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The Mass Media

Member of UMass Boston community diagnosed with active tuberculosis

A+student+wears+a+mask+while+studying+in+the+Campus+Center.+Photo+by+Saichand+Chowdary+%2F+Mass+Media+Staff.
Saichand Chowdary
A student wears a mask while studying in the Campus Center. Photo by Saichand Chowdary / Mass Media Staff.

UMass Boston’s University Health Services released a mass email Monday, Nov. 6 that notified students, staff and faculty of a campus member who was recently diagnosed with active tuberculosis. The email, sent out to the Campus Community by UHS Director Robert Pomales, said that University officials were notified of the diagnosis by the Boston Public Health Commission, and as of the time his statement was issued, “The individual is currently receiving treatment and may have been infected with TB many years before developing active TB infection.” [1]

Moreover, Pomales mentioned that, “Approximately 39 people on campus have been identified as potentially having close contact with the person with active TB. Those people have been contacted and informed about steps they can take to protect themselves.” [1] When a UHS worker was asked what these precautionary steps were, they were unsure, but believed that whatever these measures consisted of promoted the safety of UMass Boston’s community to the highest degree. 

Pomales emphasized another message in his email—congruent with the memo provided by one of his members of staff—that outlined the course of action UHS is taking, ensuring that, “Appropriate testing and guidance is occurring.” Furthermore, he gave some much-needed reassurance to the University:

“Although TB is a serious disease caused by a germ that is spread through the air, it is important to note that the general UMass Boston community is not at increased risk for getting a TB infection as a result of this case.” [1] Pomales’ remarks come with a lot of important truths; active tuberculosis, despite being a major infection that can cause a serious decline in health, is still extremely hard to contract due to its lack of potency during a time of exposure. DeWayne Lehman, UMass Boston’s Director of Communications, doubled down on Pomales’ point in an email sent to The Mass Media:

“As with all exposures to infectious disease, the risk relates to many factors such as length of time and proximity (e.g. COVID or flu). The likelihood of contracting TB without very close and prolonged exposure is very small. The risk posed by brief contact such as an elevator ride, or the types of contact common in most public spaces for example, is almost non-existent.” Lehman also made sure to promise, “If any student is concerned about somehow being exposed, they are welcome to schedule an appointment with a University Health Services provider to assess the need for a screening test.” [2]

It is not the first time a student has been diagnosed with active tuberculosis on campus. WCVB reported there was a case that posed similar circumstances in May 2019; the diagnosis affected 59 people in close proximity. [3] For nursing student Megan Jacob, a diagnosis within UMass Boston’s community still ventured into uncharted territory.

Jacob commented, “It is surprising to hear that a student contracted TB. It’s not a rare disease, although I have never heard of any students getting it while I’ve been a student here.”  She also gave a brief rundown of the different stages of tuberculosis, and the implications they hold for individuals dealing with the said stages:

“The main [stages of tuberculosis] to understand are Primary Progressive TB, Secondary TB and Latent TB. Primary progressive is when you’re exposed to the pathogen and it immediately develops into an active infection […] Secondary TB is when it starts out as latent and the person doesn’t show any symptoms of being infected until they become immunocompromised, that’s when the TB becomes an active infection. Lastly, there’s Latent TB. Tuberculosis bacteria lays dormant in your body and is an inactive infection. Latent isn’t contagious or harmful to the person as long as it stays latent.” Jacob also talked about common symptoms that arise in a person who is infected with active tuberculosis; she said, “Things to look out for […] are low grade fever, night sweats, weight loss and a cough that has sputum.” 

Jacob remarked that it’s important to take precautionary steps in prevention when dealing with a disease like tuberculosis too. “The most important precaution is to wear an [N95 mask] because TB is an airborne disease transmitted through coughing, sneezing, laughing, etc. In the hospital setting, the patient with TB will be isolated in a room with negative pressure air.” She explained. “Not all people who test positive for TB have the active infection […] People who have [Latent Tuberculosis] will test positive even though they aren’t contagious to others […] people who have had the [Bacille Calmette-Guérin] vaccine will test positive for the infection even though they aren’t sick with the infection.” 

