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Chapter 12 : Tuberculosis in Enclosed Populations

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Abstract:

This chapter reviews the factors involved in the transmission of tuberculosis (TB) in various congregate settings and the methods employed for curtailment and prevention. The probability of transmission of depends on the concentration of infectious droplet nuclei in the air, the duration of exposure to these particles, and the closeness of contact with infectious persons. At least three factors contribute to the high rate of TB in correctional and detention facilities. First, disparate numbers of incarcerated persons are at high risk for infection (e.g., users of illicit substances, persons of low socioeconomic status, and persons with HIV infection). Second, the physical structure of the facilities contributes to disease transmission, as facilities often provide close living quarters, might have inadequate ventilation, and can be overcrowded. Third, movement of inmates into and out of overcrowded and inadequately ventilated facilities, coupled with existing TB related risk factors of the inmates, makes correctional and detention facilities a high-risk environment for the transmission of TB and makes implementation of TB control measures particularly difficult. UV germicidal irradiation (UVGI) is the least well understood of the three approaches to air disinfection despite its use for over 70 years. Although there are good laboratory data supporting the germicidal activity against a number of virulent bacteria, viruses, and mycobacteria (including ), there are few recent field trials showing that it can prevent TB transmission in populations.

Citation: Segal-Maurer S. 2011. Tuberculosis in Enclosed Populations, p 205-223. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch12

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Tables

Generic image for table
Table 1.

Factors contributing to nosocomial outbreaks of MDR-TB, 1990s

Citation: Segal-Maurer S. 2011. Tuberculosis in Enclosed Populations, p 205-223. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch12
Generic image for table
Table 2.

Factors contributing to TB outbreaks in correctional facilities, 1990s

Citation: Segal-Maurer S. 2011. Tuberculosis in Enclosed Populations, p 205-223. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch12
Generic image for table
Table 3.

Factors contributing to TB outbreaks in shelters and SRO hotels, 1990s

Citation: Segal-Maurer S. 2011. Tuberculosis in Enclosed Populations, p 205-223. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch12
Generic image for table
Table 4.

Risk factors for spread of in LTCFs, 1990s

Citation: Segal-Maurer S. 2011. Tuberculosis in Enclosed Populations, p 205-223. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch12
Generic image for table
Table 5.

Criteria for airborne isolation

Citation: Segal-Maurer S. 2011. Tuberculosis in Enclosed Populations, p 205-223. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch12

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