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Tuberculosis in Enclosed Populations

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  • Author: Sorana Segal-Maurer1
  • Editor: David Schlossberg3
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: The Dr. James J. Rahal Jr. Division of Infectious Diseases, NewYork-Presbyterian/Queens, Flushing, NY 11355; 2: Weill Cornell Medicine, New York, NY 10065; 3: Philadelphia Health Department, Philadelphia, PA
  • Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0041-2017
  • Received 29 December 2016 Accepted 10 January 2017 Published 31 March 2017
  • Sorana Segal-Maurer, sxsegalm@nyp.org
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  • Abstract:

    Transmission of tuberculosis (TB) is most effective in close contact indoor environments in various congregate settings including health care facilities, homeless shelters, correctional facilities, long-term care facilities, as well as community settings such as homes, schools, workplaces, and various modes of transportation. Outbreaks are fueled by numerous factors including the HIV epidemic, ease of global travel, unstable socio-economic and/or political situations, and lapses in response to potentially infectious patients. Organized approaches to TB control include an appropriate index of suspicion, identification and isolation of contagious patients in appropriate facilities, use of environmental controls, and personal protective equipment in accordance to national and international published guidelines. These all require tailoring to the various settings where TB is encountered using a determination of risk. Concerted efforts at the local, regional, national, and international levels at identifying patients with active disease, enforcing completion of treatment, and testing and fully treating patients with latent TB infection are paramount in reducing TB burden and continued transmission.

  • Citation: Segal-Maurer S. 2017. Tuberculosis in Enclosed Populations. Microbiol Spectrum 5(2):TNMI7-0041-2017. doi:10.1128/microbiolspec.TNMI7-0041-2017.

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2017-03-31
2017-11-20

Abstract:

Transmission of tuberculosis (TB) is most effective in close contact indoor environments in various congregate settings including health care facilities, homeless shelters, correctional facilities, long-term care facilities, as well as community settings such as homes, schools, workplaces, and various modes of transportation. Outbreaks are fueled by numerous factors including the HIV epidemic, ease of global travel, unstable socio-economic and/or political situations, and lapses in response to potentially infectious patients. Organized approaches to TB control include an appropriate index of suspicion, identification and isolation of contagious patients in appropriate facilities, use of environmental controls, and personal protective equipment in accordance to national and international published guidelines. These all require tailoring to the various settings where TB is encountered using a determination of risk. Concerted efforts at the local, regional, national, and international levels at identifying patients with active disease, enforcing completion of treatment, and testing and fully treating patients with latent TB infection are paramount in reducing TB burden and continued transmission.

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Tables

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TABLE 1

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

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0041-2017
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TABLE 2

Factors contributing to TB outbreaks in correctional facilities, 1990s

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0041-2017
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TABLE 3

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

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0041-2017
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TABLE 4

Risk factors for spread of in LTCFs, 1990s

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0041-2017
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TABLE 5

Criteria for AII

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0041-2017
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TABLE 6

Ongoing risk for spread of

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0041-2017

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