Outbreaks of tuberculosis have been reported in prisons, nursing homes, urban homeless shelters, and other crowded settings.
We report a nonresidential outbreak of tuberculosis that originated in a neighborhood bar.
A homeless patient with highly infectious pulmonary tuberculosis was a regular patron of a neighborhood bar during a long symptomatic interval before diagnosis.
We investigated 97 other regular customers and employees of the bar through interviews, tuberculin skin testing, and chest roentgenography.
We performed DNA fingerprinting on isolates from the index patient and 11 other patients.
The index patient apparently infected 41 of 97 contacts (42%), resulting in 14 cases of active tuberculosis and 27 cases of infection but no disease.
Four other cases of active tuberculosis occurred among regular customers of the bar who were missed by the contact investigation.
There were also two secondary cases.
Radiographic findings in active cases included upper-lobe disease in seven cases and negative chest films at the time of diagnosis in four cases.
All 12 culture isolates we tested had the same chromosomal-DNA restriction pattern.
The spread of tuberculosis in a neighborhood bar can be a major public health problem.
The high rate of infection and disease among the contacts was unexpected and was not due to coinfection with the human immunodeficiency virus.
(N Engl J Med 1995 ; 333 : 222-7.).
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Poumon, Contagion, Dispersion, Etude cas, Homme, Appareil respiratoire pathologie, Poumon pathologie
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Lung, Contagion, Dispersion, Case study, Human, Respiratory disease, Lung disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0442860
Code Inist : 002B05B02O. Création : 01/03/1996.