Tuberculosis exposure: Babies exposed after birthdate excluded from list; side effects of treatment

As some parents weigh the risks of the Tuberculosis treatment their babies are encouraged to undergo, other parents are concerned why the Health Department and Providence Memorial Hospital are not including infants exposed to the dangerous disease after their date of birth.

Providence officials said they cross referenced babies who were born during a shift the infected employee was on duty. But some parents said their babies were exposed after their date of birth when the infants stayed at the nursery days after being born.

Las Cruces resident Melissa Martinez said her daughter was exposed after she was born and the hospital did not include her in the list of exposed babies. According to the hospital schedule of times the infected employee was on duty, Martinez’s baby was in the nursery during her shifts, yet Martinez did not receive a letter urging her to test her baby for TB.

“When I called because she wasn’t exposed on her date of birth I wasn’t on the list to receive a letter, and I had to ask them (the Health Department) to please research to make sure she wasn’t exposed. Had I not done that – I wouldn’t have known she was exposed and needed to be tested for TB,” Martinez said.

On Wednesday, a Providence administrator could not explain why the hospital is not counting babies who could have been exposed to tb after their date of birth. He said the health department decided who was at risk. The Health Department Director Robert Resendes said it was Providence who cross reference the list and later added the Health Department used the guidelines set out by the Department of State Health Services.

Carrie Williams, the Director of Media Relations for the Texas Department of State Health Services said “the key aspects we evaluate in determining the scope of a contact investigation include duration and intensity of exposure, the environment (ventilation) and whether there are medical issues that put a potentially exposed person at higher risk of developing the disease. Age also comes into play, as the immune systems of newborns are not as well developed and may not be strong enough to fight off tuberculosis.”

SIDE EFFECTS OF TREATMENT AND TESTS
According to the Health Department, babies under six months old will be prescribed treatment for three months, even if they initially test negative for TB. Resendes said the babies will be prescribed Isoniazid, the most common TB medication.

Local pediatrician, Dr. Alison Days said the biggest risk of taking the medication is in the babies’ livers. “Isoniazid is processed through the liver so it can have some toxicity, theoretically usually its in people who are being treated for a long period of time – taken more than 9 months but people can see symptoms in the first couple of months. Though it’s rare.”

She said babies livers are more vulnerable than adults and parents should watch for side effects. “Some of the signs of damage are jaundice, vomiting, change in appetite, failure to thrive,” she said.

The possible side effects are temporary and Dr. Days believes the risk of not taking the medication is greater than not taking it. “If you’re not doing the treatment means basically waiting until they have symptoms and in that period of time they might transition to having the disease. Babies under 6 months are much more likely to be fatally infected if they’re infected or have much more complications.”

For more on the medicine given to babies for possible TB exposure, go to http://bit.ly/1rntpCS