When Makiko Imamura, third year Sapporo, Japan graduate student, was a baby, she received a protective vaccination in Japan that later caused her to test falsely positive for tuberculosis when she came to the University of Kansas.
Currently, only international students are required by the University to test for TB because they are considered high-risk. Since 2006, the University has used a more accurate test to reduce false positives.
If a bill now being considered by the Kansas Legislature is passed, all students on campus will be required to fill out a TB screening questionnaire and, in some cases, be tested for the illness beginning as soon as the fall 2010 semester.
Tuberculosis is caused by a bacterium. It is spread by coughing and being in close quarters with someone who has an active case of TB, said Dr. Leah Luckeroth, staff physician at Watkins Memorial Health Center. With dorm situations, international students and studying abroad in high-risk locations, TB has multiple opportunities to spread.
This fall, 450 students have been tested for TB, Luckeroth said, and she expects about 200 more this spring.
"I'd like to have the best test possible," Luckeroth said. "It's my job to get them treated, if they're infected, before it gets to you."
According to the Kansas Department of Health and Environment, there were 3,074 latent, or inactive, TB cases reported in Kansas 2006. The majority of cases were reported by people between ages 15-24 and the highest rate of cases was found in Asian or Pacific Islanders.
If international students do not get screened for TB before they enroll for the first time at the University, Watkins will place a hold on their account, Michael Ediger, Associate Director of International Student Scholar Services said. In some cases the student may be disenrolled, Ediger said. Imamura had a hold placed on her account when she tried to enroll for this spring.
"I talked to Watkins about it and they took the hold off since I've been enrolled consecutively," Imamura said.
When new international students arrive at the University, they are highly encouraged, but not required, to attend orientation, Ediger said. If they don't chose to go to orientation, the office of International Student Scholar Services informs them that they will have a hold on their account from Watkins.
"Our office has a strong rapport with Watkins," Ediger said. "If there is a student who hasn't done a follow up, ISSS is involved in contacting the student."
If a student has KU Health Insurance, the TB test cost will be covered, Watkins Registered Nurse, Patty Quinlan said. For other Insurance companies, the policies and coverage varies. Watkins was the third lab in the state to offer the newer and more accurate test called the QFT-G test, short QuantiFERON-TB Gold Test, Quinlan said.
"It's more mainstream now but I'm pretty proud of the fact that we were one of the original testing sites," Quinlan said.
If a TB skin test or QTF-G test result is positive, a chest X-Ray is taken and the person has a 10 percent chance of it becoming active, Luckeroth said.
"After someone has been exposed to TB, the highest risk is during the first two years," Luckeroth said.
Luckeroth said the first case of TB she ever encountered as a doctor was in an 80-year-old women who was exposed to TB when she was a child, but it did not activate until her senior years.
"It activates under stress," Luckeroth said. "If an international student is exposed and then comes here and gets stressed because of the new situation, it can cause it to activate."
If a student has the inactive virus, they are encouraged to take a pill to help prevent it from becoming active, but it is optional. A person who has active TB is required to take measures to cure it, which includes at least four different pills. With the QTF-G test, Luckeroth said there is a better chance of diagnosing TB. Imamura said she though it was a good idea to have a more accurate test.
"It would save time if you didn't have to get an X-Ray and you could avoid radiation," Imamura said.
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