A school and community outbreak of tuberculosis in Auckland

Aim To describe a school and community outbreak of tuberculosis in South Au ckland in 1997/8. Methods. Cases were diagnosed according to national guidelines at Middlemor e, Green Lane and Starship Hospitals. Public health follow-up was conducted by Auckland Healthcare. Results. Twelve cases were diagnosed during the outbreak. Nine cases were f rom the same South Auckland secondary school; six reported no association o utside school. Three cases were in younger children who had close household contact with two of the school cases. Nine cases (including eight from the school) had identical Mycobacterium tuberculosis isolates on restriction f ragment length polymorphism testing. No microbiological culture was obtaine d from the three remaining cases. Contact investigation detected five of th e cases. Chemoprophylaxis was prescribed for twenty-six school students, tw o adult staff, and nine household contacts. Conclusion. This is the first published account of a tuberculosis outbreak in a New Zealand school setting for decades. Recognition of the outbreak wa s delayed. DNA fingerprinting played a valuable role in the investigation. The source case may have been a school student. The social impact of the ou tbreak and preventability with routine adolescent BCG vaccination are discu ssed.