Tuberculosis Outbreak in a Housing Unit for Human Immunodeficiency Virus--Infected Patients in a Correctional Facility: Transmission Risk Factors and Effective Outbreak Control

Abstract

In 1995, an outbreak of tuberculosis (TB) occurred among residents of a correctional-facility housing unit for inmates infected with human immunodeficiency virus (HIV). We isolated and treated patients who were suspected to have TB. To determine risk factors for in-prison transmission of TB, we conducted a case-control study to compare inmate case patients infected with a distinct outbreak strain of TB with control subjects who resided in the HIV unit. We identified 15 case patients during a 4-month period. Among inmates with a CD4 count of µ100 cells/mm³, case patients were more likely than control subjects to spend ≥20 hours per week in a communal day room (odds ratio, 42; P = .002) and were less likely to have a television in their single-person room (odds ratio, 0.10; P = .003). The communal day room was a likely site of transmission. Successful collaboration between the correctional system and public health departments halted the outbreak.