Dr. David Sigmon, a UMass Boston professor who specializes in Physiology and Pathophysiology in cardiovascular and renal health, offered insight into the science behind tuberculosis and its effects on patients. Sigmon, who prefaced that he is not an expert on infectious disease, graciously gave his time to speak about the matter. He elucidated, “[Active tuberculosis] is spread through particles, drop particles […] some of the active TB can come out when they’re speaking, and […] aerosolize, and then a person will breathe it in, and it will colonize their lungs.” Sigmon said that a key factor in the spread of tuberculosis is that the contaminants linger in the air for hours, and that, due to this, “people who can possibly get it are within a six-foot radius of a contaminated person.”

Similarly, to what Pomales and Lehman said, Sigmon hammered home, “If you come into contact with TB and you are a healthy individual, your immune system is going to wall it off in your lungs. Your macrophages, which are part of your immune system, your t-cells, which are part of your immune system, will wall it off into something that is known as a ghon focus.” A ghon focus, as noted by wikipedia, is a lesion caused by TB that is present in a non-immune body. [4] Sigmon pointed out that the lesion would translate into latent tuberculosis, and over time, if the person were to become immunocompromised—due to external factors like drugs or other infections—it would form secondary tuberculosis, which matches the explanation that Jacob gave. 

When asked about whether somebody who contracts latent tuberculosis could contract active tuberculosis when exposed to case of active tuberculosis, Sigmon made it clear, “There is something known as a reinfection, and many times, when a person has latent TB and has a reinfection, they then develop active TB, so […] in some cases, yes.” Regarding the use of skin tests, Sigmon said, “The skin test is the most accurate test right now.” However, coinciding with what Jacob said in regard to the BCG vaccine, Sigmon expressed, “There are many countries that give the BCG vaccine, and those individuals will test positive on a TB test. If those individuals, when they come to the United States and […] they test positive, what [medical professionals] will do is they will send them for a chest x-ray to take a look and see if they can find any latent lesions, or any lesions at all within the lungs. And if they don’t have the latent lesions—especially if they’ve already said to them that they’ve had the BCG vaccine—that is the reason they tested positive.”

Lastly, Sigmon said, “The BCG vaccine was developed to treat severe forms of TB (and) the BCG vaccine is not good at preventing transmission.” Sigmon’s claims are backed up by the Oxford vaccine group—an affiliation of Oxford University—who reported, “The vaccine is 70-80% effective against the most severe forms of TB, such as TB meningitis.” [5] The World Health Organization also published, “The impact of BCG vaccination on transmission of Mtb is […] limited (because) It does not prevent primary infection and, more importantly, does not prevent reactivation of latent pulmonary infection, the principal source of bacillary spread in the community.” [6]

Tuberculosis is not a disease that is prominent in everyday life. There are certainly some fears that come with the idea of the infection spreading, but UMass Boston, in cooperation with UHS and the BPHC, has effectively de-escalated the situation through its proactivity, and has continuously proven that it is not one to worry about. The immediate call to action by UMass Boston’s officials exemplified their ability to take care of incidents in a timely manner. By safeguarding the UMass Boston community through the university’s alert system, while also rendering solace and encouragement during moments of stress, the campus will be able to move on from this phenomenon quickly, with the implication of keeping smooth sails for the remainder of the year. 

 

  1. Pomales email – Google Docs
  2. Lehman email – Google Docs
  3. Campus alert issued after student diagnosed with tuberculosis (wcvb.com)
  4. About Us | Vaccine Knowledge Project (ox.ac.uk)
  5. BCG (who.int)
  6. https://www.who.int/teams/health-product-policy-and-standards/standards-and-specifications/vaccines-quality/bcg

 

 

About the Contributor
Nick Collins, Sports Editor