Estudio de los brotes de tuberculosis que han generado informes epidemiológicos en Cataluña (1998-2002)

OBJECTIVE: To analyze the characteristics of tuberculosis outbreaks declared under vigilance programs in Catalonia. METHODS: Descriptive study of outbreaks from 1998 through 2002 for which reports were available. An outbreak was defined as 3 or more associated cases appearing within a year. For 2 health care regions, outbreaks for which there were full surveillance reports with contact tracing were compared to outbreaks identified but which had not been fully reported. RESULTS: Twenty-seven outbreaks were analyzed. Nineteen (70%) occurred within families. A total of 22 outbreaks were declared upon identification of the true index case and 5 upon detection of secondary cases. The mean annual incidence of outbreaks was 0.40/100 100 inhabitants. Most cases were in males 16 to 40 years of age and involved cavitary lesions and a clinically significant diagnostic delay. Twenty-seven outbreaks caused 69 secondary cases. A longer diagnostic delay was seen to correspond to a larger number of secondary cases (P=.08). In the 2 health care regions analyzed, full surveillance reports with contact tracing were issued for 2 of the 14 outbreaks detected (14.4%). CONCLUSIONS: Tuberculosis outbreaks are common but investigative follow-up is scarce. The size of the outbreak is related to the length of diagnostic delay. Rapid diagnosis, contact tracing, and the issuance of a public health report should be priorities in all outbreaks detected.