Typhoid Helga

Via ProMED-mail: Eurosurveillance reports on a tuberculosis outbreak at a Stockholm nursery school:

A female assistant at a nursery in a wealthy suburb of Stockholm was diagnosed with smear positive advanced pulmonary tuberculosis in August 2005. She had lost weight and been coughing for several months before diagnosis. The chest x ray showed bilateral cavitary lesions. Infection with an isoniazid-resistant strain of Mycobacterium tuberculosis was confirmed on culture.
All children and adults with a presumed exposure at the nursery were listed and examined. One three year old boywas found to be ill with fever, was admitted to hospital immediately, and diagnosed with primary tuberculosis with hilar adenopathy.
In total 141, children were exposed and of these, 35 (25%) had a TST ≥ 10mm and/or an abnormal chest x ray. Out of 20 children with an abnormal chest x ray, eight had bronchoalveolar infiltrates with hilar adenopathy and 12 hilar adenopathy only. One seven year old girl had a disseminated tuberculosis.