title: Tuberculosis outbreak in an immigrant reception center in Israel: a clinical and epidemiologic perspective.
abstract: Tuberculosis (TB) outbreaks in congregate settings pose a public health concern and a clinical challenge. We report a TB outbreak involving 6 cases of active TB among 28 recent Ethiopian immigrants (EIs) in an immigrant reception center in Israel. The outbreak erupted several weeks after a meticulous pre-immigration TB screening of this group. All five culture-positive TB patients were infected with the CAS1_DELHI family, SIT 25 strain. Pulmonary involvement manifested as only a persistent cough without systemic symptoms. This outbreak occurred because of miscommunication among healthcare staff and between healthcare staff and the EI index case. It was fuelled by the staff ignorance of the social bonds within the group, and the sluggish once-monthly schedule of the on-site TB clinic operated at the reception center, which further lacked radiography facilities. This outbreak highlights the challenges of screening for active TB among immigrants and hard to reach groups.
authors.affiliation: Nazareth Tuberculosis Clinic, Nazareth Hospital, Nazareth, Faculty of Medicine in Galilee Bar-Ilan University.
authors.forename: Hashem
authors.initials: H
authors.lastname: Bishara
authors.forename: Moshe
authors.initials: M
authors.lastname: Lidji
authors.forename: Drora
authors.initials: D
authors.lastname: Goldblatt
authors.forename: Efrat
authors.initials: E
authors.lastname: Rorman
authors.forename: Zohar
authors.initials: Z
authors.lastname: Mor
authors.forename: Daniel
authors.initials: D
authors.lastname: Weiler-Ravell
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016358:Contact Tracing; D004196:Disease Outbreaks; D054242:Emigrants and Immigrants; D005002:Ethiopia / Q000208:ethnology; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D009161:Mycobacterium / Q000235:genetics / Q000302:isolation & purification*; D011634:Public Health; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D055815:Young Adult
keywords: Tuberculosis; immigration; public health; screening