An outbreak of multidrug-resistant tuberculosis among refugees in Austria, 2005-2006

In 2005-2006, the Austrian reference laboratory for tuberculosis (TB) identified multidrug-resistant (MDR) isolates from four cases of TB showing genotypes indistinguishable from each other.

To clarify the chain of transmission of this MDR-TB strain.

An epidemiological case series investigation by reviewing TB notification reports and hospital discharge letters.

The 38-year-old primary case of the MDR-TB cluster had initially been identified as a case of non-MDR pulmonary TB in June 2004, 7 months after being detained for illegal immigration. In March 2005, he was lost to follow-up for 4 months. In June 2005, he presented with pulmonary and laryngeal TB due to MDR-TB. After discharge, the case was again lost to follow-up until April 2006, when he was readmitted with recurrent MDR-TB. A three-case cluster of pulmonary MDR-TB sharing the same strain as the primary case was detected in April 2006: the index case's 5-month-old daughter and a 25-year-old friend with a 6-month-old son.

As MDR-TB has originated in the human immunodeficiency virus seronegative community in Austria, there is a clear need to implement national guidelines for the management of drug-resistant TB in Austria.