Tuberculosis Outbreak in a Primary School, Milan, Italy

Faccini, Marino; Codecasa, Luigi; Ciconali, Giorgio; Cammarata, Serafina; Borriello, Catia; Gioia, Costanza De; Za, Alessandro; Marino, Andrea; Vighi, Valentina; Ferrarese, Maurizio; Gesu, Giovanni; Mazzola, Ester; Castaldi, Silvana

doi:10.3201/eid1902.120527

Cited by 35 publications

(26 citation statements)

References 7 publications

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“…Most pre-college students have great academic pressure due to the nationwide college entrance examinations and the lack of physical exercise in China. Numerous previous relevant literatures reported crowded living, insufficient ventilation, persistent contact with tuberculosis cases and diagnostic delay as the primary factors causing pulmonary tuberculosis outbreaks among high school students [11, 21, 22]. Our results showed that students who resided in the same class as the index case were at a significantly higher risk than other students.…”

Section: Discussionsupporting

confidence: 44%

A tuberculosis school outbreak in China, 2018: reaching an often overlooked adolescent population

You

Zhu

et al. 2019

Epidemiol. Infect.

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Adolescents have been largely neglected from tuberculosis control efforts. In low- to medium burden settings much of the tuberculosis burden in this age group occurs from school outbreaks. We report on a large tuberculosis outbreak in adolescents from a boarding high school in Jiangsu Province, China. From March to June 2018, a tuberculosis outbreak occurred in a boarding high school. We conducted an outbreak investigation involving clinical diagnostic tests and molecular analysis to determine the outbreak origin. Cases were detected through symptom screening, tuberculin skin testing (TST), chest radiography, sputum smear, solid sputum culture and GeneXpert MTB/RIF. Mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) genotyping and spoligotyping methods were performed on Mycobacterium tuberculosis (M. tuberculosis) isolates to identify the outbreak origin. A total of 845 students and 131 teachers/staff attended a TST screening for tuberculosis infection. The prevalence of elevated tuberculin reactions at ≥5, ≥10 and ≥15 mm was 12.19% (119/976), 6.35% (62/976) and 3.28% (32/976), respectively. Radiographic abnormalities were present in 5.73% (56 of 976) individuals, 40 students and 16 teachers/staff. Of these, 12 students were diagnosed with confirmed tuberculosis. In total, 14 students (two index cases and 12 confirmed cases) were diagnosed and reported in the tuberculosis outbreak, an attack rate of 1.7% (14/847) among students (two index cases and 845 screened students). Results from MIRU-VNTR typing and spoligotyping analyses demonstrated that three M. tuberculosis strains belong to the Beijing family with corresponding MIRU-VNTR alleles. This school-based tuberculosis outbreak among adolescents demonstrates that transmission among individuals in this age group is common and must be prioritised. It suggests that identifying and timely diagnosis of smear-positive cases, especially in the early phase of outbreaks, is the key to preventing further spread among close contacts.

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Section: Discussionsupporting

confidence: 44%

A tuberculosis school outbreak in China, 2018: reaching an often overlooked adolescent population

You

Zhu

et al. 2019

Epidemiol. Infect.

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“…Indeed, TB outbreaks in schools are relatively common (e.g. [10]), and both schools and workplaces are important settings for screening potential contacts of index cases [9]. The population in the model is spatially distributed according to estimates of the population density [11] over 219 square cells covering the state territory.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of contact investigations for tuberculosis control in Arkansas

Guzzetta

Ajelli

Yang

et al. 2015

Journal of Theoretical Biology

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Comprehensive assessment of the effectiveness of contact investigations for tuberculosis (TB) control is still lacking. In this study, we use a computational model, calibrated against notification data from Arkansas during the period 2001–2011, that reproduces independent data on key features of TB transmission and epidemiology. The model estimates that the Arkansas contact investigations program has avoided 18.6% (12.1–25.9%) of TB cases and 23.7% (16.4–30.6%) of TB deaths that would have occurred during 2001–2014 if passive diagnosis alone were implemented. If contacts of sputum smear-negative cases had not been included in the program, the percentage reduction would have been remarkably lower. In addition, we predict that achieving national targets for performance indicators of contact investigation programs has strong potential to further reduce TB transmission and burden. However, contact investigations are expected to have limited effectiveness on avoiding reactivation cases of latent infections over the next 60 years.

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“…This is of particular importance for diseases diffused in marginalized parts of the population that may have little access to Internet, and that in any case are not exchanging information with people belonging to other social classes, but that may nonetheless be part of their "physical" neighborhood, for instance by commuting together, or meeting at work, etc. Just as an example, a person living in Europe or USA rarely considers the possibility of contracting tuberculosis, which is indeed rather a rare disease [19] but may cause sudden outbreaks in specific areas [20].…”

Section: Discussionmentioning

confidence: 99%

Epidemic spreading and risk perception in multiplex networks: a self-organized percolation method

Massaro

Bagnoli

2015

ESAIM: Proc.

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Abstract. The contribution of this paper is twofold. First, we develop a self-organized method which is able the evaluate the percolation threshold of the SIS dynamics in general networks by comparing computational results with theoretical ones. Then, we apply this method to the case of risk perception in which the probability of being infected is reduced by a component which is function of the information about the disease. We then study the interplay between epidemic spreading and risk perception on multiplex networks. The system is represented by two layers: one representing the physical contacts and the other one the virtual contacts in which people exchange information and become aware of the disease. The final contribution of this paper is to comprehend the effectiveness of the source of information in modelling the risk perception in epidemic modelling: we found that the similarity between the physical and the information networks determine the possibility of stopping the infection for a sufficiently high precaution level: if the networks are too different there is no mean of avoiding the epidemics.Résumé. La contribution de cet article est double. Tout d'abord, nous développons une méthode auto-organisée qui est en mesure d'évaluer le seuil de percolation de la dynamique SIS dans les réseaux généraux en confrontant les résultats de simulation aux résultats théoriques. Ensuite, nous appliquons cette méthode pour le cas de la perception du risque dans lequel la probabilité d'infection est réduite d'unélément qui est fonction de l'information sur la maladie. Nousétudions après l'interaction entre la propagation de l'épidémie et la perception du risque sur des réseaux multiplex. Le système est représenté par deux couches: une représentation des contacts physiques et l'autre les contacts virtuels dans lesquels les genséchangent des informations et prennent conscience de la maladie. La contribution finale de ce papier est de permettre la compréhension de l'efficacité de la source de l'information dans la représentation de la perception du risque pour la modélisation de l'épidémie. Nous avons constaté que la similitude entre les réseaux d'information et les réseaux physiques détermine la possibilité d'arrêter l'infection pour un niveau de précaution suffisammentélevé. En d'autres termes, si les réseaux sont trop différents il n'y a pas moyen d'éviter lesépidémies. * FB acknowledges partial financial support from the EU projects 288021 (EINS -Network of Excellence in Internet Science) and 611299 (SciCafe2.0). The authors are grateful to Dr. Nicola Perra for helpful discussions.

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Tuberculosis Outbreak in a Primary School, Milan, Italy

Cited by 35 publications

References 7 publications

A tuberculosis school outbreak in China, 2018: reaching an often overlooked adolescent population

A tuberculosis school outbreak in China, 2018: reaching an often overlooked adolescent population

Effectiveness of contact investigations for tuberculosis control in Arkansas

Epidemic spreading and risk perception in multiplex networks: a self-organized percolation method

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