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[Tuberculosis microepidemic in a commuter bus].

T Yagi1, Y Sasaki, F Yamagishi

  • 1Division of Thoracic Disease, National Chiba-Higashi Hospital, Japan.

Kekkaku : [Tuberculosis]
|July 29, 1999
PubMed
Summary

A tuberculosis outbreak occurred on a commuter bus, infecting five employees. Poor ventilation in the bus

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • A 22-year-old female employee of an electronics company was diagnosed with tuberculosis (TB) in June 1996.
  • Her initial diagnosis was based on chest roentgenogram findings and a high sputum smear (Gaffky 6).

Observation:

  • A screening of 49 employees in October 1996 revealed two new TB cases and three individuals requiring preventive treatment.
  • These five employees had limited contact at work but shared the same commuter bus.
  • The bus utilized a closed-loop air recirculation system, suggesting inadequate ventilation.

Findings:

  • Tuberculin skin test (TST) results showed a bimodal distribution of erythema diameters.
  • Two employees were diagnosed with active tuberculosis via chest X-ray.
  • Three employees received preventive isoniazid (INH) therapy due to strong TST reactions.

Implications:

  • The study strongly suggests transmission of tuberculosis occurred within the commuter bus environment.
  • Inadequate ventilation in the bus's air-conditioning system likely facilitated the micro-outbreak.
  • This highlights the risk of airborne infectious disease transmission in enclosed, poorly ventilated shared transport.

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