Abstract
Contact investigation of infants exposed to TB-infected healthcare personnel at two Postpatume care centers
Yeon-Kyeng Lee, Ph.D1, Yunhyung Kwon, Ph.D1, Sodam Lee, MS1, Kanghee Lee, MD, Ph.D1, Unyoung Go, MD, Ph.D1 and Korea Tuberculosis epidemic investigation service (KTEIS)2
(1)Korea Centers for Diseases Control and Prevention (KCDC), Chungcheongbuk-do, Korea, Republic of (South), (2)Korea Centers for Diseases Control and Prevention, Cheongju-si, Korea, Republic of (South)
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: In Korea, Tuberculosis (TB) contact investigations in congregate settings were conducted most frequently in schools since 2011. In 2015, there were two contact investigations in postpartum care (PPC) centers associated with healthcare personnel who had active pulmonary TB. We analyzed data on infants exposed to TB infected healthcare personnel, in two different PPC centers, who had sputum smear negative, culture positive, active pulmonary TB.
Methods: KCDC with local jurisdictional authorities conducted contact investigations immediately after being notified of TB-infected healthcare personnel via the national TB surveillance system. In the two investigations, non-infant contacts of infectious personnel were evaluated for TB infection with Chest X-ray (CXR) and Tuberculin Skin Testing (TST) or Interferon-Gamma Releases Assays (IGRAs). Infant contacts of the TB-infected personnel during possible infectious periods were examined using CXR and TST. Contacts under 12 weeks old at initial examination were offered isoniazid treatment until they reached 12 weeks old, and contacts were retested at > 8 weeks after their last contact if their initial test was performed < 8 weeks of last contact.
Results: In the contact investigations, a total of 514 infant contacts aged from 2 weeks to 7 months were identified. Among infant contacts, 475 were eligible for investigation. Forty-three out of the 475 infants were recommended to receive Latent Tuberculosis Infection treatment based upon positive TST results with a 9 month isoniazid regimen or a 3 month isoniazid/rifampin regimen according to the Korean National Guidelines for TB. All assessed infant contacts were ruled out for active TB based upon negative CXR results, in the absence of symptoms.
Conclusion: There were no active TB infections among infant contacts. Infants, however, are more likely to develop life threatening TB disease than adults and should have TB infection rapidly identified and treated after exposure. Treatment of LTBI in children is important to prevent developing active TB disease.
Epidemiology Public health or related research