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Extensive transmission of Mycobacterium tuberculosis among children on a school bus

Edmundo Neira-Munoz1, Janette Smith, Paul Cockcroft

  • 1Hampshire and Isle of Wight Health Protection Agency, Hampshire, UK. edmundo.neira@ports.nhs.uk

The Pediatric Infectious Disease Journal
|August 6, 2008
PubMed

Insights

A school bus driver's tuberculosis transmission led to an outbreak in children. Early diagnosis is crucial, as many exposed children showed positive results on interferon-gamma release assays, with some developing active tuberculosis.

Area of Science:

  • Communicable disease epidemiology
  • Pediatric infectious diseases
  • Mycobacterium tuberculosis research

Background:

  • School environments can facilitate infectious disease transmission.
  • Tuberculosis (TB) remains a global health concern, particularly in vulnerable populations.
  • Early detection of TB infection is critical to prevent disease progression and onward transmission.

Observation:

  • A school bus driver with infectious tuberculosis (TB) exposed numerous schoolchildren.
  • Two versions of interferon-gamma release assays (IGRAs) were used to assess infection in exposed children.
  • A significant proportion of exposed children tested positive using IGRAs.

Findings:

  • Out of 34 exposed children, 18 (55%) had a positive interferon-gamma release assay result, indicating latent or active TB infection.
  • Four children progressed to develop active tuberculosis disease following exposure.
  • The study indicates highly efficient transmission of TB in this school bus setting.

Implications:

  • School bus environments represent a potential high-risk setting for TB transmission.
  • Prompt identification and management of infectious individuals in schools are essential.
  • IGRAs are valuable tools for detecting TB infection in pediatric populations following exposure.
  • This outbreak underscores the need for enhanced surveillance and early diagnostic strategies in schools to control TB spread.

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