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A pseudo outbreak of tuberculosis
1Royal Liverpool Children's Hospital.
Abstract:
Three cases of suspected tuberculosis were diagnosed over a ten day period at an oncology unit. Case finding was carried out and six further cases were diagnosed. However, doubts were raised about these diagnoses and a review of the outbreak investigation was carried out. Investigation of laboratory procedures found that the 'outbreak' was likely to be due to a contaminated phenol red solution. This incident highlights the importance of a critical evaluation of outbreak investigations, and the need for close collaboration between clinicians, epidemiologists and laboratory staff.
Insights
A suspected tuberculosis outbreak in an oncology unit was investigated. The outbreak was likely caused by a contaminated phenol red solution, not actual tuberculosis cases.
Area of Science:
- Medical Microbiology
- Infectious Disease Epidemiology
- Oncology
Background:
- An apparent tuberculosis outbreak was identified in an oncology unit over a 10-day period.
- Initial case finding resulted in the diagnosis of nine suspected tuberculosis cases.
Purpose of the Study:
- To critically evaluate an outbreak investigation of suspected tuberculosis.
- To identify the root cause of the apparent "outbreak" and prevent future occurrences.
Main Methods:
- Review of the initial outbreak investigation procedures.
- Detailed investigation of laboratory protocols and reagents.
Main Results:
- The investigation revealed that the suspected tuberculosis 'outbreak' was likely a false positive due to a contaminated phenol red solution.
- No evidence of actual tuberculosis transmission was found among the oncology patients.
Conclusions:
- Contaminated laboratory reagents can mimic infectious disease outbreaks.
- Critical evaluation of outbreak investigations and interdisciplinary collaboration are essential for accurate diagnosis and patient safety.