A school and community outbreak of tuberculosis in Auckland.
OBJECTIVE
To describe a school and community outbreak of tuberculosis in South Auckland in 1997/8.


METHODS
Cases were diagnosed according to national guidelines at Middlemore, Green Lane and Starship Hospitals. Public health follow-up was conducted by Auckland Healthcare.


RESULTS
Twelve cases were diagnosed during the outbreak. Nine cases were from the same South Auckland secondary school; six reported no association outside school. Three cases were in younger children who had close household contact with two of the school cases. Nine cases (including eight from the school) had identical Mycobacterium tuberculosis isolates on restriction fragment length polymorphism testing. No microbiological culture was obtained from the three remaining cases. Contact investigation detected five of the cases. Chemoprophylaxis was prescribed for twenty-six school students, two adult staff, and nine household contacts.


CONCLUSIONS
This is the first published account of a tuberculosis outbreak in a New Zealand school setting for decades. Recognition of the outbreak was delayed. DNA fingerprinting played a valuable role in the investigation. The source case may have been a school student. The social impact of the outbreak and preventability with routine adolescent BCG vaccination are discussed.
Calder
L
L
Community Services, Auckland Healthcare.
Hampton
L
L
Prentice
D
D
Reeve
M
M
Vaughan
A
A
Vaughan
R
R
Harrison
A
A
Voss
L
L
Morris
A J
AJ
Singh
H
H
Koberstein
V
V
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001500:BCG Vaccine / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D016172:DNA Fingerprinting; D004196:Disease Outbreaks / Q000517:prevention & control; D006801:Humans; D007223:Infant; D009520:New Zealand / Q000453:epidemiology; D010139:Pacific Islands / Q000208:ethnology; D012150:Polymorphism, Restriction Fragment Length; D012574:Schools; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control
D000995:Antitubercular Agents; D001500:BCG Vaccine