Outbreak of Pulmonary Tuberculosis in a Chinese High School, 2009–2010

Details

• Alternative Title:
  J Epidemiol
• Personal Author:
  Fang, Yirong ; Zhang, Lijie ; Tu, Chunyu ; Ye, Dongqing ; Fontaine, Robert ; Ma, Huilai ; Hao, Jiahu ; Fu, Lijun ; Ying, Xijun ; Chen, Qifeng ; Wang, Yong ; Liu, Huihui ; Zhu, Bao-Ping
• Description:
  Background
  
  In February 2009, a high school student was diagnosed with sputum-smear positive pulmonary tuberculosis (TB). One year later, 2 other students in the same grade developed sputum-smear positive TB.
  
  Methods
  
  We used tuberculin skin testing (TST), chest radiography, sputum smear, and symptomatology for case identification. We defined latent TB infection (LTBI) as a TST induration of 15 mm or larger, probable TB as a chest radiograph indicative of TB plus productive cough/hemoptysis for at least 2 weeks or TST induration of 15 mm or larger, and confirmed TB as 2 or more positive sputum smears or 1 positive sputum smear plus a chest radiograph indicative of TB.
  
  Results
  
  Of students in the same grade as the primary case-student, 26% (122/476) had LTBI and 4.8% (23/476) had probable/confirmed TB. Of teachers, 43% (18/42) had LTBI and none had probable/confirmed TB. Sharing a classroom with the primary case-student increased risk for LTBI (rate ratio = 2.5; 95% CI: 1.9–3.4) and probable/confirmed TB (rate ratio = 17, 95% CI: 7.8–39). Of students with LTBI in February 2009 who refused prophylaxis, 50% (11/22) had probable/confirmed TB in April 2010.
  
  Conclusions
  
  This TB outbreak was likely started by delayed diagnosis of TB in the case-student and was facilitated by lack of post-exposure chemoprophylaxis. Post-exposure prophylaxis is strongly recommended for all TST-positive students.
  
  
• Subjects:
  Disease Outbreaks Female Humans Latent Tuberculosis Male Mass Screening Post-Exposure Prophylaxis Retrospective Studies Schools Short Communication Tuberculosis, Pulmonary

  More +
• Source:
  J Epidemiol. 2013; 23(4):307-312.
• Document Type:
  Journal Article
• Place as Subject:
  China
• Volume:
  23
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:12e79378dabefedfb40d298d717398717bfc90edd47fb19ffd5f0ff9cd472022
• Download URL:
  https://stacks.cdc.gov/view/cdc/21145/cdc_21145_DS1.pdf
• File Type:
  [PDF - 204.12 KB ]