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A school- and community-based outbreak of Mycobacterium tuberculosis in Northern Italy, 1992–3

Published online by Cambridge University Press:  15 May 2009

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In late 1992, three cases of smear-positive tuberculosis were diagnosed among secondary school students in Lodi, Italy. The three attended different schools but travelled on the same bus. Schoolmates, other bus riders, family members, and friends underwent tine testing and X-rays. Of the 3188 students tested, 277 (8·7 %) were reactors. Independent risk factors for tine reactivity among students included living in the same town (odds ratio [OR] = 4·8; 95% confidence intervals [CI] = 3·8–6·0); having classroom contact (OR = 4·4; 95% CI = 3·4–5·7); or riding the same bus (OR = 5·4; 95% CI = 4·3–6·7) as a smear-positive case. Twenty-four cases of pulmonary tuberculosis were identified. The index case was a student whose father had had cavitary tuberculosis. Despite being tine test positive in 1989, he was not given prophylaxis and was lost to follow-up. This large outbreak emphasizes the need for identification and prompt chemoprophylaxis of reactors, especially in vulnerable adolescent populations.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1994

References

REFERENCES

1.Lincoln, EM. Epidemics of tuberculosis. Adv Tuberc Res 1965; 14: 157201.Google Scholar
2.World Health Organization. Tuberculosis Control Program. Secular trends of tuberculosis in Western Europe: WHO/TB/92. Geneva, 1992.Google Scholar
3.Dean, AG, Dean, JA, Burton, AH, Dicker, RC. Epi Info, Version 5: A word processing, database, and statistics program for epidemiology on microcomputers. USD, Incorporated, Stone Mountain, Georgia, 1990.Google Scholar
4. Statistical Package for the Social Sciences, SPSS Inc., Chicago, Illinois.Google Scholar
5.Starke, JR, Jacobs, RF, Jereb, J. Resurgence of tuberculosis in children. J Pediatr 1991; 120: 839–55.Google Scholar
6.Mahady, SCF. An outbreak of primary tuberculosis in school children. Clinical aspects. Am Rev Resp Dis 1961; 34: 348–58.Google Scholar
7.Darney, PD, Clenny, ND. Tuberculosis outbreak in an Alabama high school. JAMA 1971: 216: 2117–18.CrossRefGoogle Scholar
8.Sacks, JJ, Brenner, ER, Breeden, DC, Anders, HM, Parker, RL. Epidemiology of a tuberculosis outbreak in a South Carolina junior high school. AJPH 1985; 75: 361–5.Google Scholar
9.Monterroso, ER, Bleed, D, Farley, T, McFarland, L. Mycobacterium tuberculosis outbreak in a plywood factory, Arkansas. Abstract, EIS Conference, Atlanta, GA, 20 04, 1993.Google Scholar
10.Catanzaro, A. Multiple puncture skin test and Mantoux test in Southeast Asian refugees. Chest 1985; 37: 346–50.Google Scholar
11.American Thoracic Society. Control of tuberculosis in the United States. Am Rev Resp Dis 1992; 146: 1623–33.CrossRefGoogle Scholar
12.Styblo, K. Epidemiology of tuberculosis. Infektionskrankheiten und ihre Erreger 1984; Band 4/VI: 77161.Google Scholar
13.Rezza, G, De Rose, A, De Roberto, D, Serafin, I. Diffusione dell'infezione da HIV nei tossicodipendenti afferenti ai servizi d'assistenza pubblici in Italia 1990. L'Igiene Moderna 1992; 98: 739–51.Google Scholar