Moore M, Valway S E, Ihle W, Onorato I M
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Clin Infect Dis. 1999 Jan;28(1):52-6. doi: 10.1086/515089.
In January 1996, smear- and culture-positive tuberculosis (TB) was diagnosed for a 22-year-old black man after he had traveled on two U.S. passenger trains (29.1 hours) and a bus (5.5 hours) over 2 days. To determine if transmission had occurred, passengers and crew were notified of the potential exposure and instructed to undergo a tuberculin skin test (TST). Of the 240 persons who completed screening, 4 (2%) had a documented TST conversion (increase in induration of > or = 10 mm between successive TSTs), 11 (5%) had a single positive TST (> or = 10 mm), and 225 (94%) had a negative TST (< 10 mm). For two persons who underwent conversion, no other risk factors for a conversion were identified other than exposure to the ill passenger during train and/or bus travel. These findings support limited transmission of Mycobacterium tuberculosis from a potentially highly infectious passenger to other persons during extended train and bus travel.
1996年1月，一名22岁的黑人男性在两天内乘坐了两趟美国客运列车（29.1小时）和一辆公共汽车（5.5小时）后，被诊断出涂片和培养均呈阳性的结核病。为确定是否发生了传播，已将潜在暴露情况通知了乘客和乘务人员，并指示他们接受结核菌素皮肤试验（TST）。在完成筛查的240人中，4人（2%）有记录显示TST结果发生转变（连续两次TST之间硬结增大≥10毫米），11人（5%）单次TST呈阳性（≥10毫米），225人（94%）TST呈阴性（<10毫米）。对于两名TST结果发生转变的人员，除了在火车和/或公共汽车旅行期间接触患病乘客外，未发现其他导致结果转变的风险因素。这些发现支持在长时间的火车和公共汽车旅行期间，结核分枝杆菌从一名潜在的高传染性乘客向其他人员发生了有限的传播。
