13-years of Tuberculosis in the St. Bernard Parish, Louisiana
At the Region 1 TB clinic in New Orleans, LA extensive tuberculosis (TB) contact investigations have occurred over the last 13 years involving the same cluster of individuals. The objectives of this study were to investigate these cases and link them epidemiologically.
In this IRB-approved study, the subject population consisted of the family members and their contacts between the years 2000 and 2013. Information on demographics, diagnosis, risk factors, and treatment was collected via reviewing medical records and interviewing the involved personnel. A family tree and maps were created based on the zip-codes of their residence.
69 cases were reviewed (47 adults, 22 children) as of April 2014. All the 37 (17 males, 20 females) individuals were otherwise healthy (HIV negative when tested), of white race, and US. born with no travel history outside of the USA. The family tree and mapping data outlined four families with involvement of four generations, mainly residing in the St. Bernard Parish. Smoking history was reported in 19 and drug use was reported in 3 individuals.
Out of 69 cases, 30 were reported as latent tuberculosis infection (LTBI), 11 as having no infection, and 4 remained unknown. 50% of LTBI patients completed age-appropriate treatment. 24 were active cases of TB, including 6 cases of children. 23 out of 24 individuals completed appropriate treatment for active TB infection with directly observed therapy (DOT). One individual migrated to another region towards the end of the therapy. There were 12 subjects who had a repeat treatment either as a latent TB or an active case. Of those repeat cases, 5 patients had active TB twice and they were treated with appropriate TB therapy with DOT each time. 17 out of 18 (1 diagnosed at death) TB strains isolated from adult active pulmonary cases were all pan-sensitive. The genotypes of the collected strains were identical from the years 2000 (3), 2006 (5), and 2008 (1).
We are reporting the largest outbreak of tuberculosis, spanning over 13 years, in the St. Bernard Parish in the state of Louisiana. The next part of the project would involve searching for etiologies for persistence of TB in this cluster of individuals by tracing their migration, work and social activities more closely.
J. Shariff, None
C. Brown, None
T. Noel, None
C. Degraw, None
J. Schieffelin, None
M. Silio, None
J. Ali, None