Abstract:

Objective: To investigate and analyze a cluster epidemic of pulmonary tuberculosis in a boarding school in Fengtai District of Beijing, and to provide reference for the prevention and control of pulmonary tuberculosis in boarding schools and students from high-risk areas. Methods: A descriptive epidemiological method was used to investigate an outbreak of pulmonary tuberculosis in a school in Fengtai District of Beijing. According to the epidemiological investigation of the first case, the range of close contacts was determined. Symptom screening, tuberculin skin test (TST) and chest X-ray were used to screen the close contacts, and those with abnormal chest X-ray were further diagnosed. From June 2018 to April 2019, a total of 4 close contacts were screened, once every 3 months. Results: A total of 23 active pulmonary tuberculosis patients and 81 latent tuberculosis patients were found in the school, of which 17 patients were found by chest X-ray screening.The attack rate of pulmonary tuberculosis in senior high school was 4.8% (23/483), of which the attack rate of the first case class was 28.3% (15/53), and the attack rate of other classes was 1.9% (8/430). The risk of tuberculosis in class 5 was higher than that in other classes, and the difference was statistically significant (χ²=72.74,P<0.001), which was 15.21 (95%CI: 6.06-38.17) times that of other classes in senior high school. The overall attack rate of students in the class composed of students in Yushu Tibetan Autonomous Prefecture of Qinghai Province (referred to as ‘Yushu class’) was 8.7% (20/229), the latent infection rate of Mycobacterium tuberculosis was 27.3% (62/227), and the latent infection rate of Mycobacterium tuberculosis in other classes was 7.5% (19/252). The infection risk of students in Yushu class was higher than that in other classes, and the difference was statistically significant (χ²=33.23,P<0.001), which was 3.62 (95%CI: 2.09-6.29) times that of other classes. Conclusion: It is necessary to strengthen the standardization of the infectious disease prevention and control system in boarding schools. In particular, it is necessary to develop effective prevention and control measures for collectively enrolled students in Beijing in areas with high incidence of tuberculosis, rationally use chest X-ray examination, detect tuberculosis patients as early as possible, and effectively curb the spread of tuberculosis in schools.

Key words: Students, Tuberculosis, pulmonary/prevention and control, Disease outbreak