Public health officials and staff at the Newton County Detention Center are tracking and testing at least 140 people who may have been regularly exposed to a Newton County man diagnosed with contagious tuberculosis and have confirmed at least three cases of TB transmission.
Anthony Underwood, 32, of Covington was arrested May 9 for not complying with treatment prescribed by the East Metro Health District for tuberculosis.
Underwood had been incarcerated at the Newton County Detention Center on other charges when it was discovered on May 2, during a routine testing given to inmates after 10 days at the jail, that he had a contagious stage of the disease, said Lisa Smith, a licensed practical nurse at the Detention Center.
Underwood was treated at Newton Medical Center and released on condition that he put himself in isolation at home - meaning he was not to leave the house or be in contact with other residents of the house - and take the medication administered by nurses during home visits, according to East Metro Health District spokesperson Vernon Goins.
But when District staff came by, he was not at home.
Currently, Underwood is undergoing a four-month treatment in the jail's medical ward in a special negative pressure room where air from the room is drawn out and released safely away from staff or inmates said Smith, who added that Underwood was cooperative in his treatment. This was the first case of active tuberculosis she had seen in seven years working at the jail, she said.
About 200 to 250 total people at the jail are undergoing skin tests for tuberculosis as a precautionary measure, including all staff and the approximately 70 inmates in the pod where Underwood was previously housed. Although there were still about 75 people left to test, as of Tuesday, there were no positive results said Smith.
The health district is testing about 40 people outside of the jail who came in regular contact with Underwood, including 11 family members, 14 extended family members and 15 friends and associates, Goins said.
Out of those 40 people, 25 had positive skin tests, and three tested positive for contagious tuberculosis through a lung sputum test, with two more are suspected to have contagious tuberculosis but awaiting test results. Those five people are undergoing treatment, said Goins, and the three confirmed cases are not associated with schools or other institutions.
The health district is still trying to determine where and when Underwood contracted the disease.
Five other health districts - DeKalb, LaGrange, Northeast, North Central and North - have begun investigating and tracking down possible exposed persons based on Underwood's reported travels. Underwood listed a painting company as his last known employer, according to the Newton County Detention Center.
Tuberculosis is transmitted through the air by regular, repeated exposure to someone who has an active case of tuberculosis in their lungs and not by casual transmission, Goins said.
"If he was in a room with you in a theater, no, you're not going to catch it. That's not the way it works," he said.
Tuberculosis is tested at three levels, explained Goins. Exposure, determined by a skin test, means a person has been exposed to someone with TB in the past and has developed antibodies for the tuberculosis-causing bacterium, but does not mean they have the disease. A chest x-ray can determine if a person is positive for latent tuberculosis. This means the person has the bacterium in their body but is not sick from it and is not infectious, although they could be in the future. A person found to be contagious with a test of phlegm or sputum from their lungs is likely experiencing symptoms and is infectious to others.
Refusing tuberculosis treatment is extremely rare, said Goins, who added this was only the third time in 25 years of working with the district that he had seen a situation requiring detention. The last case involved a teenage illegal alien in Gwinnett County who was detained, treated and eventually deported last year.
There were 59 reported cases of tuberculosis, both latent and active cases, last year in the East Metro district, which is composed of Newton, Rockdale, and Gwinnett County.
Treatment and the tracking efforts connected to Underwood's case are going to take about a year, said Goins.
"(The TB) bacterium grows extremely slowly. You can have it for months, some even years," said Goins. "A year from now we will still be sorting through this."
