title: Tuberculosis in a New York plant: analysis and observations.
abstract: A case of active open pulmonary tuberculosis was accidently and randomly encountered in the midst of a population of middle-aged service employees. A tuberculin survey and x-ray study did not reveal transmission of disease to coworkers. This fortuitous outcome was unexpected. Hypothetical explanations are advanced to account for the extraordinarily high rate of tuberculin reactors in the plant (21.4% to 47.4%) and for the apparent low level or limited infectivity of the index case. The investigation was pursued methodically with selective use of the attack rate to develop successive hypotheses from a spate of complex findings. It is suggested that (because of inherent similarities) occupational physicians will find this type of approach to be effective in the investigation of outbreaks of occupational disease.
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D009787:Occupational Medicine; D011859:Radiography; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000635:transmission; D014691:Ventilation