A Tuberculosis Outbreak in a University, Taichung, Taiwan, 2015

DOI: 10.6525/TEB.201802_34(4).0002

Hsiang-Chun Lin1, Kung-Ching Wang1, Shao-Hui Tsai1, Chih-Chi Yang3, Pei-Fang Lai1, Hsiu-Chuan Lu4, Hsueh-Hua Cheng5, Pi-Long Liu1, Ching-Fen Ko1,2*

2018 Vol.34 NO.4

Correspondence Author: Ching-Fen Ko1,2*

  • 1Central Regional Center, Centers for Disease Control, Ministry of Health and Welfare, Taiwan
  • 2Department of Public Health, Tzu Chi University
  • 3Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taiwan
  • 4Health Bureau of Taichung City Government, Taiwan
  • 5Xitun District Public Health Center, Taichung City, Taiwan


Eleven confirmed tuberculosis cases were confirmed in a university in Taichung from July 2014 to October 2015. One contact notified in September 2015 showed identical genotype of the index case. In October 2015, another case was confirmed, thus a tuberculosis cluster in the campus was confirmed. Invited experts found suspect abnormality on the chest X-ray of the index case before the admission to school, but the physical examination reported normal, resulting in the case lurking and spreading tuberculosis to other students in the campus. Therefore, we suggested schools to improve the tracking mechanism of entrants’ physical examination with abnormal findings, to enhance the contact tracing and latent tuberculosis infection (LTBI) treatment, and to improve the quality of the chest X-ray interpretation. Since the interruption rate of the nine-month isoniazid latent tuberculosis infection (LTBI) treatment was high (45%), we also suggested that schools should establish a responsible unit to take care of students and to prevent clusters. Currently, the monitoring system of Taiwan Centers for Disease Control can facilitate the identification of clusters in an early phase.