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Calif. County Officials To Require TB Tests for All Students

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Health authorities in Orange County, Calif., have announced plans to require all prospective students to prove that they have been tested for tuberculosis.

The order comes in the wake of what officials have called the worst outbreak of drug-resistant TB at a high school ever reported.

Dr. Jody Meador, the county health department's tuberculosis controller, said the new requirement was necessary in light of a growing incidence of the respiratory disease nationwide, particularly among children. (See Education Week, Sept. 18, 1991.)

But she acknowledged that the mandate was given greater impetus by an outbreak of a drug-resistant strain of TB at the county's La Quinta High School.

More than 220 La Quinta students, nearly a quarter of the student body, tested positive for TB last September, according to published reports.

Another 84 students, who had not previously been tested or whose tests had proved negative, tested positive in June.

A dozen students are currently being treated for drug-resistant TB, and one student with an active case of the disease has had part of a lung removed.

Dr. Meador said there are currently a total of 450 reported cases of TB in the county, adding that there had been an 88 percent increase in the number of reported cases in the last five years.

Children could be tested in several ways, including by private physicians and the health department, she explained.

District 'Fully Supportive'

The school district, Dr. Meador added, is "fully supportive'' of the new requirement.

Children who have not been tested, she added, could be barred from classes.

Orange County joins a number of jurisdictions nationwide that are developing programs to combat the disease. Some have looked to a pioneering program in Camden, N.J., that has for years tested children at school for TB. (See Education Week, July 14, 1993.)

The efforts come at a time when the disease is spreading more rapidly among children than in the population as a whole.

Between 1985 and 1992, the number of children under age 15 with active TB rose 35 percent, from 1,261 cases to 1,707. The total number of Americans diagnosed with active TB in 1992 was 26,673--a 20 percent rise from 1985.

Children's immature immune systems leave them more susceptible than adults to the tuberculosis bacteria, experts say.

The spread of TB in recent years has been linked to such factors as the spread of AIDS and increased immigration from regions where the disease is prevalent.

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