Essays
https://doi.org/10.3325/cmj.2021.62.90
Tuberculosis in schools: an outbreak in northeastern Italy and some key health protection interventions
Luca Cegolon
; Local Health Unit N.2, “Marca Trevigiana” Public Health Department, Treviso, Italy
Giuseppe Mastrangelo
; Department of Cardiac, Thoracic, Vascular Sciences & Public Health, Padua University, Padua, Italy
Davide Gentili
; Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
Mario Mastromarino
; Local Health Unit N.2, “Marca Trevigiana” Public Health Department, Treviso, Italy
Andrea Cegolon
; Department of Political, Social and International Relationships, University of Macerata, Macerata, Italy
Giuseppe Pichierri
; Department of Microbiology, Kingston Hospital NHS Foundation Trust, Kingston upon Thames, United Kingdom
Sandro Cinquetti
; Local Health Unit N.2, “Marca Trevigiana” Public Health Department, Treviso, Italy
Saverio Bellizzi
; Partnership for Maternal, Newborn & Child Health, Geneva, Switzerland
Giovanni Sotgiu
; Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
Abstract
In April 2019, a tuberculosis (TB) outbreak, likely triggered
by re-activation of a highly contagious latent tuberculosis
infection (LTBI) in a school teacher, was reported in a primary school in the Veneto Region (northeastern Italy). The
infection, having probably been dormant for decades, rapidly spread further to two school teachers and up to 11 pupils, a total of 13 cases of active TB that received appropriate TB treatment. Ten out of the remaining 95 school staff
members (10.5%) and 34/546 (6.2%) remaining school pupils tested positive on tuberculin skin test (TST). Moreover,
2% (2/97) of pupils attending the first year of junior secondary school within the same municipality during 2017/18
(having completed the above primary school) were also
found positive on TST. Since none of 3 school teachers or
84 pupils who completed the last year of primary school in
2017 and attended the second year of a junior secondary
school were found to be TST positive, the beginning of the
outbreak was dated from January 2018 onwards. Therefore,
active TB in the index case may have been potentially infectious and undiagnosed for about 14 months, leading to
extensive exposure of close contacts, especially students
(1). Anyone with recognized LTBI status – among school
staff or pupils – was placed on prophylaxis with isoniazid for 6 months (1).
Keywords
Hrčak ID:
278048
URI
Publication date:
25.2.2021.
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