TB case prompts massive health investigation

31 January 2005

AMSTERDAM — The largest tuberculosis (TB) investigation in Dutch history begins in Zeist on Monday. Five percent of the 15,000 people undergoing tests are expected to have been infected with the bacteria.

Johan van Oldebarneveldtlaan, an employee of a C1000 supermarket in the central Dutch city, was diagnosed with a very infectious form of TB in November last year. Initial tests confirmed that the 25-year-old man’s entire family and 40 of his 79 colleagues have also been infected.

Zeist City Council and the health authority GGD Midden-Nederland decided to examine every customer who shopped at the supermarket between 1 January and 18 November 2004. Based on a telephone survey, the GGD expects to test 15,000 people from the municipality this week.

Three-quarters of the C1000 customers urged to report for an examination will undergo Mantoux tests on Monday and Tuesday. The procedure involves testing exposure to TB by injecting diluted tuberculin under the skin. The people undergoing this test will have to report back on Thursday and Friday for the results.

For people older than 60, lung x-rays will be taken in a mobile health clinic and the results will be known in three weeks time.

TB doctor and the co-ordinator of the KNCV Tuberculosis Fund, Vincent Kuyvenhoven, told newspaper De Volkskrant that it is reasonable to expect 5 percent of the people examined will be infected with TB. “But it could also be 10 percent,” he said.

Kuyvenhoven — who said the investigation was the largest of its kind in the Netherlands — explained that the infection rate is dependent on many factors. This includes how close the infected supermarket employee came into contact with customers.

The costs of the operation are estimated at EUR 500,000, to be paid by the Zeist council. The municipality has requested assistance from the national government and Utrecht province, with Mayor Rudi Boekhoven saying that the town should not be held fully accountable for such a large investigation.

Meanwhile, the C1000 staff member is still at home sick, while his infected colleagues are taking medicines and are still working.

But an eight-year-old boy whose father works at the supermarket — and was infected with TB — has also been infected with the bacteria. So too has the boy’s friend, but neither of them have contracted the actual illness and therefore do not pose a risk to other people.

Nevertheless, GGD Flevoland is examining the boy’s classmates in his home town of Zeewolde. The classmates of his friend — who attends another school — will not be examined, newspaper Algemeen Dagblad reported.

Tuberculosis is an infectious disease of humans and animals caused by the tubercle bacillus. A TB infection of the lungs causes the coughing up of mucus and sputum, fever, weight loss and chest pain.

Not everyone who is infected with the TB bacteria contracts the illness and most people do not report health problems. On average, about 10 percent become sick, but the bacteria can be killed by a six-month treatment of medicine.

Subject: Dutch news