Tuberculosis Outbreak Investigations in the United States, 2002–2008

DOI: 10.3201/
Mitruka K, Oeltmann JE, Ijaz K, Haddad MB. Tuberculosis outbreak investigations in the United States, 2002–2008. Emerg Infect Dis. 2011 Mar; [Epub ahead of print]

Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

To understand circumstances of tuberculosis transmission that strain public health resources, we systematically reviewed Centers for Disease Control and Prevention (CDC) staff reports of US outbreaks in which CDC participated during 2002–2008 that involved >3 culture-confirmed tuberculosis cases linked by genotype and epidemiology. Twenty-seven outbreaks, representing 398 patients, were reviewed. Twenty-four of the 27 outbreaks involved primarily US-born patients; substance abuse was another predominant feature of outbreaks. Prolonged infectiousness because of provider- and patient-related factors was common. In 17 outbreaks, a drug house was a notable contributing factor. The most frequently documented intervention to control the outbreak was prioritizing contacts according to risk for infection and disease progression to ensure that the highest risk contacts were completely evaluated. US-born persons with reported substance abuse most strongly characterized the tuberculosis outbreaks in this review. Substance abuse remains one of the greatest challenges to controlling tuberculosis transmission in the United States.
http://www.cdc.gov/eid/content/17/3/pdfs/10-1550.pdf

TUBERCULOSIS: outbreak in Co. Cork on the rise in children

ANTOINETTE KELLY,
25 children in an elementary school in Co. Cork have been diagnosed with tuberculosis (TB) since screening began a week ago.
Out of the 25 children five of the young children have the full blown infection and the additional 20 have a latent form of the disease.
Up to the middle of this week 220 children attending Ballintemple National School have been screened as well as the staff.
Despite three staff members being referred to a respiratory physician no cases of TB were reported.
An additional 100 children are to be screened in the coming week.
Despite a start back date this week the school has remained closed but promised to open its doors by September 6.
Dr Margaret O’Sullivan, public health consultant, stresses in the letter that "it is very important that no one returns to the school unless they have been screened and advised by the investigating medical teams" — except the new junior infant class.
O'Sullivan also mentioned it's "crucial to appreciate that any child returning to the school who has been diagnosed with active TB is… on treatment and... not currently infectious".
The TB outbreak was first reported at the end of July and by August 17 three children were diagnosed with it.
http://www.irishcentral.com/news/-Tuberculosis-outbreak-in-Co-Cork-on-the-rise-in-children-102054653.html