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[Outbreak of tuberculosis in a school].

OBJECTIVE
To show the importance of preventive action in primary care in a case of tuberculosis.


DESIGN
A descriptive study.


SETTING
Castelldefels school, Barcelona.


PARTICIPANTS
Students and teachers, contacts of a case of tuberculosis.


INTERVENTIONS
On June 30, 1995, a case of pulmonary tuberculosis in an adult at a school was notified. In line with the Procedure for Prevention and Control of Tuberculosis of the public health council, the work contacts of the case were administered the tuberculin reaction test (TR) and a thoracic X-ray, with chemoprophylaxis or chemotherapy recommended, depending on the result.


RESULTS
394 TR (92.5%) were performed on 426 children. From the first to the second check-up at three months, 56 (14.2%) presented a positive reaction and had a thoracic X-ray. Eight cases of the illness were diagnosed and treated with chemotherapy: secondary chemoprophylaxis was recommended for 48. 36 of the 39 adults in the school had a TR, and 35 a thoracic X-ray. Two cases of the active illness were diagnosed and secondary chemoprophylaxis was recommended to a teacher. The staff of the sports' centre was also checked, with 18 monitors having a thoracic X-ray and 14 the TR. Secondary chemoprophylaxis was recommended in three cases.


CONCLUSIONS
Rapid action when faced with a case of tuberculosis is basic in the fight against this disease, in order to break the epidemiological chain and find any new cases of disease. Primary care must assume a leading role in early detection and treatment of these patients. Good coordination between different care levels is essential.