title: An outbreak of tuberculosis in the South West of England related to a public house.
abstract: There had been a continuous decline in Mycobacterium tuberculosis infection (TB) during the last century until the trend plateaued in the mid-1980's and started to increase in the early 1990's in the United Kingdom (UK). In England and Wales the incidence of TB has increased by 11% between 1993 and 1998 with an overall incidence equal to 10.9/100,000 population. In the South West (SW) of England the incidence of TB is less than the UK average (4.6/100,000). We report an outbreak of TB in the SW of England which was based around a local public house. Sixteen patients received treatment and thirteen received chemo-prophylaxis. Using a rapid IS6 110- based PCR and Restricted Fragment Length Polymorphism Method, all mycobacteria isolated were shown to be identical, and all cultures were sensitive to the usual anti-mycobacterial drugs. All patients were white Caucasians and none were from high risk groups. Despite the absence of conventional close household contacts a significant number of secondary cases were detected. Possible links between TB cases should be considered even in areas of low prevalence.
authors.affiliation: Department of Respiratory Medicine, Royal Devon and Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK. khalidgbr@doctors.org.uk
authors.forename: K A
authors.initials: KA
authors.lastname: Gaber
authors.forename: A
authors.initials: A
authors.lastname: Maggs
authors.forename: G
authors.initials: G
authors.lastname: Thould
authors.forename: J M
authors.initials: JM
authors.lastname: Goldman