Tuberculosis outbreak in a housing unit for human immunodeficiency virus-infected patients in a correctional facility: transmission risk factors and effective outbreak control.
In 1995, an outbreak of tuberculosis (TB) occurred among residents of a correctional-facility housing unit for inmates infected with human immunodeficiency virus (HIV). We isolated and treated patients who were suspected to have TB. To determine risk factors for in-prison transmission of TB, we conducted a case-control study to compare inmate case patients infected with a distinct outbreak strain of TB with control subjects who resided in the HIV unit. We identified 15 case patients during a 4-month period. Among inmates with a CD4 count of <100 cells/mm(3), case patients were more likely than control subjects to spend >/=20 hours per week in a communal day room (odds ratio, 42; P=.002) and were less likely to have a television in their single-person room (odds ratio, 0.10; P=.003). The communal day room was a likely site of transmission. Successful collaboration between the correctional system and public health departments halted the outbreak.
Mohle-Boetani
Janet C
JC
Tuberculosis Control Branch, Division of Communicable Disease Control, California Department of Health Services, Berkeley, CA, 94704, USA. jmohlebo@dhs.ca.gov
Miguelino
Vanessa
V
Dewsnup
Daniel H
DH
Desmond
Edward
E
Horowitz
Evalyn
E
Waterman
Stephen H
SH
Bick
Joseph
J
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000635:transmission; D000328:Adult; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D011330:Prisons; D012307:Risk Factors; D014376:Tuberculosis / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission