A Tuberculosis Outbreak Among Senior High School Students in China in 2011

Abstract

Objective: An outbreak of pulmonary tuberculosis (PTB) occurred in students attending Licai Training School, Gujiao City, China, in early 2011. The epidemic characteristics and possible contributory factors relating to the spread of this outbreak of PTB were studied in a field investigation and are reported here. Methods: Cases were detected by PTB symptom screening, tuberculin skin testing (TST), chest X-radiography, and examination of sputum smears and cultures for all students, school staff and close family contacts of patients with PTB. Results: Of the 287 students attending the school, 45 (15.7%) were diagnosed with PTB and two (0.7%) had a positive smear. No PTB was found among staff and close family contacts. Prevalence was high in Science Class 27 and the two floors of the dormitory building where the smear-positive TB patients studied and lived. The frequency of strong TST positivity was also high in Science Class 27 and among close contacts living in the same dormitories as the PTB patients. Conclusions: Several avoidable factors likely to have enhanced disease transmission were identified and several recommendations are made to reduce the risk of future TB outbreaks in schools.