gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Tuberculosis in 14 au pairs in Germany

Tuberkulose bei 14 Au Pairs in Deutschland

Meeting Abstract

Suche in Medline nach

  • H. Geerdes-Fenge - Gesundheitsamt München-Land, München, Germany
  • G. Loytved - Gesundheitsamt Würzburg, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocINF 09-4

DOI: 10.3205/10kit019, URN: urn:nbn:de:0183-10kit0194

Veröffentlicht: 2. Juni 2010

© 2010 Geerdes-Fenge et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objectives: To assess the risk of tuberculosis infection in host families of au pairs with tuberculosis in Germany.

Methods: Retrospective study of au pairs with tuberculosis and their contacts. Data were registered by German local health authorities.

Results: Between 2002 and 2009, ten au pairs with sputum smear positive (ss+) tuberculosis were registered by local health authorities in Bavaria; three individual reports of other states (Baden-Wurttemberg, Hessen, Northrhine-Westfalia) are included in the report. One case was detected by screening. Demographic data: 14 women, mean age 22.5 yrs (range 19–27). Country of origin: Kenia (5 cases), Georgia (4 cases), Mongolia (2 cases), Russia, Romania, Nepal (1 case each). Time between entry and first symptoms: median 6 months (range 0–18 months). Time between first symptoms and diagnosis: median 2.8 months (range 0.7–4.7 months).

Infection in contacts: In two cases, the diagnosis was established in less than four weeks after the onset of symptoms. There was no tuberculosis infection in the respective host families; one ss+ tuberculosis occurred 12 months later in the sister of one au pair; fingerprinting was not performed.

One case was detected by screening with an interferon-gamma-release-assay; diagnosis was made by x-ray, sputum cultures were negative; no infection occurred in the host familiy.

In 11 cases, diagnosis of ss+ tb was established after a delay of 1.3–5 months after the onset of symptoms. In each of these 11 cases, at least one infection occurred; a total of 39 persons were infected: 12 children, 4 mothers and 5 fathers in the host families as well as 7 children and 11 adults with close contact to the au pairs. Most infected children adhered to isoniazid prophylaxis. One child and two adults developed tuberculosis; in one case, molecular fingerprinting confirmed mycobacterial identity.

Conclusions: Tuberculosis in au pairs from high prevalence countries represents a risk for tuberculosis infection in the host families, especially in young children. Since first symptoms of tuberculosis developed after 0–18 months after entry, screening by x-ray before entry would not have been diagnostic in most cases. Screening should be performed after the arrival of au pairs in Germany and consist of a check for symptoms and an interferon-gamma-release-assay. If either is positive, a chest x-ray should be performed, and information about tuberculosis should be given to the au pair and the host family.