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A pulmonary tuberculosis outbreak in a long-term care facility
Epidemiology and Infection
|November 24, 2015
Summary
Tuberculosis outbreaks in long-term care facilities are a significant risk. Comprehensive screening, even for initial TST-negative individuals, is crucial for controlling TB spread due to long latent periods.
Area of Science:
- Infectious Diseases
- Public Health
- Gerontology
Background:
- Elderly individuals in long-term care facilities (LTCFs) are susceptible to tuberculosis (TB) reactivation.
- Latent tuberculosis infection (LTBI) increases the risk of developing active TB disease in this population.
Purpose of the Study:
- To report and analyze a tuberculosis outbreak among residents and staff in a LTCF.
- To investigate the transmission dynamics and identify risk factors associated with the outbreak.
Main Methods:
- Conducted an outbreak investigation following the identification of two TB cases.
- Administered tuberculin skin tests (TST), bacteriological examinations, and chest radiographs to all staff and residents.
- Defined an outbreak based on epidemiologically linked cases with identical Mycobacterium tuberculosis genotype isolates.
Main Results:
- The outbreak involved nine individuals (eight residents, one staff member) diagnosed with TB between September 2011 and October 2012.
- Estimated latent and infectious periods using the Becker method at 223.6 and 55.9 days, respectively.
- Identified two TST-negative resident contacts who were later diagnosed with TB through comprehensive screening.
Conclusions:
- Comprehensive TB screening in LTCFs is essential, particularly for elderly individuals, due to potentially long latent periods.
- The findings highlight the necessity of considering LTBI treatment for elderly contacts to effectively control TB outbreaks in LTCFs.
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