[Epidemic outbreak of tuberculosis].
OBJECTIVE
To describe how collaboration between epidemiological surveillance and primary and specialist health care centres enabled rapid intervention during an outbreak of tuberculosis in a nursery school.


METHODS
A child minder was diagnosed with tuberculosis. The persons exposed were identified. These were four child minders and 58 children under 4 years of age. The respective primary care pediatricians carried out a tuberculin test in all of the children. Children with a positive tuberculin test underwent radiological and microbiological study to rule out the disease. The adults underwent the same procedure.


RESULTS
Detection among the children was rapid; 32.8 % were infected and six showed alterations in thoracic x-rays and were considered to be ill. In three children Mycobacterium tuberculosis was isolated and was genetically similar to the index case. Primary chemoprophylaxis was carried out in all children with a negative tuberculin test; secondary chemoprophylaxis was administered to infected children and specific treatment to the ill. In all children, evolution was satisfactory.


CONCLUSIONS
Periodic surveillance for tuberculosis should be carried out among adults working with children. Genetic study of the strains isolated facilitates epidemiological analysis of these microepidemics.
Bernaola Iturbe
E
E
Unidad de Enfermedades Infecciosas. Servicio de Pediatría. Hospital Virgen del Camino. Pamplona. bernaola@teleline.es
Barricarte Gurrea
A
A
Urtiaga Domínguez
M
M
Hernández Lagunas
T
T
Torroba Alvarez
L
L
D000328:Adult; D002656:Child Day Care Centers; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014376:Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control