An Epidemic of Primary Tuberculosis in a Canadian Aboriginal Community

In 1987, an outbreak of primary tuberculosis occurred in a Canadian aboriginal community of 350 people. The source case was a young woman who had been symptomatic for four months with smear positive cavitary pulmonary tuberculosis. Her 17 siblings and their families were frequent close contacts. Amo...

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Main Authors: Manuel W Mah, Elizabeth Anne Fanning
Format: Article
Language:English
Published: Wiley 1991-01-01
Series:Canadian Journal of Infectious Diseases
Online Access:http://dx.doi.org/10.1155/1991/312417
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author Manuel W Mah
Elizabeth Anne Fanning
author_facet Manuel W Mah
Elizabeth Anne Fanning
author_sort Manuel W Mah
collection DOAJ
description In 1987, an outbreak of primary tuberculosis occurred in a Canadian aboriginal community of 350 people. The source case was a young woman who had been symptomatic for four months with smear positive cavitary pulmonary tuberculosis. Her 17 siblings and their families were frequent close contacts. Among the 626 persons surveyed in the community and environs, 35 additional active cases of tuberculosis were identified. The mean age of cases was 13 years and the median age 10 years. The method of diagnosis was bacteriological in 20 and radiological in 16. There were 257 positive tuberculin reactors of whom 120 had no previous record of a positive skin test. Isoniazid prophylaxis was recommended to all new reactors, close household contacts, reactors under the age of 35 years and reactors with lung scars. One late case was identified at one year of follow-up in a contact who had refused prophylaxis. The rates of infection and disease were higher in the family (65% and 46%, respectively) than in the community and environs (19% and 5.6%, respectively). This report illustrates the nature of a point source epidemic of primary tuberculosis in a susceptible community with a predictable reservoir of infection. The delay in diagnosis of the source case allowed numerous new infections to occur. However, prompt aggressive contact follow-up was successful in containing the epidemic. To prevent future outbreaks, the reservoir of infected persons must be identified and administered chemoprophylaxis.
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spelling doaj-art-ebbcf5bf442f4d01b717438f7ed055722025-08-20T02:22:21ZengWileyCanadian Journal of Infectious Diseases1180-23321991-01-012413314110.1155/1991/312417An Epidemic of Primary Tuberculosis in a Canadian Aboriginal CommunityManuel W Mah0Elizabeth Anne Fanning1Division of Infectious Disease, Department of Medicine, University of Alberta, Edmonton, Alberta, CanadaDivision of Infectious Disease, Department of Medicine, University of Alberta, Edmonton, Alberta, CanadaIn 1987, an outbreak of primary tuberculosis occurred in a Canadian aboriginal community of 350 people. The source case was a young woman who had been symptomatic for four months with smear positive cavitary pulmonary tuberculosis. Her 17 siblings and their families were frequent close contacts. Among the 626 persons surveyed in the community and environs, 35 additional active cases of tuberculosis were identified. The mean age of cases was 13 years and the median age 10 years. The method of diagnosis was bacteriological in 20 and radiological in 16. There were 257 positive tuberculin reactors of whom 120 had no previous record of a positive skin test. Isoniazid prophylaxis was recommended to all new reactors, close household contacts, reactors under the age of 35 years and reactors with lung scars. One late case was identified at one year of follow-up in a contact who had refused prophylaxis. The rates of infection and disease were higher in the family (65% and 46%, respectively) than in the community and environs (19% and 5.6%, respectively). This report illustrates the nature of a point source epidemic of primary tuberculosis in a susceptible community with a predictable reservoir of infection. The delay in diagnosis of the source case allowed numerous new infections to occur. However, prompt aggressive contact follow-up was successful in containing the epidemic. To prevent future outbreaks, the reservoir of infected persons must be identified and administered chemoprophylaxis.http://dx.doi.org/10.1155/1991/312417
spellingShingle Manuel W Mah
Elizabeth Anne Fanning
An Epidemic of Primary Tuberculosis in a Canadian Aboriginal Community
Canadian Journal of Infectious Diseases
title An Epidemic of Primary Tuberculosis in a Canadian Aboriginal Community
title_full An Epidemic of Primary Tuberculosis in a Canadian Aboriginal Community
title_fullStr An Epidemic of Primary Tuberculosis in a Canadian Aboriginal Community
title_full_unstemmed An Epidemic of Primary Tuberculosis in a Canadian Aboriginal Community
title_short An Epidemic of Primary Tuberculosis in a Canadian Aboriginal Community
title_sort epidemic of primary tuberculosis in a canadian aboriginal community
url http://dx.doi.org/10.1155/1991/312417
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