A multidrug-resistant strain of tuberculosis discovered in Allen County in December will cost the state and county $250,000 in medication alone for the first year of treatment.
The Fort Wayne-Allen County Board of Health heard an update Monday on the Fort Wayne Community Schools student who contracted an active case of tuberculosis in December. Since then, the student’s disease was identified as multidrug-resistant strain, meaning it’s not responding to the most powerful first-line drugs used to treat TB.
The school and health department did not release information on the student, citing privacy laws.
The county must pay for the treatment of highly infectious, communicable diseases like TB if the affected person cannot pay for treatment, department spokesman John Silcox said.
“We attempt to tap into any available insurance or resources, but with this case, neither is available,” Silcox said. “It’s unfortunate because this happens to be a case where the treatment is more expensive because of the nature of the TB.”
A person with a regular case of TB is treated over six months; a person with a multidrug-resistant strain is treated over two years with six medications and injections. A patient with multidrug-resistant TB must be treated with a second line of drugs, and if that does not work, a third line. In addition, the person must usually resort to having the infected part of his lungs surgically removed.
The $250,000 estimated cost of medications, according to Silcox, comprises $200,000 for one year of treatment for the patient for the six main medications provided by the Indiana State Department of Health and $50,000 for two years’ worth of additional medications the county will be responsible for.
Silcox said those “are over and above the other meds – ones that would likely be prescribed to combat reactions to those other drugs, etc.,” he said.
Silcox added that the estimate is on the high side.
Besides the medications, other costs for the two-year treatment are difficult to estimate, Silcox said, until tests are ordered, medicines are prescribed and surgery decisions are made.
“Depending on whether the patient becomes eligible for Medicaid and whether any surgery is necessary, it will likely be a minimum of $40,000 to $50,000 and a maximum of $50,000 to $115,000,” Silcox said, “but again, it is too early to predict.”
Board President Joseph Steensma said the cost could be staggering, but the county does not have a choice.
“It’s frustrating, because in some way, shape or form the taxpayer bears a substantial burden in this case,” Steensma said. “But TB and other communicable diseases cannot be treated effectively without spending the necessary funds.
“We have an obligation to the public” to pay for treatment, Steensma said. “If we put up barriers to treatment, then this person might infect one, two, or 20 more.”
“We can’t just lock them up; we have no choice,” board member Rick Regedanz said. “We must try to aggressively attack this (disease).
“If we had three such cases instead of one, it would be our entire budget for the year,” he said.
Earlier in the month, nearly 150 Fort Wayne Community School students were identified as having possibly come in contact with the active case, and those students were screened for TB.
The testing included students from Anthis Career Center, Wayne High School, Northrop High School and Ward Education Center.
The person with TB is now in isolation and undergoing treatment, and no one else associated with that person has been identified with active TB, although testing is ongoing.
“The health department is in the process of evaluating the results of the first round of testing and will repeat the process in eight weeks,” said Dr. Deborah McMahan, health commissioner.
A second round of TB skin testing is required in eight to 10 weeks to rule out TB infection, so it will likely be a few months before health officials know whether anyone else was infected and needs treatment.
The state has reported five multidrug-resistant cases of TB, and the Anthis case is the first in Allen County, McMahan said.
TB is caused by a tiny organism known as mycobacterium tuberculosis and is highly contagious, spread from person to person through the air, according to information on the local health department’s website.
TB is not spread by kissing, shaking hands or touching objects such as bed linens or toilet seats. It usually requires close contact over a period of time.
Symptoms of TB, which usually settles in the lungs but may infect other parts of the body, include weakness, weight loss, fever, night sweats, coughing, sometimes coughing up blood and chest pain.
In most cases, TB is treatable; however, people with TB can die if they do not get proper treatment. Even if someone is infected with TB bacteria, it does not mean the person will get TB.
Most people who become infected do not develop the disease because their bodies’ defenses protect them. Only people with symptoms of active TB can spread the disease to others.
