Nurse's TB Death Raises Troubling Questions

I have reported a couple of times on the death of a Virginia nurse from an undiagnosed tuberculosis infection. (here and here). And, although I hate to say "I told you so," OSHA's decision last year to withdraw the tuberculosis standard is looking dumber and dumber as the number of TB cases in many states creep up. This article in the Virginian-Pilot raises a number of disturbing questions:

When guards drop or awareness of the disease’s threat lessens, TB can kill.

Sometimes guidelines established to thwart it don’t prove enough. Nowhere is that clearer than in the case of 52-year-old Deborah Byrd Chrysostomides, the Chesapeake General nurse who died seven weeks ago.

Questions linger about her case and whether more could have been done to prevent it –certainly, from the more than 100 patients and visitors who have since tested positive for TB, and also from those closest to her.

Tim Peluso, the fiance of the once-vibrant and compassionate nurse, questions whether the hospital could have done more to detect her illness when she displayed TB symptoms. Hospital and public-health officials wonder whether Chrysostomides ever sought medical help, as she claimed to friends and a supervisor. If so, why didn’t a doctor diagnose her sooner?

And why can’t public-health officials find the doctor who supposedly treated her?

Two questions that loom largest for the general public: How could her illness have gone undetected in a hospital, of all places, and should anything be changed to keep such cases from occurring again?

Despite weeks of investigation by state health officials, some questions may never be answered. But what the investigations have been able to determine is that three of the usual safeguards against the spread of tuberculosis broke down : One, the expectation that a health professional will seek and receive proper treatment.

Two, the assumption that supervisors would notice someone with obvious symptoms, and make sure that person seeks help or stops working. And three, the reliance on annual tuberculosis screenings for health-care employees to flag a brewing TB outbreak.