Fears of tuberculosis loom over one Texas school district where hundreds of students must be tested this week before returning to classrooms in late August.

On Monday, Fort Bend County Health & Human Services (HHS) announced that 647 students and 27 faculty members at George Bush High School, who were potentially exposed to a case of active tuberculosis on campus in May, must undergo TB blood testing on Thursday, August 3.

County health officials set up testing for them in June. Although only 228 people appeared, Fort Bend HHS identified 11 new TB blood-positive cases. They will conduct this second round of testing for the notified students and staffers not previously tested or requiring retesting.

“A positive test does not mean that the person is ill with active TB disease; it simply means that they have been exposed to the bacteria and are infected,” said Fort Bend County HHS Monday in a press release. “The infected person may never develop TB disease and cannot spread the disease to anyone else while only testing positive.”

TB is caused by Mycobacterium tuberculosis. Breitbart Texas reported the illness spreads from the coughs, sneezes, wheezes and other respiratory fluids of a person with an active infection. While typically considered a lung affliction, it can affect other organs in the body. Health officials say it takes prolonged and close contact with an infected person to catch TB. When someone tests positive for TB but does not get sick it is classified as latent TB infection (LTBI). A person with active TB manifests symptoms like chest pain, muscle fatigue, weight loss, lethargy, and coughing up blood. Active TB can spread rapidly.

The new school year in Fort Bend ISD begins on August 22. According to the district, 2,276 students attended George Bush High in 2016-17. Presently, little else is known about the origin of the school’s TB outbreak and federal privacy laws protect student information.

Breitbart Texas spoke with Fort Bend County HHS Deputy Director Kaye Reynolds. Although she did not address inquiries regarding the current high school TB testing or any demographic information on “patient zero,” she said that, in 2016, the county reported a total of 27 TB cases within the general population: five of these cases were U.S.-born individuals, five cases originated with people who came from Central and South America, 11 were persons of Asian origin, and six, she listed as “other.” Reynolds did not identify if TB cases were active, blood-positive, or latent.

Recently, Breitbart Texas obtained the 2016 Fort Bend County Clinical Health Tuberculosis Annual Progress Report through an open records request. It provided insights into situations the county’s three case managers faced in handling last year’s reported TB cases. Specifically, it identified barriers these workers encountered when trying to deliver timely diagnostic testing and/or treatment to “Class B immigrants and refugees.”

Reynolds clarified that Class B referred to latent TB where B1 reflected an abnormal X-ray requiring further testing and B2 meant individuals looked fine but the county health department still sent them on for further precautionary treatment.

According to the report, one hurdle case managers experienced was that immigrants and refugees often resided at different addresses than those listed in their paperwork. For example, some gave out Catholic Charities as their residence even though they lived elsewhere. Locating these people delayed “complying with the 30 days of arrival compliance.”

“We are learning as we go along,” the report stated. “We know to contact Catholic Charities now as soon as we get an immigrant/refugee with that address to cut down on the location time.”

Another stumbling block was that migrants and refugees did not always complete TB drug treatment “due to the fluid movement of this population.” After these individuals arrived and got jobs, they moved without notifying case managers to forward medical records. The report noted the difficulty “to get the family member or sponsor to return with the client for refills due to the family/sponsor being busy with work.”

In 2007, the U.S. Centers for Disease Control and Prevention (CDC) recorded the TB incident rate at its lowest since national reporting began in 1953, but found the TB rate among foreign-born persons in the U.S. 9.7 times greater than U.S.-born individuals. In cities that housed many newly arriving immigrants and refugees, TB rates jumped well above the national average. Drug-resistant TB and extrapulmonary disease, higher among the foreign-born population, made “diagnosis and management of these cases both challenging and essential for effective prevention and control of TB.”

In 2015, the CDC attributed 66.4 percent of reported U.S. TB cases to foreign-born persons, reflecting a case rate roughly 13 times higher than among their U.S.-born counterparts.

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Fort Bend County Clinical Health TB Annual Progress Rpt CY 2016 by BreitbartTexas on Scribd