Minnesota Health Officials Conceal Case of Active TB in High School for Six Weeks

A student or staff member at St. Louis Park High School in suburban Minneapolis, Minnesota, was diagnosed with active tuberculosis (TB) in late November, but Hennepin County Department of Health officials and St. Louis Park Public Schools officials concealed that information from the public until the second week of January, six weeks later.

“Some parents received letters in the mail Thursday saying their teenagers may have been exposed to an infectious disease,” WCCO reported.

“In late November, the school district was notified by the Hennepin County Department of Health that an individual at the high school had been diagnosed with active (TB),” St. Louis Park Public Schools Superintendent Rob Metz wrote in a letter sent to parents of students dated January 11.

The letter was sent in three languages: English, Spanish, and Somali.

“By the time we were notified, the individual was receiving medical care and posed no further risk or exposure to the school,” Metz said.

“The Tuberculosis experts at the Hennepin County Department of Health asked us to wait to communicate this information and arrange for the testing until they could determine who needed to be tested,” Metz admitted.

The concealment of the diagnosis of active TB stands in marked contrast to the decision by Omaha Public School officials and Douglas County, Nebraska, public health officials, who in November, as soon as the diagnosis was confirmed, released to the public news that a student at Benson Magnet High School, where 18 percent of all students are refugees, had been diagnosed with active TB .

Public health and public school officials in Rock Hill, South Carolina, also released news that a middle school student had been diagnosed with active TB in December during the first week of January.

One public health expert was stunned by the failure of the Hennepin County Department of Health, the Minnesota Department of Health, and the St. Louis Park Public Schools to immediately inform the students, their parents, and staff members of the risk of TB to which they had been exposed.

“The proper thing to do when an active case of TB is discovered is to notify and test contacts immediately,” Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons, tells Breitbart News, adding, “If negative, they need to be tested again in about six weeks. One infected person can affect many. One that he infects can infect many, and soon you have exponential spread and an epidemic. In fact, close contacts of the known patient may have already been spreading disease, especially if they are all refugees that were living in crowded conditions.”

“Moreover,” Dr. Orient continued, “the fact that the individual is receiving care does not guarantee that he is not a risk. Has he had three negative sputum tests? Remember, it may take six weeks to be sure the organism is not going to grow. Is it sensitive to the prescribed drugs? Is the individual taking the drugs faithfully?”

“Yes, I think this failure to follow standard public health procedures is stunning,” Orient concludes.

St. Louis Park Public Schools Superintendent Metz sent the late notice of the case of active TB to parents eight days after he announced he was resigning to become deputy director of a program called Building Assets, Reducing Risks that began at St. Louis Park High School.

“The Building Assets, Reducing Risks position became a possibility after the center won a $20 million U.S. Department of Education grant to implement or expand the initiative in at least 116 schools nationally within the next five years,” the Sun Sailor reported:

The federal government has already helped fund expansions of the Building Assets, Reducing Risks program to dozens of schools. The new funding will help the program expand to 50 additional schools across five states, according to the U.S. Department of Education.

The Building Assets, Reducing Risks program began as a way for the St. Louis Park School District to help freshmen transition to high school. At the time, nearly half of St. Louis Park ninth-grade students failed at least one class. Other risks on the rise then included higher rates of substance abuse, truancy and discipline referrals.

Breitbart News contacted Metz and St. Louis Public Schools Board of Education Chairman Joe Tatalovich for comment but did not receive a response.

As Breitbart News reported on January 9, 36 percent of all cases of active TB in Minnesota between 2012 and 2015, or 225 out of 610, were diagnosed in refugees resettled in the state by the federal government, the highest rate in any of the 46 states in which the Centers for Disease Control (CDC) obtains data.

Refugees account for less than one percent of the state’s population of 5.5 million, according to one estimate.

Minnesota leads the country by far in one category of public health: refugee TB per capita. During the four years between 2012 and 2015, 4.08 cases of refugee TB were diagnosed for every 100,000 residents of the state.

Nebraska trailed Minnesota in a very distant second, with 1.26 cases of refugee TB diagnosed for every 100,000 residents of the state during the same four-year period.

Eighty-five percent of all TB cases diagnosed in Minnesota in 2015, or 128 out of 150, were foreign-born, 19 percent higher than the national average of 66 percent.

Seventy-two percent of the 39,669 refugees who have been resettled by the federal government in Minnesota since 2003, or 28,831 out of 39,669, arrived from five high TB burden countries: Somalia (16,069), Burma (7,975), Ethiopia (3,399), Bhutan (1157), and the Democratic Republic of Congo (231), according to the Department of State.

