RESUMEN
In July 2013, a passenger died of infectious extensively drug-resistant tuberculosis (XDR-TB) on board of an aircraft after a 3-hour flight from Turkey to Germany. Initial information indicated the patient had moved about the aircraft coughing blood. We thus aimed to contact and inform all persons exposed within the aircraft and to test them for newly acquired TB infection. Two-stage testing within 8 weeks from exposure and at least 8 weeks after exposure was suggested, using either interferon gamma release assays (IGRAs) or tuberculin skin test (TST). The TST cut-off was defined at a diameter > 10 mm; for differentiation between conversion and boosting, conversion was defined as increase of skin induration > 5 mm. Overall, 155 passengers and seven crew members were included in the investigation: the questionnaire response rate was 83%; 112 (69%) persons were tested at least once for TB infection. In one passenger, who sat next to the area where the patient died, a test conversion was registered. As of March 2017, no secondary active TB cases have been reported. We describe an unusual situation in which we applied contact tracing beyond existing European guidelines; we found one latent tuberculosis infection in a passenger, which we consider probably newly acquired.
Asunto(s)
Trazado de Contacto/métodos , Exposición a Riesgos Ambientales/efectos adversos , Tuberculosis Extensivamente Resistente a Drogas/diagnóstico , Mycobacterium tuberculosis/efectos de los fármacos , Viaje , Prueba de Tuberculina/estadística & datos numéricos , Adolescente , Adulto , Anciano , Aeronaves , Niño , Preescolar , Tuberculosis Extensivamente Resistente a Drogas/mortalidad , Tuberculosis Extensivamente Resistente a Drogas/transmisión , Femenino , Alemania , Humanos , Lactante , Ensayos de Liberación de Interferón gamma , Masculino , Persona de Mediana Edad , Medición de Riesgo , Encuestas y Cuestionarios , Turquía , Adulto JovenRESUMEN
Seven outbreaks of disease characterized by a pustular rash and suspected to have been caused by human monkeypox virus were investigated. The outbreaks occurred between February and August 2001 in the province of Equateur in the Democratic Republic of Congo. The outbreaks involved a total of 31 persons and caused five deaths. Specimens from 14 patients were available and were analyzed by electron microscopy, virus isolation, and PCR assays specific for monkeypox virus and varicella-zoster virus. We provide evidence that two outbreaks were indeed caused by monkeypox virus (16 cases, with four deaths), that in two outbreaks both monkeypox and varicella-zoster virus were involved (seven cases, with one death), and that two outbreaks were cases of chickenpox caused by infection with varicella-zoster virus (six cases, with no deaths). In one outbreak, no evidence for either monkeypox or chickenpox was found (two cases, with no deaths).