RESUMO
BACKGROUND: In February 2009, a high school student was diagnosed with sputum-smear positive pulmonary tuberculosis (TB). One year later, 2 other students in the same grade developed sputum-smear positive TB. METHODS: We used tuberculin skin testing (TST), chest radiography, sputum smear, and symptomatology for case identification. We defined latent TB infection (LTBI) as a TST induration of 15 mm or larger, probable TB as a chest radiograph indicative of TB plus productive cough/hemoptysis for at least 2 weeks or TST induration of 15 mm or larger, and confirmed TB as 2 or more positive sputum smears or 1 positive sputum smear plus a chest radiograph indicative of TB. RESULTS: Of students in the same grade as the primary case-student, 26% (122/476) had LTBI and 4.8% (23/476) had probable/confirmed TB. Of teachers, 43% (18/42) had LTBI and none had probable/confirmed TB. Sharing a classroom with the primary case-student increased risk for LTBI (rate ratio = 2.5; 95% CI: 1.9-3.4) and probable/confirmed TB (rate ratio = 17, 95% CI: 7.8-39). Of students with LTBI in February 2009 who refused prophylaxis, 50% (11/22) had probable/confirmed TB in April 2010. CONCLUSIONS: This TB outbreak was likely started by delayed diagnosis of TB in the case-student and was facilitated by lack of post-exposure chemoprophylaxis. Post-exposure prophylaxis is strongly recommended for all TST-positive students.
Assuntos
Surtos de Doenças/prevenção & controle , Instituições Acadêmicas , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/prevenção & controle , China/epidemiologia , Feminino , Humanos , Tuberculose Latente/epidemiologia , Masculino , Programas de Rastreamento/métodos , Profilaxia Pós-Exposição/estatística & dados numéricos , Estudos Retrospectivos , Tuberculose Pulmonar/diagnósticoRESUMO
According to "The Scheme of Schistosomiasis Surveillance in Zhejiang Province", the status of Oncomelania snails, and the schistosome infection of permanent residents, floating population, and livestock were surveyed in a provincial surveillance site of Shengzhou City, from 2008 to 2011. In 4 years, the area with residual snails was 3,060 m2, and no infected snails were found among 595 living snails. The positive rate of sero-tests for schistosomiasis of the permanent residents was 0.77%, and that of the floating population was 1.09%. No schistosomiasis cases were found. In conclusion, the area with residual snails is small and its distribution is scattered, and we still should strengthen the surveillance of snail status and imported schistosomiasis cases.