MSC Seaside Waitress Dies From Highly Infectious Tuberculosis

MSC Seaside Waitress Dies From Highly Infectious Tuberculosis
MSC Seaside Waitress Dies From Highly Infectious Tuberculosis

Nobuhle 'Buhle' BhenguCruise Bruise Investigates Exposé – MSC Seaside Waitress Dies From Highly Infectious Tuberculosis

On Tuesday, February 12, 2019, Nobuhle ‘Buhle’ Bhengu,  30, from uMlazi, South Africa, was a crew member waitress aboard MSC Cruises ship MSC Seaside when she suddenly become ill.  Later, it was determined the illness was due to highly infectious Tuberculosis (TB) disease (see video below) and she passed away while in the Bahamas during a 7-day Eastern Caribbean cruise.

Bhengu complained of symptoms including body pains and tiredness. She was taken to a hospital on February 8, where a doctor said she was anemic and needed a blood transfusion. When she died a few days later, MSC Cruises notified her family in South Africa that she had died, they said she had stomach flu. Though, she had symptoms as early as January, it was determined days after her death that she died from Tuberculosis.

Bahamas Tuberculosis Contact TracingNobuhle 'Buhle' Bhengu Harbor

Though the Bahamas has Tuberculosis (TB) Contact Tracing, there is no evidence that was ever initiated in this case.  “A member of the Tuberculosis (TB) Control Team interviews every client identified with or suspected of having TB. The purpose of the interview is to identify the people with whom they have been in close contact, and thus are at risk for being infected with TB. These identified individuals will be contacted and also investigated for TB infection and TB disease.”

I found no evidence, MSC Seaside was boarded by Centers for Disease Control and Prevention (CD) employees,  after the ship returned to Miami, in order to perform the contact tracing, as reqquired by the CDC.

Kyle McGowan is the Chief of Staff at the Centers for Disease Control and Prevention (CDC). Prior to joining CDC, Kyle most recently served as the Director of External Affairs at the U.S. Department of Health and Human Services. In that capacity, he worked in the immediate office of the Secretary and across all HHS staff and operating divisions to listen to and coordinate with external groups. He worked closely with the Secretary’s public affairs team to amplify and spread HHS’s priorities directly to external groups and partners, and worked directly on many of the agency’s priority issues including the opioids epidemic, drug pricing, and health reform. (Source: BIO page for Office of the Chief of Staff)

It’s interesting that most states’ Public health officials,  ask that food establishment owners or operators  have  their  employees tested for TB since the disease is curable with proper treatment. MSC Seaside sailed out of Miami, Florida, where state law outlines five key components of an effective tuberculosis program (surveillance, diagnosis, treatment, case management and education) are available statewide.

After receiving the news of her death, Buhle’s family immediately started to enquire about their daughters death and how they could get her body back [unaware of her Tuberculosis] so that they could say their last goodbyes and give her the burial she deserves.

It is then that, the family was told that the body of Buhle would not be sent back to South Africa but rather the Nassau Bahamas Government had decided that the body would be cremated without the consent of the family and without consulting the relevant South African authorities. What the family did not know, Buhle’s body was contaminated with highly infectious Tuberculosis disease, even after her death, hence the reason for mandatory cremation.

Having received news of Buhle’s death, some family members quickly flew out of  South Africa and went to the Bahamas with hope that they could convince the Bahamian authorities otherwise and at least get to view Buhle’s body. Unfortunately upon arrival they were immediately told that they would neither be given the body nor will they be given the chance to identify the body of Nobuhle and instead were informed that the  body was due for cremation on March 12, 2019.

Bhengu was due to return home on March 27 after her current contract with MSC expired. However, she suddenly became ill in January after complaining of a sore body. Only a couple weeks later, she would have been home back in South Africa for her end of contract vacation,  infecting her family, perhaps even her twin sister.

Tuberculosis Infection or Tuberculosis Disease
Source: CDC

Were you on that cruise, was Buhle your server on this cruise? 

MSC Seaside embarked from Miami, Florida on a 7-night Eastern Caribbean cruise on Saturday, February 2, 2019. The cruise ship then called at San Juan, Puerto Rico; Charlotte Amalie, United States Virgin Islands; Philipsburg, St. Maarten and Nassau in the Bahamas before returning to Miami.

About Tuberculosis (TB)

Tuberculosis (TB) is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.

As a cruise ship waitress, Bhengu had direct contact while waitressing in MSC Seaside restaurants during her illness,  serving many passengers during the 7-day Caribbean cruise, which sailed out of Miami, Florida on February 2, 2019.

Centers for Disease Control and Prevention – Tuberculosis

Centers for Disease Control and Prevention report on Latent TB Infection and TB Disease,” The bacteria that cause TB is spread through the air from person to person when a person with TB disease coughs, speaks, or sings. People nearby may breathe in these bacteria and become infected. There are two types of TB conditions: latent TB infection and TB disease.

