Tuberculosis skin test conversion rates evaluated at an overseas military hospital

As a result of a perceived increase in purified protein derivative skin test converters, purified protein derivative skin testing of hospital staff and epidemiological evaluation were undertaken. A possible common source of tuberculosis exposure was identified and evaluated. This patient was skin test positive but never provided prophylactic treatment in Spain, and normal case management procedures failed. The Andalusia region, where the naval base is located, has a reported rate of about 15 new tuberculosis cases per 100,000 persons per year, whereas the rate for the entire country of Spain is 22 per 100,000 persons. More than half of the new cases of tuberculosis reported in Spain come from this region. As a result of this work, improved personal prevention programs were instituted and hospital and base orientation regarding the unique risk of tuberculosis in this region was improved.