A Train Passenger with Pulmonary Tuberculosis: Evidence of Limited Transmission During Travel

Moore, Monica; Valway, Sarah E.; Ihle, Walter; Onorato, Ida M.

doi:10.1086/515089

Cited by 48 publications

(41 citation statements)

References 9 publications

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“…An investigation in United States indicated the limited transmission of TB from a potentially highly infectious passenger to other persons during extended train and bus travel. [32] Therefore, we suppose that it is a good opportunity of TB transmission for a great deal of population who make a long journey in the closed coaches in winter, even though we have not direct proofs in this study.…”

Section: Discussionmentioning

confidence: 82%

Seasonal Variations in Notification of Active Tuberculosis Cases in China, 2005–2012

Wang

Zhang

et al. 2013

PLoS ONE

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BackgroundAlthough seasonal variation in tuberculosis (TB) incidence has been described in many countries, it remains unknown in China.MethodsA time series decomposition analysis (X-12-ARIMA) was performed to examine the seasonal variation in active TB cases nationwide from 2005 through 2012 in China. Seasonal amplitude was calculated for the evaluation of TB seasonal variation.ResultsA total of 7.78 million active TB cases were reported over a period of 8 years. A spring peak (April) was observed with seasonal amplitude of 46.3%, compared with the winter trough (February). Most cases in provinces with subtropical and tropical monsoon climate showed lower amplitudes than those in temperate continental, plateau and mountain climate regions. The magnitude of seasonality varied inversely with annual average temperature, r (95% CI) = -0.71 (-0.79, -0.61). The seasonal amplitudes were 56.7, 60.5, 40.6, 46.4 and 50.9% for patients aged ≤14, 15–24, 25–44, 45–64, and ≥65 years, respectively. Students demonstrated greater seasonal amplitude than peasants, migrant workers and workers (115.3% vs. 43.5, 41.6 and 48.1%). Patients with pulmonary TB had lower amplitude compared to patients with pleural and other extra-pulmonary TB (EPTB) (45.9% vs. 52.0 and 56.3%). Relapse cases with sputum smear positive TB (SS+ TB) had significantly higher seasonal amplitude compared to new cases with sputum smear positive TB (52.2% vs. 41.6%).ConclusionsTB is a seasonal disease in China. The peak and trough of TB transmission actually are in winter and in autumn respectively after factors of delay are removed. Higher amplitudes of TB seasonality are more likely to happen in temperate continental, plateau and mountain climate regions and regions with lower annual average temperature, and young person, students, patients with EPTB and relapse cases with SS+ TB are more likely to be affected by TB seasonality.

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Section: Discussionmentioning

confidence: 82%

Seasonal Variations in Notification of Active Tuberculosis Cases in China, 2005–2012

Wang

Zhang

et al. 2013

PLoS ONE

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“…Associations with TB transmission included longer flights and seating in close proximity to the index case. These data suggest that, while in-flight TB transmission is possible, there is no greater risk of TB transmission during air travel compared with other modes of transport such as rail or bus,144 or within office buildings 145…”

Section: Background Literature Reviewmentioning

confidence: 88%

“…Laryngeal TB is thought to be more infectious than pulmonary TB. A report of an index case with laryngeal TB travelling on two short flights (<2 h) was published in 1996 146. Of 161 possible in-flight contacts, only five were TST-positive and all had another risk factor for TB.…”

Section: Background Literature Reviewmentioning

confidence: 99%

Managing passengers with stable respiratory disease planning air travel: British Thoracic Society recommendations

Ahmedzai¹,

Balfour‐Lynn²,

Bewick³

et al. 2011

Thorax

197

298

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“…5 However, the value of intensive TB contact investigations in transportation-related settings remains unclear. 4,6,7,[10][11][12] This investigation yielded insufficient evidence that M. tuberculosis transmission from the driver to medically fragile passengers occurred. In addition, only 27% of passengers diagnosed with latent M. tuberculosis infection completed treatment, which is well below the national target of 85%.…”

Section: Discussionmentioning

confidence: 97%

Passenger Contact Investigation Associated with a Transport Driver with Pulmonary Tuberculosis

Powell

Lamb

Sisk³

et al. 2012

Public Health Rep

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Objectives. In October 2008, pulmonary tuberculosis (TB) was diagnosed in a driver who had transported 762 passengers in the District of Columbia metropolitan area during his infectious period. A passenger contact investigation was conducted by the six public health jurisdictions because of concern that some passengers might be infected with HIV or have other medical conditions that put them at increased risk for developing TB disease if infected.Methods. Authorities evaluated 92 of 100 passengers with at least 90 minutes of cumulative exposure. Passengers with fewer than 90 minutes of cumulative exposure were evaluated if they had contacted the health department after exposure and had a medical condition that increased their risk of TB. A tuberculin skin test (TST) result of at least 5 millimeters induration was considered positive.Results. Of 153 passengers who completed TST evaluation, 11 (7%) had positive TST results. TST results were not associated with exposure time or high-risk medical conditions. No TB cases were identified in the passengers.Conclusions. The investigation yielded insufficient evidence that Mycobacterium tuberculosis transmission to passengers had occurred. TB-control programs should consider transportation-related passenger contact investigations low priority unless exposure is repetitive or single-trip exposure is long.

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A Train Passenger with Pulmonary Tuberculosis: Evidence of Limited Transmission During Travel

Cited by 48 publications

References 9 publications

Seasonal Variations in Notification of Active Tuberculosis Cases in China, 2005–2012

Seasonal Variations in Notification of Active Tuberculosis Cases in China, 2005–2012

Managing passengers with stable respiratory disease planning air travel: British Thoracic Society recommendations

Passenger Contact Investigation Associated with a Transport Driver with Pulmonary Tuberculosis

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