Pop-up clinic set up by area health officials in a northwest Omaha YMCA, to test people exposed to a person ill with tuberculosis. (Courtesy of Douglas County Health Department)
OMAHA — Back-to-back public health emergencies in Nebraska’s largest county received encouraging status updates during a Wednesday meeting of the Douglas County Board of Health.
One of the situations involved a raccoon rabies variant not seen previously in Nebraska.
The other concerned an active tuberculosis case at a drop-in child care center that potentially exposed about 550 people, largely kids.
Both have sparked unusual mobilizations.
County Health Director Lindsay Huse told the board that all signs indicate that the rabies variant — detected in a stray kitten whose history is unknown — has not spread locally.
Of several hundred animals and roadkill specimens looked at so far, she said, none turned up positive.
“That is excellent news — we hope it stays that way,” Huse said.
Just as that response was winding down, she said, ”we had another great big public health emergency…not much of a break there.”
The more recent tuberculosis investigation, announced on Nov. 9, started after an active case was tied to the northwest Omaha Westview YMCA Childwatch. The center provides short-term care for children while a parent or guardian is working out.
Huse said the county typically investigates 15 to 20 tuberculosis cases a year. TB can be fatal if not treated.
“What makes this particular instance kind of unique is really the scope,” she said.
Tracing efforts identified the more than 550 possible exposures. Testing quickly began, as did preventative treatment for children under age 5.
Depending on the time of possible exposure, follow-up tests may be needed. So far, Huse said, no related active cases have surfaced.
“I feel really good that it’s probably not going to result in an outbreak situation,” Huse said.
She added, “There will be a point, it’ll take a little bit of time, several weeks, before I can say with certainty that, ‘We’re good.’”
This past weekend, 272 children who had been contacted by the county underwent testing at Children’s Nebraska, said Justin Frederick, the county health department’s deputy director.
Pre-schoolers are at higher risk of progressing rapidly to active TB after infection. Little ones who may have been more recently exposed and who require a follow-up test also were offered treatment to prevent infection and progression.
More testing is taking place this week at clinics at the YMCA site, with about 150 people registered.
Frederick said in an interview that others at risk have chosen to see their family physician. Exposures could have occurred from late May through October at the Childwatch near 156th and Ida Streets.
“At this point, I’m feeling very comfortable with the response,” Frederick said.
He said it was important to say there is no “real worry” of exposure to the general population.
TB bacteria can spread through the air, when an infected person coughs, speaks or sings. Testing was recommended only for those who had close contact on one or more occasions with the contagious patient.
Health officials have declined to identify the original patient. They said they were helping the person isolate and that the person was following a medication regimen until testing is negative.
Huse declared an official public emergency Monday, opening up the door for additional resources.
The county and its partners in October initiated a multi-pronged response that included trapping raccoons with bait so they could be examined, vaccinated and released.
“They were able to vaccinate 753 raccoons, 41 skunks, four cats and a fox,” Huse told the health board. “So that was a pretty successful effort.”
Other phases include testing roadkill and dead animals, and that continues possibly through February, Huse said. About 18,000 oral rabies vaccine packets also were laid out in the county.
Concern was heightened because raccoons are so common in Nebraska and frequently come into contact with people’s pets. Huse said the raccoon rabies strain involved had not previously been detected west of the Appalachian mountains.
Six people who handled the baby cat, and four people at the veterinarian’s office, underwent appropriate treatment.
Health and animal agencies had no luck finding the animal’s “backstory,” Frederick said, adding that the “hypothesis” is that the kitten or its mother was brought here somehow from the East Coast.
Said Huse of the variant: “I am cautiously optimistic that it is not established here in Douglas County.”
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