Linn County's response to a tuberculosis outbreak nearly two years ago may help other public health organizations in similar situations.

A large poster detailing how Linn County Public Health officials and staff from the Albany Helping Hands homeless shelter contained an outbreak of tuberculosis in late 2007 and early 2008, was displayed in June at the National TB Conference in Atlanta, Ga.

The outbreak led to changes in the shelter's rules, and there have been no new TB cases since.

The poster, prepared by the state's public health office, was one of 55 from around the country that detailed how health officials deal with real-life events.

The poster's theme was "TB Elimination, It Takes a Village," explained Pat Crozier, Linn public health program manager.

The first case reported at the Albany shelter came in August 2007. The Public Health Department began a testing and information program in early October. A second case was diagnosed in December and a second round of testing took place in February. The last case of TB was reported in May.

"We identified 409 people who were possibly exposed," said Debby Uri, communicable disease nurse. "Of those, 41 were determined to be noncontagious but had latent TB."

The shelter is open to virtually anyone, making its population highly transient, officials said. Shelter management agreed to establish new rules that would require anyone seeking admission to provide an up-to-date medical card.

"It's always an issue when you have a public facility like ours that serves a lot of folks," said shelter vice president John Donovan. "Our goal is to be as safe as possible, so we instituted a policy with the public health people that's working well overall."

Every guest must now provide an updated medical card or submit to taking a TB test. If they enter the shelter during the middle of the night, they are kept in quarantine until a test can be administered the next morning.

"It's working out well," Donovan said. "We just want to be as cautious and as smart as possible, yet fulfill our mission to the people."

The shelter can serve a maximum 125 persons per night. In 2008, there were 31,076 shelter nights and nearly 59,000 meals served.

Public Health administrator Frank Moore praised Albany Helping Hands as an "active player in making this happen so successfully."

The county records on average one case of active TB per year. Public health staff now visit the shelter twice weekly to administer tests.

The county administered more than 1,000 TB tests in 2008, up from just 300 in 2007, Moore said.

Tuberculosis is a disease that usually infects the lungs, but can infect any part of the body. It is spread by person-to-person contact or through the air.

A person can be infected with TB, which means they have TB germs in their body that are being contained by their immune system, or have TB, which means they are actually sick.

Symptoms include a persistent cough, constant fatigue, weight loss, loss of appetite, fever, coughing up blood and night sweats.