Re: TB testing singles out migrant workers' Kids

[Guest guest]

Wednesday, February 8, 2006

Brewster school district TB testing singles out

migrant workers' kids

Action taken without state, county consultation

Graman

Staff writer

February 8, 2006

The school district in Brewster, Wash. – already named in a federal

civil rights lawsuit brought by the parents of Latino students – now has

singled out the children of migrant workers for tuberculosis testing as a

condition of enrollment, without consulting state or county health officials, according to those officials.

Selectively testing one population is not standard

practice, especially when no one shows symptoms of tuberculosis, said Dr.

Kim Thorburn, Spokane

County health officer.

"If you are insistent (on testing), it should be

all students," Thorburn said. "There are all these policy considerations

that should have been worked out. It's just not the way we do TB control."

Concerned about October news reports of a case

of tuberculosis at Coeur d'Alene High School, Brewster school Superintendent

Jim kept at least four students who tested positive for tuberculosis

out of school "until a doctor can assure us in writing that they do not actually

have TB," according to a Jan. 17 e-mail sent to Kim Field, tuberculosis

program manager for the Washington Department of Health.

wrote Field that "13 of my migrant students"

were tested, and seven tested positive. Of those, three students had transferred

to another school district, leaving four in the Brewster district. It's unclear

whether more than the 13 have since been tested.

"I assume we will get letters from doctors indicating

it is safe for these students to return to school," wrote. "If so,

we may not have a problem. If not, what steps should we be taking in order

to protect the rest of our students? Notification of parents? Testing of

all students?"

The testing, apparently done by a local health

care provider, occurred without consulting either the Department of Health

or the Okanogan County Health District, Field said. Only migrant students

were tested.

was out of town on Tuesday and unavailable

for comment. Brewster school board member Dina Divas declined to comment

other than to say, "We are testing."

According to 's e-mail to the Department of

Health, 80 percent of the Brewster

School District's student

body is Hispanic and 40 percent are the children of migrant workers.

Mexico has a higher tuberculosis rate than the United States.

For this reason, Mexican children often are inoculated with the Bacillus

Calmette-Guerin, or BCG vaccine, which can cause skin tests to read positive.

According to the Spokane Regional Health District, there are other reasons

for false positives, and a positive test does not mean an individual has

active tuberculosis or can infect others.

More than 30 students, faculty and staff of Coeur d'Alene High School showed positive reactions

to tests after a student was hospitalized with an active case of tuberculosis

believed to have been contracted outside the country, The Spokesman-Review

has reported. None of those has shown symptoms of the bacterial disease,

and none was kept out of school.

In a follow-up telephone conversation with Field,

spoke of steps the Brewster

School District took

to protect its students against tuberculosis. Field summarized the conversation

in a Jan. 19 e-mail to other public health officials including Thorburn:

"Community members raised the issue of concern

for TB when they heard about the Idaho student."

"The school decided to screen all migrants (from

Mexico)."

"This individual () excluded all the students

from school initially – and said they had to be released back to school."

"The individual went to our DOH Web site to 'learn'

about TB and discovered the difference between infection and disease."

"He stated he has allowed the children to return

to school unless they 'have symptoms.' "

"He stated that as a school district they will

continue to screen all migrant children for school entry."

Field said that she thought called to say

he had reversed his decision to continue screening, but that was not the

case.

"I referred him to the local health officer and

local health department," said Field, adding that still had not notified

the Okanogan County Health District.

"I was a little upset that we weren't notified,"

said Lauri , public health nurse for the health district.

said she knew of no other school district

in Okanogan

County testing students,

but that Brewster has the largest Latino population in the county.

Field, who has been with the state's tuberculosis

program since 1993, also said such testing is not standard practice in Washington state.

Because positive tests for TB are not required to be reported under state

law, the Department of Health has no record of who was tested or who did the

testing.

None of the district's three clinics contacted

by The Spokesman-Review provided the tests, according to their spokespersons.

The Brewster

School District, and high

school Principal Randy were named as defendants in a civil rights

lawsuit filed in U.S. District Court in Spokane in October. Eight Latino parents

allege the district discriminated against their children by singling them

out for disciplinary action not imposed on non-Latino students.

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