Tuberculosis (TB) outbreaks in congregate settings pose a public health concern and a clinical challenge. We report a TB outbreak involving 6 cases of active TB among 28 recent Ethiopian immigrants (EIs) in an immigrant reception center in Israel. The outbreak erupted several weeks after a meticulous pre-immigration TB screening of this group. All five culture-positive TB patients were infected with the CAS1-DELHI family, SIT 25 strain. Pulmonary involvement manifested as only a persistent cough without systemic symptoms. This outbreak occurred because of miscommunication among healthcare staff and between healthcare staff and the EI index case. It was fuelled by the staff ignorance of the social bonds within the group, and the sluggish once-monthly schedule of the on-site TB clinic operated at the reception center, which further lacked radiography facilities. This outbreak highlights the challenges of screening for active TB among immigrants and hard to reach groups. © 2014 Informa Healthcare.

Screening Immigration tuberculosis Public health

genetics immigrant transmission sputum smear Israel mass screening medical examination follow up human immigration Cohort Studies Ethiopian Mycobacterium ethambutol plus isoniazid plus pyrazinamide plus rifampicin abnormal respiratory sound sputum culture variable number of tandem repeat Mycobacterium tuberculosis social bonding screening test ethnology disease duration Young Adult Humans migrant treatment duration lung tuberculosis male Emigrants and Immigrants case report preschool child female tuberculosis Child, Preschool contact examination isolation and purification Disease Outbreaks Contact Tracing Article receptive field epidemic Ethiopia adult thorax radiography microbiology cohort analysis public health problem public health Child