Demora diagnóstica como principal factor contribuyente a un importante brote de tuberculosis en una universidad / Diagnostic delay as main contributing factor to a large outbreak of tuberculosis in a university

OBJETIVO: Describir las características epidemiológicas de un importante brote de tuberculosis en el ámbito universitario y los principales factores de riesgo asociados. MÉTODO: Se realizó un análisis descriptivo de los datos recogidos de las personas enfermas y de los contactos. Para el estudio de contactos se siguieron las pautas establecidas en el Programa de Tuberculosis de la Comunidad Autónoma del País Vasco. Seis de las cepas del brote fueron enviadas al Centro Nacional de Microbiología para su tipado molecular. RESULTADOS: El número total de casos del brote fue de 11. La tasa de infección tuberculosa en el aula del caso índice, incluidas las personas enfermas, fue del 88,1% (59 infectados y solo 8 no infectados). La demora diagnóstica del caso índice fue de 260 días, y en los otros 8 casos sintomáticos osciló entre 10 y 70 días. El patrón obtenido por las 2 técnicas de genotipado fue idéntico en las 6 cepas estudiadas. CONCLUSIONES: La gran demora diagnóstica del caso índice auténtico, que se diagnosticó en el estudio de contactos, y las malas condiciones de ventilación del aula determinaron el alto número de casos secundarios asociados a este brote

OBJECTIVE: To describe the epidemiological characteristics of a large tuberculosis outbreak in the university environment and the main risk factors associated with it. METHOD: A descriptive analysis of the data collected from sick individuals and their contacts was made. For the contact tracing, the guidelines established in the Tuberculosis Programme of the Autonomous Community of the Basque Country were followed. Six of the outbreak strains were sent to the National Centre of Microbiology for molecular typing. RESULTS: The total number of cases of the outbreak was 11. The rate of tuberculosis infection in the classroom of the index case, including the sick individuals, was 88.1% (59 infected and only 8 uninfected). The diagnostic delay of the index case was 260 days, and in the other 8 symptomatic cases it ranged between 10 and 70 days. The pattern obtained by the 2 genotyping techniques was identical in the 6 strains studied. CONCLUSIONS: The long diagnostic delay of the authentic index case, which was diagnosed in the contact tracing, and the poor ventilation conditions of the classroom, determined the high number of secondary cases associated with this outbreak

Diagnostic delay as main contributing factor to a large outbreak of tuberculosis in a university. / Demora diagnóstica como principal factor contribuyente a un importante brote de tuberculosis en una universidad.

OBJECTIVE: To describe the epidemiological characteristics of a large tuberculosis outbreak in the university environment and the main risk factors associated with it. METHOD: A descriptive analysis of the data collected from sick individuals and their contacts was made. For the contact tracing, the guidelines established in the Tuberculosis Programme of the Autonomous Community of the Basque Country were followed. Six of the outbreak strains were sent to the National Centre of Microbiology for molecular typing. RESULTS: The total number of cases of the outbreak was 11. The rate of tuberculosis infection in the classroom of the index case, including the sick individuals, was 88.1% (59 infected and only 8 uninfected). The diagnostic delay of the index case was 260 days, and in the other 8 symptomatic cases it ranged between 10 and 70 days. The pattern obtained by the 2genotyping techniques was identical in the 6 strains studied. CONCLUSIONS: The long diagnostic delay of the authentic index case, which was diagnosed in the contact tracing, and the poor ventilation conditions of the classroom, determined the high number of secondary cases associated with this outbreak.