One hundred and thirty-six Somali refugees and 20 Ethiopian refugees have been resettled in the city of St. Louis Park, which had a population in 2015 of 48,534.

The state of Minnesota is home to the largest Somali community in the United States, most of whom live in the Minneapolis-Saint Paul metropolitan area.

In a presentation made to the St. Louis Park Multicultural Advisory Committee, Human Rights Commission, and Police Advisory Commission in August 2016, Minnesota State demographer Susan Brower reported the city’s 2015 population was 48,354, and had grown slightly less than 1.5 percent annually between 2010 and 2015.

During the 2010-2014 period, 80 percent of the city’s population, or 37,056 out of 46,466, was white non-Hispanic, according to Brower.

Twenty percent of the city’s population during the 2010-2014 period, or 9,400 out of 46,466, were Populations of Color: 3,329 were black; 2,052 were Latino; 2,051 were “Multi-Other;” 1,790 were Asian; and 188 were American Indian, Brower reported.

Neither the Hennepin County Health Department, the Minnesota Department of Health, nor the St. Louis Park School District disclosed whether the individual diagnosed with active TB was a foreign-born refugee, a foreign-born resident with a different original immigration entry status, or U.S.-born.

St. Louis Park Public Schools did not respond to questions from Breitbart News as to the percentage of the 1,400 students who attend St. Louis Park High School who are refugees.

St. Louis Park High School employs two English Language Learner (ELL) teachers.

The St. Louis Park Public Schools website states that “over 250 children [receive] ELL services” out of the district’s 4,590 students (K-12), about five percent of all enrolled students.

“The school district says someone who had TB but was unaware was inside the building while contagious during the months of September, October and November. The school has about 1,400 students,” WCCO reported.

The testing of students for latent TB is voluntary and is planned to take place at the end of January.

The TB bacteria is transmitted from a contagious individual with active TB to a healthy individual through air droplets from coughing, sneezing, or other methods of contact.

Once the TB bacteria is in a person’s system, he has latent TB, which is neither active nor contagious, but which can develop into active contagious TB.

Only four percent of the general population has latent TB. Foreign-born residents of the United States, and refugees in particular, have a much higher rate of latent TB, ranging from 11 percent in Florida to 35 percent in Vermont.

Twenty-two percent of refugees arriving in Minnesota tested positive for latent TB in 2014.

Ten percent of those who have latent TB in the general population develop active TB at some point.

According to several recent medical studies, including one done in 2013 at the University of California at San Diego, refugee communities with high rates of latent TB experience a higher rate of activation than the general population. This difference may be due to the greater stresses placed on their immune systems.

In that U.C. San Diego study, the problem was particularly acute among refugees from sub-Saharan Africa, primarily Somalis and Ethiopians:

The prevalence of LTBI [latent tuberculosis infection] was highest among refugees from sub-Saharan Africa (43 percent) and was associated with current smoking and having a clinical comorbidity that increases the risk for active tuberculosis.

…

Although refugees from sub-Saharan Africa had the highest prevalence of infection, they were significantly less likely to initiate treatment than refugees from the Middle East. Refugees with postsecondary education were significantly more likely to initiate LTBI treatment.

Breitbart News contacted the office of Sen. Amy Klobuchar (D-MN), the former county attorney for Hennepin County, for comment on the handling of the St. Louis Park High School active TB case by Minnesota officials, but did not receive a response.

Klobuchar is up for re-election in 2018. In November, President-elect Donald Trump lost the state of Minnesota to Hillary Clinton by 43,785 votes, only 1.5 percent of the more than 2.7 million votes cast in the state.

Before Trump’s electoral victory in November, Klobuchar’s seat was considered safe in 2018.

Public concerns about health, security, and crime related to high levels of refugee resettlement, however, helped power Trump’s wins in the nearby states of Wisconsin and Michigan, and his better-than-expected showing in Minnesota.

There is no evidence that the individual diagnosed with active TB at St. Louis Park High School in November was either foreign-born or a foreign-born refugee.

However, the six weeks concealment of the diagnosis from the public by Minnesota officials, combined with their failure to affirmatively declare whether the individual was foreign-born, a foreign-born refugee, or U.S.-born, all serve to heighten public distrust of public officials in Minnesota and fuel anti-incumbent sentiment just as Klobuchar begins to prepare for her re-election campaign.

Incumbent Governor Mark Dayton, a Democrat, has said he will not run for re-election to a third term in 2018, so that race is less likely to be influenced by anti-incumbent sentiment.