title: An outbreak of multidrug-resistant tuberculosis among refugees in Austria, 2005-2006.
abstract: METHODS
  In 2005-2006, the Austrian reference laboratory for tuberculosis (TB) identified multidrug-resistant (MDR) isolates from four cases of TB showing genotypes indistinguishable from each other.
  
  
  OBJECTIVE
  To clarify the chain of transmission of this MDR-TB strain.
  
  
  METHODS
  An epidemiological case series investigation by reviewing TB notification reports and hospital discharge letters.
  
  
  RESULTS
  The 38-year-old primary case of the MDR-TB cluster had initially been identified as a case of non-MDR pulmonary TB in June 2004, 7 months after being detained for illegal immigration. In March 2005, he was lost to follow-up for 4 months. In June 2005, he presented with pulmonary and laryngeal TB due to MDR-TB. After discharge, the case was again lost to follow-up until April 2006, when he was readmitted with recurrent MDR-TB. A three-case cluster of pulmonary MDR-TB sharing the same strain as the primary case was detected in April 2006: the index case's 5-month-old daughter and a 25-year-old friend with a 6-month-old son.
  
  
  CONCLUSIONS
  As MDR-TB has originated in the human immunodeficiency virus seronegative community in Austria, there is a clear need to implement national guidelines for the management of drug-resistant TB in Austria.
authors.affiliation: Austrian Agency for Health and Food Safety (AGES), Vienna, Austria.
authors.forename: D
authors.initials: D
authors.lastname: Schmid
authors.forename: R
authors.initials: R
authors.lastname: Fretz
authors.forename: H-W
authors.initials: HW
authors.lastname: Kuo
authors.forename: R
authors.initials: R
authors.lastname: Rumetshofer
authors.forename: S
authors.initials: S
authors.lastname: Meusburger
authors.forename: E
authors.initials: E
authors.lastname: Magnet
authors.forename: G
authors.initials: G
authors.lastname: Hürbe
authors.forename: A
authors.initials: A
authors.lastname: Indra
authors.forename: W
authors.initials: W
authors.lastname: Ruppitsch
authors.forename: A T
authors.initials: AT
authors.lastname: Pietzka
authors.forename: F
authors.initials: F
authors.lastname: Allerberger
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage; D001317:Austria / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012036:Refugees; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics
chemical_list: D000995:Antitubercular Agents