Texas: Shelter Begins Screening for Tuberculosis

Fort Worth's Presbyterian Night Shelter, which provides a night off the streets for those who have fallen on hard times, has started aggressively screening its residents for tuberculosis. Residents are already being asked to show a card proving that they have been screened by the Tarrant County Public Health Department for the disease. By the end of next month, the cards will become mandatory.

"We had a long, hard discussion about this," shelter Director John Suggs said. "We are the shelter of last resort. If you show up, we take you in." But because TB is dangerous, the residents should also be protected, Suggs said. "Folks here have a lot of other health problems and immune-system problems," he said, "and you certainly don't want them coming in and getting tuberculosis when we are trying to help them."

The effort is also the first time the county Health Department has mandated TB screening, said Gerry Burgess, division manager for TB elimination. After three rounds of screening, totaling about 460 chest X-rays, five TB cases have been confirmed and another five are suspected pending final lab results, Burgess said. The goal is eventually to expand mandatory screening to other shelters in the county, she said.

"The people that are in the shelters go out and are around other people in the community," Burgess said. "They are out in day-labor camps. They take day jobs. Some of them have just fallen on hard times and need a place to stay for a month or so. You don't want to put them in an environment that puts them at risk for acquiring a communicable disease," she said.

Oklahoma has already implemented a similar approach, mandating testing at shelters in Oklahoma and Tulsa counties, said Dr. Jon Tillinghast, TB control officer for the Oklahoma State Department of Health. "We certainly have had a decrease in active TB cases in the shelters since we started that program," he said.

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