Health and education authorities in central China have denied downplaying news of a tuberculosis outbreak at a local high school.

In a press conference on Sunday, the head of the education bureau in Taojiang County, Hunan province, said the school was not aware of any infections until early August, when the county disease control center notified the bureau of confirmed cases — though the first patient had been diagnosed in January.

By Thursday, 72 students at Taojiang No. 4 High School were being either treated or monitored for TB. Among them were 29 confirmed cases of the infectious disease and five others deemed probable, according to the Health and Family Planning Commission of Hunan Province. 

In a statement on Saturday, the county said the first six patients from the school — all seniors — actively concealed that they were students. It wasn’t until late July, when an employee at the clinic overheard a conversation among them, that anyone realized a classroom outbreak could be imminent.

However, students at the school said rumors of a TB epidemic were already spreading long before the official investigation started in August. “We saw several classmates take medicine … Some even told us that they had TB,” one student told The Beijing News in a video interview on Friday. The student, who has since been diagnosed herself, said that other students even termed her class “the TB class.” Yet when some students started wearing face masks, she said, their teacher asked the students to remove them to avoid causing “panic.”

When school principal Yang Yu was asked why the school didn’t notice the disease spreading, he said: “Our teachers are in charge of teaching. They can’t diagnose TB, right?”

Though curable and preventable, TB is highly contagious. The airborne disease is caused by bacteria and is a serious condition that doesn’t get enough attention in China, according to Li Liang, vice dean of Beijing Chest Hospital, a leading institution for TB research. In 2016, official statistics say there were 836,236 new cases of TB in China, accounting for almost 8 percent of cases globally. Among infectious diseases in the country, TB carries the second-highest mortality rate after AIDS.

Poor ventilation in classrooms, constant contact among students, and weakened immune systems from academic stress could all contribute to outbreaks in schools, Li told Sixth Tone. The first TB case at the school appeared in a class of 89 students, all of whom are set to take the grueling national college entrance exam in 2018.

The parent of one student who was diagnosed with TB in August suspected the school had intentionally suppressed news about the disease. “If the school had acted earlier, even though my son would still have been infected, he could have recovered sooner,” his mother told The Beijing News.

TB often escapes notice, according to Li, because not all patients show signs of infection, and symptoms like a cough or fever are common to many other illnesses. Those who are diagnosed often prefer to keep it quiet: “They are worried society will discriminate against them for having a contagious disease,” Li said, adding that high school seniors may be particularly anxious if they fear the condition could affect college admissions.

In June, the Ministry of Education released the country’s first guidelines on the control and prevention of TB in schools, asking schools to check for the disease during routine pre-enrollment medical checks and advising teachers to pay close attention to suspected cases. “It is crucial for schools and the public to know more about the disease,” Li said. “The earlier the diagnosis, the more effective treatment is.” On Monday, a vocational high school in Taojiang also reported an outbreak, with eight confirmed cases of TB.

According to Sunday’s press conference, 50 of the 72 students whom doctors treated or monitored have been given the green light to return to class. The school will arrange online courses for the remainder of the students, and the government will cover all treatment costs.

But some of the students say the outbreak has weakened not only their physical health, but also their confidence for the national college entrance exam next June. “The class has been destroyed and broken,” said one student in the video interview.

Editor: Qian Jinghua.

(Header image: A doctor who specializes in the treatment of tuberculosis talks to a patient suspected to have the disease at the Beijing Chest Hospital, March 27, 2009. IC)