Public health guidance on investigation and control of tuberculosis incidents affecting children in congregate settings

public health guidance

​This report aims to bring the different components of generic outbreak management and tuberculosis specific policies and guidelines together, to develop a more comprehensive package of guidance to capture the elements that are specific for TB incidents affecting children in congregate settings.

Executive summary

This report provides public health guidance on how to investigate and control a tuberculosis incident among children - such as an outbreak -, in congregate settings outside the household. The findings are the end result of an assessment of current national health practices, policies and guidelines and of the conclusions of an ad hoc independent expert panel. 
 
The assessment of current common practices in the European Union and European Economic Area (EU/EEA) identified that most countries follow similar approaches in the investigation and control phases of tuberculosis (TB) incidents. ECDC gathered the different components of generic outbreak management and TB policies and guidelines to develop a comprehensive guidance on:

  • Triggers and scope of a TB incident investigation
  • Preparedness, planning, responsibilities
  • Investigation and control of a TB incident
  • Communication plan
  • Incident/outbreak documentation and evaluation

With this document, ECDC encourages EU/EAA countries to raise the profile of childhood TB in national childhood TB prevention and control strategies and guidelines.

Childhood tuberculosis

Young children who are exposed to people with infectious tuberculosis have an increased risk of developing TB disease within one year after being infected. Childhood TB is therefore an indicator of ongoing transmission within a community. Rapidly identifying the source of infection and performing contact investigation around the source case is essential for interrupting transmission. Early detection is also important for successful treatment since infants and young children are particularly susceptible to developing severe forms of TB disease.
 
The notion that childhood TB represents a sentinel event of recent transmission highlights the need for in depth analysis and knowledge of the epidemiology and control of childhood TB in settings such as the EU/EEA. To stop the transmission of Mycobacterium tuberculosis to children is an essential step towards eliminating TB, as infected children are a pool of infection for future generations.