title: High rate of transmission of tuberculosis in an office: impact of delayed diagnosis.
abstract: We identified two cases of tuberculosis (TB) in office co-workers in Melbourne, Victoria, Australia; the Mycobacterium tuberculosis isolates were found to be identical with use of restriction fragment length polymorphism. Contact tracing was performed for 195 of 210 workers by means of the tuberculin skin test. Risk of infection was assessed according to a number of variables. Office contacts were exposed to infectious TB for 4 months; at least 24% of employees were infected. There was an association between sitting in proximity to the case during the period of exposure (OR, 4.24; 95% CI, 1.06-19.67). On-site workers had a higher risk of being infected (OR, 5.48; CI, 1.51-23.54) than did visiting workers. Workers in this office were exposed to open pulmonary TB for prolonged periods. The prevalence of TB infection (24%) among these workers was high compared with the infection rate (2%-7%) in the general community. Delay in diagnosis was the major factor responsible for the spread of TB in this office.
authors.affiliation: Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21209, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: MacIntyre
authors.forename: A J
authors.initials: AJ
authors.lastname: Plant
authors.forename: J
authors.initials: J
authors.lastname: Hulls
authors.forename: J A
authors.initials: JA
authors.lastname: Streeton
authors.forename: N M
authors.initials: NM
authors.lastname: Graham
authors.forename: G J
authors.initials: GJ
authors.lastname: Rouch
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology*; D012150:Polymorphism, Restriction Fragment Length; D012307:Risk Factors; D013997:Time Factors; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*