[A report of outbreaks of pulmonary tuberculosis in two bars]

We experienced small outbreaks of M. tuberculosis infection in two bars. 9 patients were diagnosed as tuberculosis by identifying M. tuberculosis from their sputa. Six of them were regular customers or employees of the bar, one of them was a family members. Each outbreak within the two bars was suspected of the common source of infection, because one patient was a regular customer of the both bars. The analysis of restriction fragment length polymorphism (RFLP) was done on 5 strains of M. tuberculosis which were isolated from five of 9 patients. The result unexpectedly showed that 5 isolates were classified into 3 groups. Within each group, identical fingerprints were shown. It does mean that each outbreak in two bars was originated from independent source. There was also one relapsed case of tuberculosis. He was suspected of relapsed tuberculosis after a period of 7 years because of the similarity of drug resistance compared with his primary tuberculosis. It was cleared up that 3 different strains of M. tuberculosis were concerned with these outbreaks in the two bars. In this case, almost all patients were heavy drinkers, however, liver dysfunction and malnutrition were not recognized among them. These experiences indicate that a place like bar may be a space of infection of M. tuberculosis. We should always keep in mind a spread of tuberculosis in a place like a bar as one of problems in tuberculosis control.