A community outbreak of tuberculosis in Southern Austria: lessons learned for a targeted use of molecular epidemiological methods and tuberculin skin testing.
A cluster of 10 cases of tuberculosis disease (one of them extrapulmonary) occurred from July 2001 until November 2003 in a health district in Southern Austria. Eight patients were culture confirmed and shared an identical strain. One of these eight cases was identified as outbreak-related by molecular strain typing only. Due to public pressure, a further 600 persons received chest X-ray and clinical examinations. Apart from one case which could be excluded from the outbreak because of a different strain pattern, no outbreak-related case of active tuberculosis was detected by this non-targeted procedure. Tuberculin skin testing, not part of the Austrian routine protocol of contact investigation in adults, was initiated after diagnosis of case 8. Forty-nine latently infected contacts were detected. Population-based genotyping of all isolates, prioritization of contact investigations and early use of targeted tuberculin skin testing are critical for effective tuberculosis control in low-incidence countries.
Schmid
D
D
Centre for Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety, Vienna, Austria.
Indra
A
A
Höger
G
G
Hasenberger
P
P
Robl
B
B
Schöffmann
M
M
Maieron
B
B
Olexsinski
G
G
Stonitsch
B
B
Prodinger
W M
WM
Allerberger
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D011159:Population Surveillance; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000235:genetics*