San Francisco Chronicle (SF); Saturday, July 13, 1991
Sabin Russell, Chronicle Staff Writer

The hospital is tightening infection-control procedures and plans to install special ventilators in eight rooms that will be set aside to handle suspected cases of the bacterial lung infection, which before antibiotics was one of history's greatest killers.

HOSPITAL WORKERS EXPOSED

It launched the retrofit plan after routine screening tests showed a doubling in the number of hospital workers exposed to the disease, and follows an outbreak of TB among 12 residents of an AIDS housing program in San Francisco last winter.

According to Dr. Henry Chambers, co-chairman of infection control at S.F. General, the most recent routine screening tests showed TB infection rates among health care workers of 3 to 4 per 1,000, or twice the usual rate. Citywide, the number of TB case has risen 334 last year from a low of 270 in 1984.

VENTILATION SYSTEMS

Chambers said the ventilation systems will be installed in eight rooms scattered throughout the hospital.

The systems, not yet chosen, will either recirculate, filter or vent the air out of the TB patients' rooms.

"It's going to be expensive, but it is not clear how expensive it will be," he said.

Currently, the hospital's TB patients -- usually no more than four at any given time -- are isolated in private rooms with a door shut and a supply of masks outside the door for the protection of visitors to the patient.

State health officials say there are more than 4,000 cases of TB in California. At 15 cases for every 100,000 residents, the figure is 50 percent higher than the national rate.

TUBERCULOSIS AND AIDS

Health experts attribute the recent increase in TB cases primarily to the number of AIDS patients who are contracting the disease because of their weakened immune system. Historically a disease of the poor, it is also showing up in Asian and Hispanic immigrants.

Gisela Schecter, director of TB control programs for San Francisco's Department of Public Health, confirmed that there was an outbreak of TB from December through April in a San Francisco home set up to house AIDS patients.

Although she would not identify the site of the outbreak, now under control, she said 12 AIDS patients came down with the disease. Four have since died, although two are thought to have succumbed to other AIDS-related conditions.

'EXPLOSIVE OUTBREAKS'

The experience has taught TB specialists that there is a potential for "explosive outbreaks" of the disease among AIDS patients, she said.

Schecter said a healthy person carrying a latent TB infection has about a 5 percent chance of contracting the disease during his or her lifetime.

But if the same person also has HIV, the chances of developing an active TB case are about 50 percent within five years, she said.

A recent survey of San Francisco TB clinic cases found that 19 percent were also infected with the AIDS virus.

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