HANOVER — A Dartmouth College student has been diagnosed with an active case of tuberculosis.
The individual, whose identity the college is withholding due to patient confidentiality laws, is currently receiving medical care off-campus and will not return until the individual has been cleared by the New Hampshire Department of Health and Human Services’ Division of Public Health Services, Dr. Mark Reed, the Dartmouth health services director, wrote in a campuswide email.
State officials on Thursday confirmed the patient is a student.
“The health and safety of our community is our most important concern, and I want to stress that there is no further risk of tuberculosis contagion to the community from this person,” Reed wrote.
Working with Dr. Elizabeth Talbot, a Geisel School of Medicine professor and New Hampshire’s deputy state epidemiologist, the college will work to identify and contact anyone who was in close contact with the sick person who may need to be screened for tuberculosis.
Tuberculosis, or TB, is caused by an airborne bacterium. There are two related conditions: active TB, which this person has contracted, and latent TB, which occurs when the bacterium is present in the body without causing illness. About 4% of people in the U.S. and 25% of people around the world have latent TB, which is not contagious.
There were 9,025 active TB cases in the United States in 2018, according to the Centers for Disease Control and Prevention. There are fewer than 20 cases of TB in New Hampshire each year and fewer than 10 in Vermont.
The TB bacteria usually attack the lungs, but also can affect other parts of the body, including the kidney and brain. TB can be fatal if not treated properly, the CDC said.
Talbot, in a community forum at Collis Center at Dartmouth on Wednesday, sought to assuage community members’ fears.
“There is nothing unusual about what’s happening,” she said.
Though worldwide TB is the leading infectious cause of death — about 1.5 million people died of TB in 2018 — Talbot said those deaths occur in places where treatment is not available.
“This is not that place,” she said to the roughly three dozen people gathered Wednesday.
Both detection of and treatment for TB have improved in recent years and TB is curable through medication, she said.
Talbot said the state will work with the college’s health service to identify other people on campus who may have inhaled bacteria that the student with the active form of the disease may have coughed into the air. Those who are at highest risk are people who were in close proximity to the patient in a small, enclosed setting. In addition, people with HIV, cancer or who are on certain medications are at an increased risk of the disease moving from its latent to active form.
Those at risk will be asked to take a blood test to determine whether they have been infected recently. People who have been infected will be offered treatment for the latent form of the disease, which usually involves taking medication for three or four months, Talbot said. She did not expect the investigation would find other people with the active form of the disease.
Though it is cold and flu season and many people are coughing, Talbot said symptoms of active TB can easily be distinguished from the cold or flu. TB does not start with a runny nose or a headache. It is characterized by a cough that lasts more than two weeks, and also may include weight loss and night sweats, she said.
She anticipated that it will take weeks or months to identify everyone who may have been infected and the investigators will look back to exposure that may have occurred during fall term. She said this is a standard process that is used on campuses and at businesses across the country.
When a member of the Dartmouth community contracted tuberculosis about a decade ago, the college also worked with the state to investigate it, college spokeswoman Diana Lawrence said in an email.
At the forum, Sandra Sowle, the college’s custodial services manager, asked what she should tell her team.
“When something like this comes out,” Sowle said she has “173 custodians that panic and call me and want to go home.”
Talbot said Sowle and other members of the community should refer to information put out by the CDC and provided at the forum about the difference between the active and the latent form of the disease. Those with concerns also can contact their primary care providers or call Dartmouth College Health Service at 603-646-9400 or the state public health team at 603-271-4496.
Henrike Frowein, a Dartmouth research compliance officer and the parent of a Dartmouth freshman, asked Talbot to quantify the risk to students. Though it was unstated at the forum what role the infected person plays at the college, Frowein said she felt the “worst-case scenario” would be that the person is a student who was living in a dorm in close proximity to others.
Talbot said that in households where one person has an active form of the disease other household members have less than a 30% chance of contracting the disease.
She assured those gathered that the investigators will reach out to those who they find may have been at risk of infection.
“We will get to you as the investigation unfolds,” she said.
Talbot will hold a second community forum in Hanover on Thursday at 1 p.m. in Dartmouth Hall Room 105.
Nora Doyle-Burr can be reached at ndo yleburr@vnews.com or 603-727-3213.
Update
This story has been updated to reflect that the person with TB is a student.
