A tuberculosis outbreak at an insecure, temporary housing facility, manga café, Tokyo, Japan, 2016–2017

Abstract

In November 2016, a woman in her 30s who stayed at an insecure, temporary housing facility, a manga café in Tokyo, Japan, for a year was diagnosed with sputum smear-positive tuberculosis (TB). Since the café had 31 staff members and provided with accommodation to many people, the local health office initiated a contact investigation. This study aims to characterise the cases found in the outbreak. A TB case was defined as a person tested bacteriologically positive for TB, or was determined to have TB by a physician. A latent TB infection case was defined as a person tested positive by interferon-γ release assay. From January 2016 through November 2017, there were 31 staff members at the manga café, of which, six developed TB disease (one smear-negative, culture-positive and five smear- and culture-negative) in addition to seven LTBI. Another long-term customer was found having sputum smear-positive TB. Variable numbers tandem repeat (VNTR) test revealed that the index patient and the long-term customer had the identical type of VNTR; however, one staff member had a different VNTR. Local health authorities should intensify screening long-term customers of such facilities for TB regularly as well as once a TB outbreak occurs.

Analysis of 605 tuberculosis outbreaks in Japan, 1993–2015: time, place and transmission site

“…Finally, the original data that MHLW disclosed did not clearly mention that the outbreaks were confirmed by molecular epidemiological evidence. However, the restriction fragment length polymorphism (RFLP) technique became available in Japan around 1995 and analysis of variable numbers tandem repeats (VNTR) became available around 2005 [ 28 – 32 ], so the authors believe that most outbreaks, particularly after 2000, were validated with the use of molecular epidemiology, exemplified by the TB outbreak reports [ 2 , 4 , 6 , 8 – 10 , 17 ].…”

“…However, about 5000 smear-positive TB cases are still reported annually [1] and these potentially infectious cases pose a public health threat to the community. TB outbreaks involving hospitals, including psychiatric hospitals, workplaces, the military, schools, prisons, and sometimes the homeless, have also been reported [2][3][4][5][6][7][8][9][10].…”

Multidrug-Resistant Tuberculosis Outbreak among Immigrants in Tokyo, Japan, 2019–2021

“…The proportion of multidrug-resistant (MDR) TB in previously untreated all types of TB was 0.6% in 2019; however, for those born in foreign countries the proportion was five-times higher (2.8%)(1). TB outbreaks including MDR-TB have also occurred (3)(4)(5)(6)(7)(8)(9)(10). In mid-September 2019, a teenage student from northeastern China studying in Tokyo was diagnosed with sputum smear-positive pulmonary TB (Pt1).…”

Epidemiology of tuberculosis in foreign students in Japan, 2015–2019: a comparison with the notification rates in their countries of origin

“…The proportion of multidrug-resistant (MDR) TB, which is resistant to the two most potent anti-TB drugs, rifampicin and isoniazid, in previously untreated all types of TB in Japan was 0.4% in 2019; however, for those born in foreign countries the proportion was much higher (2.8%) [2]. TB outbreaks have involved hospitals, workplaces, military training, schools and sometimes homeless persons [7][8][9][10][11][12][13], and an MDR-TB outbreak involving the immigrant population was also reported [14]. Pre-entry screening for TB for immigrants to Japan is expected to be initiated soon [15].…”