Abstract
We describe the results from tuberculosis (TB) contact investigations of two high-school students. Following the development of active TB in two foreign-born students, contact investigations were performed to detect contacts with active TB disease or latent TB infection (LTBI). The two students developed pulmonary TB within 2 years of immigrating to the United States. Among household contacts, no case of active TB was identified; however, LTBI was identified in 7 of 20 persons screened (35%). Of the 104 high-risk school contacts identified, no cases of active TB disease were found, but 7 (9.3%) were diagnosed with LTBI. An additional 683 low-risk contacts were screened and 9 (1.5%) were positive. Schools and Public Health departments needs to be prepared for outbreak investigations and should screen only persons with a high risk of exposure to the index case with active TB in an attempt to identify secondary infections. Those persons with a low risk of exposure should not be screened.
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References
Starke JR. Universal screening for tuberculosis infection: school’s out! JAMA. 1995;274:652–3.
Pediatric Tuberculosis Collaborative Group. Targeted tuberculin skin testing and treatment of latent tuberculosis infection in children and adolescents. Pediatrics 2004;114:1175–201.
Centers for Disease Control and Prevention. Reported tuberculosis in the United States, 2006. Atlanta, GA: US Department of Health and Human Services; 2006.
Ben Franklin Tuberculosis Control Program. 2006 Annual Report. Columbus, OH: Columbus Public Health; 2006.
Centers for Disease Control and Prevention. Guidelines for the investigation of contacts of persons with infectious tuberculosis. MMWR 2005;54:RR-15.
QuantiFERON-TB Gold. Cellestis Inc, Valencia, CA http://www.cellestis.com/IRM/Company/ShowPage.aspx?CPID=1247.
National Committee for Clinical Laboratory Standards. Susceptibility testing of mycobacteria, Nocardia, and other aerobic actinomycetes: approved standards. Wayne PA: NCCLS document M24-A; 2003.
Gen-Probe. http://www.gen-probe.com/pdfs/pi/IN0014.pdf.
Centers for Disease Control and Prevention. Guide to the application of genotyping to tuberculosis prevention and control http://www.cdc.gov/tb/genotyping/manual.htm.
Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49:RR-6.
Phillips L, Carlile J, Smith D. Epidemiology of a tuberculosis outbreak in a rural Missouri high school. Pediatrics 2004;113:e514–9.
Sacks JJ, Brenner ER, Breeden DC, et al. Epidemiology of a tuberculosis outbreak in a South Carolina junior high school. Am J Public Health 1985;75:361–5.
Martinez-Lirola M, Alonso-Rodriguez N, Sanchez ML, et al. Advanced survey of tuberculosis transmission in a complex socioepidemiologic scenario with a high proportion of cases n immigrants. Clin Infect Dis. 2008;47:8–14.
Powell DA, Hunt WG. Tuberculosis in children. Adv Pediatr. 2006;53:279–322.
Reichler MR, Reves R, Bur S, et al. Evaluation of investigations conducted to detect and prevent transmission of tuberculosis. JAMA. 2002;287:991–5.
West EL, Gadkowski LB, Ostbye T, et al. Tuberculosis knowledge, attitudes, and beliefs among North Carolinians at increased risk of infection. NC Med J. 2008;69:14–20.
Kelly P. Isolation and stigma: the experience of patients with active tuberculosis. J Community Health Nurs. 1999;16:233–41.
Acknowledgments
We would like to acknowledge all the staff at the Ben Franklin TB Control program for their dedication to controlling TB in Franklin County. Special thanks to Lei San Liggins, RN for leading the contact investigations and to the Columbus Public Health (CPH) Office of Assessment and Surveillance for assistance with epidemiologic data. We would also like to thank Larry Schlesinger, MD at The Ohio State University and Debbie Coleman, RN at CPH for their critical reviews of earlier version of the manuscript.
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Wang, SH., Hunt, W.G. & Powell, D.A. Lessons Learned from Two School Tuberculosis Investigations. J Immigrant Minority Health 12, 853–858 (2010). https://doi.org/10.1007/s10903-008-9220-9
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DOI: https://doi.org/10.1007/s10903-008-9220-9