and highly encouraged for those with latent TB infection to prevent the progression to active TB disease.
How is TB treated?
Active TB disease is treated by using a combination of antibiotics. These are prescribed by health providers who specialize in treating TB disease.
For people who have latent TB infection, there are several medication options that greatly reduce the risk of developing active TB disease when taken appropriately.
Does AU screen for TB?
Yes, we have a process to screen students for TB. The purpose of this policy is to minimize the risk of tuberculosis transmission on campus.
All students received a TB questionnaire attached to their immunization forms last Spring (or upon admission). Any student whose questionnaire suggested that they may be at increased risk of TB infection was required to undergo a Quantiferon-Gold blood test. This is the most accurate TB test available with an extremely high sensitivity for identifying infection, as well as an extremely low rate of false positives. As of Fall 2021, the AU student health center only performs Quantiferon-Gold on students at risk or suspected of having tuberculosis.
I have more questions. Where can I ask them or get more information?
The Centers for Disease and Prevention (CDC) has an extensive website on TB that covers how it spreads, risk factors, symptoms, treatment, and more. In addition, please see the website of the DC Department of Health (DC DOH). You may also view the webinar (below) held by AU with DC Department of Health officials.
On Nov. 2, after the initial announcement of the TB case at AU, DC Department of Health and AU officials shared information and answered questions from the AU community.
Hear from Dr. David Reitman, AU's Student Health Center Medical Director, and Jason Beverly, TB Deputy Division Chief at the DC Department of Health, as they answer questions you might have about tuberculosis (TB), contact tracing, notification and testing protocols.
On Nov. 22, following contact tracing and testing, the DC Department of Health answered questions in this Q & A sessions. Here is an abbreviated transcript.
How many active positive cases are there at AU?
There is only one active case. That’s the original case reported to us. We haven’t identified any new active TB cases.
I heard that there were some students who had positive tests. Does this mean they have TB?
No, it doesn’t mean that. Most people with a positive TB test — both here locally and around the world — have a latent and not active infection. Latent TB doesn’t make someone sick. They cannot pass it on to others. So a positive test does not necessarily mean active TB.
What does a student with a positive Quant Gold test have to do? Can they go to class?
Yes, they can go to class. They’re not sick, they’re not contagious, and they can’t pass it on. They don’t need to isolate. They can do all their normal activities. Unlike Covid, people who can pass TB to others always have symptoms. You cannot pass latent TB on to other people. There would be no reason to limit activities with that person.
We’ve given instructions to any AU student with a positive test — all of whom, other than the original case, are latent. They should follow up with a healthcare provider to discuss treatment for latent TB infection.
If a student tests negative, does this mean that they are “TB-Free?”
It can take some time for someone who is exposed to TB to test positive on a TB test. That’s why we have to do a second TB test, eight to 10 weeks after the first test.
But again, that would almost always mean testing positive for latent, not active, TB. So it hasn’t been that they could spread it to others.
If people don’t have symptoms, they don’t have to limit activities. If people do have symptoms, it’s most likely still not TB, but we should be limiting activities anyway because of Covid if people have a cough or fever or symptoms like that.
As a reminder, everyone who was tested will be tested again. Everyone who was tested the first time needs to come back and be tested a second time in the middle or end of January.
Who should a student contact with questions?
Each contact identified received a letter from Dept of Health, and in that letter is the contact name and information of the lead investigator. Anyone who came in person to do testing on AU’s campus received a second letter with that same information. The best thing to do is call the number in that letter.
If other people have questions, there’s great information about TB on the CDC website. The best way to find that is to google “CDC TB Fact Sheets.”