Waterloo House has closed its kitchens after a chef was diagnosed with tuberculosis (TB) while three other kitchen employees have also shown signs of the disease.

Health officials have revealed that Bermuda gets two or three cases of TB each year but have reassured the public that the dangers are minimal.

Tuberculosis is an airborne infectious disease that killed more than 1.7 million people worldwide in 2006 according to the World Health Organisation (WHO).

However, if TB is detected early and fully treated, sufferers quickly become non-infectious and are eventually cured.

Chief Medical Officer John Cann said he believed Bermuda had not had a TB-related death for decades.

"There is no reason for the public to be unduly concerned about TB in this community."

He said the few cases that did crop up were identified and properly dealt with. Horizons Ltd. managing director George Wardman confirmed yesterday that a chef working at Waterloo House in Pitt's Bay Road had been diagnosed with TB after returning from a vacation to his home in Goa, India.

Mr. Wardman said: "He reported feeling poorly on Wednesday night and an ambulance was called. The employee is a patient at the KEMH and is undergoing treatment.

"Other employees who have had close proximity exposure to the patient have been tested. The results showed, not unexpectedly, that three other kitchen employees had been exposed to TB, probably in the course of their own travels abroad. Further hospital testing revealed that the disease is in its normal dormant or non-infectious stage."

He said all of those employees were also X-rayed and blood tested and shown to be no danger to themselves or to others. "As an extra precaution, the kitchen facilities were sterilised under the supervision of the Health Department.

"No further complications of the outbreak have been observed but the situation is being closely monitored by Epidemiologist Mrs. Lise Outerbridge, the Chief Medical Officer Dr. John Cann and by in-house medical staff."

Mr. Wardman said Dr. Cann had assured the management that guests should have no concern.

"However, the restaurant has been closed since Friday when the diagnosis was confirmed."

Further monitoring is expected to be finished this weekend in the hope the kitchen can re-open on Monday.

Health Permanent Secretary Warren Jones said: "It would be incorrect to say we have had an outbreak of TB. It is not unusual, we have at least two or three per year. There is no evidence of TB in the local population.

"There is no cause for alarm at all. Our detection systems are very good, immediately the hospital made contact with the Department of Health. The individual was removed and staff screened.

"It is important to remember TB is only contracted respiratorally from close personal contact.

"There is no cleaning that has to take place or nothing that can be picked up from surfaces because an individual was there. Generally these things go unnoticed from year to year."

Chief Medical Officer John Cann said: "Tuberculosis is not something you get just because you are with someone, you have to have intimate contact over a period of time for you to get infected."

Dr. Cann said Bermudians were unlikely to contract TB while travelling overseas.

"You might get it if you stayed with friends but you are not going to get it from the waiter who coughs at you once or something like that."

Bermuda gets about two or three cases a year — mostly imported, although occasionally a senior citizen has a case of reactivation where TB had been sealed off in their body when they were younger but had then been released in later years.

Dr. Cann said TB existed all around the world — even in developed countries.

"Unlike the United States and other places like the UK, Bermuda does not have that problem because we are a very small island and it was much easier to eradicate tuberculosis than it is in bigger countries where you have little pockets of TB here and there."

He said the spread of TB had been related to overcrowding and poor housing.

TB facts from the World Health Organisation

Someone in the world is newly infected with TB bacilli every second and one third of the world's population is now infected with TB.

However only five to ten percent of people who are infected with TB bacilli (but not infected with HIV) become sick or infectious at some time during their life.

But HIV and TB are a lethal combination and it is the leading cause of death among people who are HIV-positive.

Only people who are sick with TB in their lungs are infectious. When infectious people cough, sneeze, talk or spit, they propel TB germs, known as bacilli, into the air.

A person needs only to inhale a small number of these to be infected.

Left untreated, each person with active TB disease will infect on average between ten and 15 people every year.

But people infected with TB bacilli will not necessarily become sick with the disease.

The immune system walls off the TB bacilli which, protected by a thick waxy coat, can lie dormant for years.

When someone's immune system is weakened, the chances of becoming sick are greater.

Africa has the highest TB deaths while Asia has the most cases.

By nation, India has the most cases, followed by China, Indonesia, South Africa and Nigeria, according to the 2006 WHO report based on data from 202 countries and territories.

TB strains that are resistant to all major anti-TB drugs have emerged, necessitating up to two years of chemotherapy.