Notes from the Field : Large Tuberculosis Contact Investigation Involving Two Hospitals — Okaloosa County, Florida, 2014

Abstract

This report describes a large tuberculosis contact investigation in two hospitals in Okaloosa County, Florida, USA, where a tuberculosis patient received care. The patient died on 1 April 2014 and contact investigations were initiated on 10 June 2014 in hospital A and 18 June 2014 in hospital B. In total, 244 hospital contacts and 7 community contacts were sought for examination. Among 177 contacts from hospital A and 67 contacts from hospital B, 169 (95%) and 62 (93%), respectively, were tested or had a documented tuberculosis test with a negative result approximately 12 weeks after exposure to the suspected source patient. 13 (5%) hospital workers who were no longer employed by the hospitals could not be contacted. During the hospital A investigation, 2 additional nurses assigned to the same unit as the original 4 nurses with tuberculin skin test (TST) conversions had positive TST results, bringing the total to 6 (3%) conversions among 244 hospital staff members tested from both hospitals. The 6 nurses had spent a median duration of 82 h (range: 12-204 h) with the suspected source patient at hospital A during November 2013-January 2014. No conversions were identified at hospital B. Three of 4 roommates of the suspected source patient from both hospitals were tested and all had negative results. On the other hand, 3 of the 7 community contacts had positive results. One contact received treatment for latent tuberculosis infection, one was treated as a clinical tuberculosis disease case until cultures were reported as negative, and the third contact was an out-of-state resident with symptoms consistent with tuberculosis identified via a phone interview.