TB bacteria can live in the body without making you sick. This is called latent TB infection. In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with latent TB infection do not feel sick, do not have any symptoms, and cannot spread TB bacteria to others.

The Guidance for Cruise Ships: How to Report Onboard Death or Illness to CDC

  • Quarantinable Diseases (both suspected or confirmed) listed in the President’s Executive Order: cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, severe acute respiratory syndromes, and novel influenza viruses.
  • Signs and symptoms of public health interest included in the Federal Regulations:
    • (A) Fever (has a measured temperature of 100.4 °F [38 °C] or greater; or feels warm to the touch; or gives a history of feeling feverish) accompanied by one or more of the following:
      • skin rash,
      • difficulty breathing or suspected or confirmed pneumonia,
      • persistent cough or cough with bloody sputum,
      • decreased consciousness or confusion of recent onset,
      • new unexplained bruising or bleeding (without previous injury),
      • persistent vomiting (other than sea sickness),headache with stiff neck;

Elimination Tuberculosis Information for Employers in Non-Healthcare Settings

However, if the employee has TB disease, the TB control program may start a contact investigation.  The investigation  will  help  them find out how the employee may have been exposed to TB and to determine who else might be at risk.

“The TB control program will determine if the employee has latent TB infection or TB disease. Since people with latent TB infection cannot spread TB to others, nothing further will need to be done in the workplace.

If TB bacteria become active in the body and multiply, the person will go from having latent TB infection to being sick with TB disease. For this reason, people with latent TB infection are often prescribed treatment to prevent them from developing TB disease.”

On the page, CDC Tuberculosis Prevention and Control Laws, it states, “Any reporter of a suspected or confirmed case of tuberculosis shall report to the designated department or official within twenty-four (24) hours.”

According to the CDC, TB is resistent to treatment. It takes at least 6 months for the medicines to kill all the TB disease bacteria.

Florida Department of Health (DOH)

“The Florida System of Tuberculosis Care is a partnership between the Florida Department of Health (DOH) and the statewide public health system . Working together, physicians, community based clinics, laboratories, hospitals, social services agencies, academia and public health professionals form a network that assures the five key components of an effective tuberculosis program (surveillance, diagnosis, treatment, case management and education) are available
statewide.

Tuberculosis (TB) is an illness caused by Mycobacterium tuberculosis germs put into the air when a person with active TB disease of the lungs or throat (pulmonary TB) coughs or sneezes. TB is difficult to catch since it requires close contact to an active case of TB over an extended period of time. TB usually attacks the lungs, yet may infect any part of the body such as the kidney, spine and brain.

Active Tuberculosis disease can be treated with medications, but can cause severe illness or be fatal if not treated properly. Cure of active TB disease requires long-term medication. TB germs resistant to medications can emerge when patients with active TB do not complete the entire treatment and when infected contacts to active TB cases or persons at high risk for TB fail to complete treatment. Thus, completion of treatment is a vital principle for effective TB control.

A person with TB disease cannot continue to work without permission from the public health department or their personal physician. With treatment, the employee will no longer be infectious and may be back to work in a short time.”

World Health Oganization (WHO) -Warning Dead Bodies With Tuberculosis 

Risks posed by Dead Bodies After Disasters

“Contrary to common belief, there is no evidence that corpses pose a risk of epidemic disease after a natural disaster. Most agents do not survive long in the human body after death. Human remains only pose a substantial risk to health in a few special cases, such as deaths from cholera or haemorrhagic fevers.

Workers who routinely handle corpses may however risk contracting tuberculosis, bloodborne viruses (eg hepatitis B and C and HIV) and gastrointestinal infections (e.g. cholera, E. coli, hepatitis A, rotavirus diarrhoea, salmonellosis, shigellosis and typhoid/paratyphoid fevers):

  • Tuberculosis can be acquired if the bacillus is aerosolized – residual air in lungs exhaled, fluid from lungs spurted up through the nose or mouth during handling of the corpse.”

Request for comment sent to the CDC and MSC Cruises

  • Via contact form requests CDC contact form on https://wwwn.cdc.gov/dcs/ContactUs
  • Via contact via MSC contact form on https://www.msccruisesusa.com/en-us/Contact/Contact-Us.aspx

Questions For CDC and MSC Cruises

  • Where and when did Nobuhle ‘Buhle’ Bhengu contract tuberculosis?
  • Was Nobuhle ‘Buhle’ Bhengu working or in isolation prior to her death?
  • Did failure to folllow CDC protcol lead to her death?

NOTE: As of publication time, the CDC nor MSC Cruises had responded to our querry. However, the CDC has contacted us this afternoon and is looking at this case.

For more on this case see – Cruise Ship Deaths – Nobuhle Buhle Bhengu

Article Resources:

Other Recent Cruise Illness Deaths:

Video: CDC Tuberculosis (TB) Transmission and Pathogenesis Video

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