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TB in a school

You have been asked to undertake an investigation of the relationships between tuberculosis cases to efficiently identify clusters. You have access to information collected and recorded at the time the patients were identified by the local health system, including clinical, epidemiological and microbiological information.

Situation 1

November

You are notified about a possible TB outbreak in a secondary school (School A) in your area

Mrs Y, a teacher at School A has been clinically diagnosed with active pulmonary tuberculosis (smear positive) and the initial public health investigation included screening her household contacts (her husband Mr Y) as well as the 120 pupils that she has taught in the previous 3 months.

December

The microbiology report confirms that Mrs Y’s sputum sample has grown Mycobacterium tuberculosis bacteria

Febuary

You also now know that 30 of the 120 pupils screened positive by interferon gamma release assay (IGRA) and that 6 of these 30 also have had Mycobacterium tuberculosis bacteria cultured from sputum samples

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