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Lessons learned from continued TB outbreaks in a high school

We investigated the aftereffects of confirmatory QuantiFERON testing (QFT) added to a positive tuberculin skin test (TST). We reviewed the pre and post course of sequential tuberculosis (TB) outbreaks in a high school where massive 43 active TB cases had been found within one year before delayed con...

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Autores principales: Kim, Young, Kim, Byeong Ki, Choi, Hong Jo, Ryu, Sung Weon, Kim, Eui Sook, Chang, Yoon Soo, Kim, Hee Jin, Cha, Jae Hyung, Kim, Je Hyeong, Shin, Chol, Lee, Seung Heon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690470/
https://www.ncbi.nlm.nih.gov/pubmed/29145443
http://dx.doi.org/10.1371/journal.pone.0188076
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author Kim, Young
Kim, Byeong Ki
Choi, Hong Jo
Ryu, Sung Weon
Kim, Eui Sook
Chang, Yoon Soo
Kim, Hee Jin
Cha, Jae Hyung
Kim, Je Hyeong
Shin, Chol
Lee, Seung Heon
author_facet Kim, Young
Kim, Byeong Ki
Choi, Hong Jo
Ryu, Sung Weon
Kim, Eui Sook
Chang, Yoon Soo
Kim, Hee Jin
Cha, Jae Hyung
Kim, Je Hyeong
Shin, Chol
Lee, Seung Heon
author_sort Kim, Young
collection PubMed
description We investigated the aftereffects of confirmatory QuantiFERON testing (QFT) added to a positive tuberculin skin test (TST). We reviewed the pre and post course of sequential tuberculosis (TB) outbreaks in a high school where massive 43 active TB cases had been found within one year before delayed contact investigation. And we investigated the TB development in relation to initial TST and QFT during mean follow-up of 3.9 ± 0.9 years. After delayed contact investigation for two subsequent TB outbreaks, 925 contacts were divided into the following 3 groups: TST- (n = 632), TST+/QFT+ (n = 24), TST+/QFT- (n = 258). QFT- was more prevalent than QFT+ in contacts with 10mm ≤ TST <15mm (158, 61.2%) compared with TST ≥15mm (100, 38.8%) among the TST+ reactors (P < 0.001). Among the 258 TST+/QFT- subjects, 256 received no latent TB infection (LTBI) treatment, but 7 contacts developed TB during follow-up. Among these 7 patients, 4 had initial TST ≥15mm and 3 had 10mm ≤ TST <15mm. In conclusion, the delayed contact investigation for LTBI in a high school resulted in continued TB developments. False-negative QFT performed late among the TST+ reactors should not be considered criteria for LTBI treatment. Additionally, the contacts only with TST ≥15mm should be considered for LTBI treatment in congregate settings of intermediate-burden countries.
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spelling pubmed-56904702017-11-30 Lessons learned from continued TB outbreaks in a high school Kim, Young Kim, Byeong Ki Choi, Hong Jo Ryu, Sung Weon Kim, Eui Sook Chang, Yoon Soo Kim, Hee Jin Cha, Jae Hyung Kim, Je Hyeong Shin, Chol Lee, Seung Heon PLoS One Research Article We investigated the aftereffects of confirmatory QuantiFERON testing (QFT) added to a positive tuberculin skin test (TST). We reviewed the pre and post course of sequential tuberculosis (TB) outbreaks in a high school where massive 43 active TB cases had been found within one year before delayed contact investigation. And we investigated the TB development in relation to initial TST and QFT during mean follow-up of 3.9 ± 0.9 years. After delayed contact investigation for two subsequent TB outbreaks, 925 contacts were divided into the following 3 groups: TST- (n = 632), TST+/QFT+ (n = 24), TST+/QFT- (n = 258). QFT- was more prevalent than QFT+ in contacts with 10mm ≤ TST <15mm (158, 61.2%) compared with TST ≥15mm (100, 38.8%) among the TST+ reactors (P < 0.001). Among the 258 TST+/QFT- subjects, 256 received no latent TB infection (LTBI) treatment, but 7 contacts developed TB during follow-up. Among these 7 patients, 4 had initial TST ≥15mm and 3 had 10mm ≤ TST <15mm. In conclusion, the delayed contact investigation for LTBI in a high school resulted in continued TB developments. False-negative QFT performed late among the TST+ reactors should not be considered criteria for LTBI treatment. Additionally, the contacts only with TST ≥15mm should be considered for LTBI treatment in congregate settings of intermediate-burden countries. Public Library of Science 2017-11-16 /pmc/articles/PMC5690470/ /pubmed/29145443 http://dx.doi.org/10.1371/journal.pone.0188076 Text en © 2017 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kim, Young
Kim, Byeong Ki
Choi, Hong Jo
Ryu, Sung Weon
Kim, Eui Sook
Chang, Yoon Soo
Kim, Hee Jin
Cha, Jae Hyung
Kim, Je Hyeong
Shin, Chol
Lee, Seung Heon
Lessons learned from continued TB outbreaks in a high school
title Lessons learned from continued TB outbreaks in a high school
title_full Lessons learned from continued TB outbreaks in a high school
title_fullStr Lessons learned from continued TB outbreaks in a high school
title_full_unstemmed Lessons learned from continued TB outbreaks in a high school
title_short Lessons learned from continued TB outbreaks in a high school
title_sort lessons learned from continued tb outbreaks in a high school
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690470/
https://www.ncbi.nlm.nih.gov/pubmed/29145443
http://dx.doi.org/10.1371/journal.pone.0188076
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