+ Site Statistics
References:
52,654,530
Abstracts:
29,560,856
PMIDs:
28,072,755
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn

+ Translate
+ Recently Requested

The significance of tuberculin skin test in the investigation of mass outbreak of tuberculosis in schools



The significance of tuberculin skin test in the investigation of mass outbreak of tuberculosis in schools



Kekkaku 77(9): 589-595



A high school teacher was diagnosed as pulmonary tuberculosis. He was 27 years old and taught bookkeeping to the 1st year grade students in classes 3 and 6, the 2nd year grade students in classes 4 and 5. He was also the assistant teacher in charge of class 1 of the 3rd year grade students and the adviser of the badminton club in the school. He first noticed a slight cough in November 1999, and visited his physician. On December 24, he visited again for a moderate cough, fever and chill and was administered medicine and drip infusion for a cold. In the middle of January 2000, he visited another physician for a severe cough. He was referred to hospital N and was admitted due to an abnormal shadow on chest X-ray films. The result of sputum smear examination was positive for AFB, Gaffky 8. Subsequent contacts examination was conducted for 153 students and 63 teachers of the school. A tuberculin skin test survey of 153 students was also carried out, in February 2000. The diameter of erythema revealed a monomodal distribution pattern in students, however, one student was diagnosed as pulmonary tuberculosis by the chest X-ray examination, and 27 (18%) showed erythema 40 mm and larger. They were indicated chemoprophylaxis as they were most likely newly infected in this epidemic. After 2 months, a second contact examination was conducted for the students (excluding those who underwent chemoprophylaxis or had tuberculosis) and all teachers. Based on chest X-ray examination, two new students and one teacher were diagnosed as pulmonary tuberculosis, and another one student was diagnosed as tuberculous pleurisy. Comparing the erythema size distribution in the first and second tuberculin tests, the distribution of the latter markedly shifted to right, namely became much larger than the former. It was assumed that students in whom the difference in erythema diameter was larger than 17 mm between the first and second examinations had been newly infected in this epidemic. Chemoprophylaxis was indicated for 45 students and 3 teachers. After 6 months, a third contact examination was conducted for the students and teachers (excluding those who underwent chemoprophylaxis or had tuberculosis). After a year, one teacher was diagnosed as pulmonary tuberculosis by the fourth contact examination (chest X-ray). Restriction fragment length polymorphism (RFLP) analysis was carried out with 2 strains of M. tuberculosis isolated from these patients (the index case and the second teacher patient), and the RFLP pattern of 2 patients was same.

(PDF emailed within 1 workday: $29.90)

Accession: 047737599

Download citation: RISBibTeXText

PMID: 12397706



Related references

Validity of using tuberculin skin test erythema measurement for contact investigation during a tuberculosis outbreak in schoolchildren previously vaccinated with BCG. Journal of Epidemiology 15(2): 56-64, 2005

Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium tuberculosis infection in a school tuberculosis outbreak. Lancet 361(9364): 1168-1173, 2003

Evaluation of a new interferon-gamma release assay and comparison to tuberculin skin test during a tuberculosis outbreak. International Journal of Infectious Diseases 16(7): E522-E526, 2012

The significance of speaking for the transfer of bacteria, and of the tuberculin skin test for the diagnosis of tuberculosis. Monatsschrift für Kinderheilkunde 123(6): 495-497, 1975

Effect of anti-tuberculosis treatment on the tuberculin interferon-gamma response in tuberculin skin test (TST) positive health care workers and patients with tuberculosis. International Journal of Tuberculosis and Lung Disease 4(6): 555-561, 2000

Contact tracing investigation after professional exposure to tuberculosis in a Swiss hospital using both tuberculin skin test and IGRA. Swiss Medical Weekly 144(): W13988-W13988, 2015

Case report 824: Tuberculosis presenting as a soft tissue forearm mass in a patient with a negative tuberculin skin test. Skeletal Radiology 23(1): 79-81, 1994

Comparison of the interferon- gamma release assay and the tuberculin skin test for contact investigation of tuberculosis in BCG-vaccinated health care workers. Scandinavian Journal of Infectious Diseases 40(5): 373-380, 2008

Tuberculin Skin Testing In Secondary Schools In Baltimore County, Maryland. Operation Skin Test. Diseases of the Chest 45: 596-605, 1964

Predictive value of the tuberculin skin test and QuantiFERON-tuberculosis Gold In-Tube test for development of active tuberculosis in hemodialysis patients. Annals of Thoracic Medicine 11(2): 114-120, 2016

Tuberculin skin test and interferon-γ release assay show better correlation after the tuberculin 'window period' in tuberculosis contacts. Scandinavian Journal of Infectious Diseases 43(6-7): 424-429, 2011

A comparison of dual skin test with mycobacterial antigens and tuberculin skin test alone in estimating prevalence of Mycobacterium tuberculosis infection from population surveys. International Journal of Tuberculosis and Lung Disease 7(4): 312-319, 2003

Screening for latent tuberculosis infection in psoriasis and psoriatic arthritis patients in a tuberculosis-endemic country: a comparison of the QuantiFERON®-TB Gold In-Tube test and tuberculin skin test. International Journal of Dermatology 53(10): 1286-1292, 2015

Significance of the tuberculin skin test in pulmonary tuberculosis in Jamaica. Comparisons of culture-positive, culture-negative and non-tuberculous patients. West Indian Medical Journal 36(4): 231-235, 1987