Outbreak of drug-resistant tuberculosis with second-generation transmission in a high school in California

Ridzon, Renée; Kent, Joseph; Valway, Sarah E.; Weismuller, Penny; Maxwell, Roberta M.; Elcock, Maryellen; Meador, Jody; Royce, Sarah; Shefer, Abigail; Smith, Philip J.; Woodley, Charles L.; Onorato, Ida M.

doi:10.1016/s0022-3476(97)70034-9

Cited by 55 publications

(36 citation statements)

References 17 publications

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“…TB outbreaks among school students have been reported previously in low-endemicity countries such as the UK, Italy, Ireland and several states in the USA [2][3][4][5][6]. The adolescent population in boarding schools might be susceptible to outbreaks due to overcrowding and close contact among the students for long periods of time, both conditions favouring transmission of TB.…”

Section: Discussionmentioning

confidence: 99%

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Tuberculosis outbreak among students in a boarding school

Stein‐Zamir

Volovik²,

Rishpon³

et al. 2006

European Respiratory Journal

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Tuberculosis (TB) outbreaks present a public health challenge. Six cases of active TB emerged in a boarding school in Israel during 1 yr. An epidemiological outbreak investigation was performed, followed by implementation of control measures.The investigation included interviews, tuberculin skin test (TST) and chest radiographs of the students. Close contact (n5155) was defined as being in the same class or dormitory with a patient. Remote contact (n5246) was defined as being in the school.An epidemiological association was detected among five of the cases and a distinct pattern was found in molecular analysis. TST was performed in 398 (99.2%) students. Repeated (two-step) TST was applied to the close contacts. The degree of contact, country of origin and previous bacille Calmette-Guérin vaccination were significantly associated with TST reactions. Preventive directly observed therapy was completed by 157 (91.3%) students. During 5 yrs follow-up, no additional cases emerged.While investigating a tuberculosis outbreak, the definition of degree of contact is a significant predictor for detecting positive tuberculin test. Immigration from an endemic country, as well as previous bacille Calmette-Guérin vaccination have a major effect on tuberculin skin-test results. The directly observed therapy approach was found to be successful in preventing further morbidity.

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Section: Discussionmentioning

confidence: 99%

“…Boarding schools are sites where adolescents are concentrated in conditions of relative overcrowding predisposing to TB outbreaks. These outbreaks present a public health challenge with respect to investigation and control [2][3][4][5][6].…”

mentioning

confidence: 99%

Tuberculosis outbreak among students in a boarding school

Stein‐Zamir

Volovik²,

Rishpon³

et al. 2006

European Respiratory Journal

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show abstract

“…[18][19][20] Without treatment, multidrug-resistant strains can spread rapidly within vulnerable populations. [21][22][23] Because standardized short-course chemotherapy for multidrug-resistant tuberculosis has been associated with unacceptably high rates of failure and relapse, 6,10,24 new approaches to treatment in poor countries are needed. [25][26][27] We conducted a community-based project for the treatment of multidrug-resistant tuberculosis in a resource-poor setting.…”

mentioning

confidence: 99%

Community-Based Therapy for Multidrug-Resistant Tuberculosis in Lima, Peru

et al. 2003

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“…Nevertheless, different environmental or biological conditions counterbalance this weak potential for being transmitted and to causing active disease. First, Post et al [146] estimated that 8-35% of patients with MDR-TB have persistently active disease that is refractory to a multidrug regimen [156,160,180,185] and thus are a constant source of transmission of MDR-TB [67,151,160,206]. Second, Daley [40] reported that there are some populations in which drug resistance is neither detected nor treated effectively and where the longer-duration regimens might offset the bacterium's diminished capacity to cause secondary cases [21].…”

Section: Use Of Genotyping To Study the Impact Of Hiv/aids And Drug Rmentioning

confidence: 99%