PMID- 21353724
OWN - NLM
STAT- MEDLINE
DCOM- 20110706
LR  - 20161125
IS  - 1578-1852 (Electronic)
IS  - 0213-005X (Linking)
VI  - 29
IP  - 2
DP  - 2011 Feb
TI  - [Tuberculosis outbreak in a primary school: description and reflections on the 
      value of gastric juice in the management of micro-epidemics].
PG  - 90-5
LID - 10.1016/j.eimc.2010.08.006 [doi]
AB  - AIMS: To describe a tuberculosis outbreak in a primary school arising from a 
      secondary case. METHODS: Contact study and clinical study of exposed patients. 
      Chest x-ray, gastric aspirate processing, and clinical evaluation of all children 
      with a positive tuberculin skin test (TST) were recorded. Differential diagnosis 
      between tuberculosis disease (TB) and latent tuberculosis infection (LTI). 
      RESULTS: Two groups were identified: one of higher exposure to the index case (> 
      6 hours/day, for 3 months; n=17 children) and one of sporadic exposure (< 6 
      hours/day; n=82 children). Clinical or bacteriological criteria for diagnosing TB 
      were seen in 6 out of 17 (35%) highly exposed children. Four of them had clinical 
      or radiological criteria. The other two children were asymptomatic and had a 
      normal chest X ray, but had a positive gastric aspirate for M. tuberculosis. The 
      overall infection rate (TB+LTI) was 94%. One child out of 82 (1.2%) sporadically 
      exposed children had radiological criteria for TB. Staff latent infection rate 
      was 15%. Apart from the index case, there were no other tuberculosis cases among 
      the staff. Relative risk (RR) of exposed children was 28.5 (95% CI: 3-250). 
      CONCLUSIONS: Prolonged exposure to a baciliferous patient may infect almost every 
      child exposed in closed groups. It can also cause a high attack rate. In this 
      scenario, routine gastric aspirate may be considered for all children with a 
      positive TST. It may identify early subclinical TB with an increased probability 
      of isolating the M. tuberculosis. The potential benefit of this isolation may 
      reach the entire cohort.
CI  - Copyright (c) 2010 Elsevier Espana, S.L. All rights reserved.
FAU - Tagarro, Alfredo
AU  - Tagarro A
AD  - Servicio de Pediatria, Hospital Infanta Sofia, San Sebastian de Reyes, Madrid, 
      Espana. alfredotagarro@hotmail.com
FAU - Jimenez, Susana
AU  - Jimenez S
FAU - Sanchez, Aida
AU  - Sanchez A
FAU - Arroyo, Alicia
AU  - Arroyo A
FAU - Aracil, Javier
AU  - Aracil J
FAU - Canete, Alfonso
AU  - Canete A
LA  - spa
PT  - Case Reports
PT  - Journal Article
TT  - Brote de tuberculosis en un colegio de primaria: descripcion y consideraciones 
      sobre el valor del jugo gastrico en el manejo de microepidemias.
DEP - 20110225
PL  - Spain
TA  - Enferm Infecc Microbiol Clin
JT  - Enfermedades infecciosas y microbiologia clinica
JID - 9104081
SB  - IM
MH  - Adult
MH  - Child, Preschool
MH  - Contact Tracing
MH  - *Disease Outbreaks
MH  - Down Syndrome/complications
MH  - Early Diagnosis
MH  - Environmental Exposure
MH  - Faculty
MH  - Female
MH  - Gastric Juice/*microbiology
MH  - Humans
MH  - Latent Tuberculosis/diagnosis/diagnostic imaging/epidemiology
MH  - Male
MH  - Mycobacterium tuberculosis/*isolation & purification
MH  - Radiography
MH  - Risk
MH  - Schools
MH  - Spain/epidemiology
MH  - Tuberculin Test
MH  - Tuberculosis/diagnosis/diagnostic imaging/*epidemiology/microbiology/transmission
EDAT- 2011/03/01 06:00
MHDA- 2011/07/08 06:00
CRDT- 2011/03/01 06:00
PHST- 2010/02/08 00:00 [received]
PHST- 2010/06/16 00:00 [revised]
PHST- 2010/08/04 00:00 [accepted]
PHST- 2011/03/01 06:00 [entrez]
PHST- 2011/03/01 06:00 [pubmed]
PHST- 2011/07/08 06:00 [medline]
AID - S0213-005X(10)00423-4 [pii]
AID - 10.1016/j.eimc.2010.08.006 [doi]
PST - ppublish
SO  - Enferm Infecc Microbiol Clin. 2011 Feb;29(2):90-5. doi: 
      10.1016/j.eimc.2010.08.006. Epub 2011 Feb 25.