Lessons Learned from Two School Tuberculosis Investigations
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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.
KeywordsTuberculosis (TB) School Immigrant health Foreign-born
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.
- 3.Centers for Disease Control and Prevention. Reported tuberculosis in the United States, 2006. Atlanta, GA: US Department of Health and Human Services; 2006.Google Scholar
- 4.Ben Franklin Tuberculosis Control Program. 2006 Annual Report. Columbus, OH: Columbus Public Health; 2006.Google Scholar
- 5.Centers for Disease Control and Prevention. Guidelines for the investigation of contacts of persons with infectious tuberculosis. MMWR 2005;54:RR-15.Google Scholar
- 6.QuantiFERON-TB Gold. Cellestis Inc, Valencia, CA http://www.cellestis.com/IRM/Company/ShowPage.aspx?CPID=1247.
- 7.National Committee for Clinical Laboratory Standards. Susceptibility testing of mycobacteria, Nocardia, and other aerobic actinomycetes: approved standards. Wayne PA: NCCLS document M24-A; 2003.Google Scholar
- 8.Gen-Probe. http://www.gen-probe.com/pdfs/pi/IN0014.pdf.
- 9.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.
- 10.Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49:RR-6.Google Scholar
- 16.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.Google Scholar