[Contact tracing in a case of tuberculosis in a health care worker]

Tuberculosis is a public health problem, of which the nosocomial transmission from a health care worker to patients has not been well documented.

A Senegalese surgeon aged 32 was admitted to hospital on account of deterioration in his general health. He was found to have sputum positive tuberculosis and received standard treatment. We report the strategy employed for tracing the contacts of this health care worker. Of a total of 185 members of staff (permanent and temporary) and 91 patients who had been in contact with the index case, 180 (97.3%) and 71 (78%) respectively were screened. Of the 251 subjects screened, 5 staff (2.8%) and 11 patients (15.4%) showed evidence of latent tuberculous infection and 6 were treated. In total 97.3% of staff exposed were screened at the beginning of the study and 63% were reviewed at 3 months as opposed to 78% and 53% for the patients.

This study shows poor compliance with the visit 3 months after exposure and the need to standardise the procedures in order to improve the screening and follow up of contacts.