Tuberculosis outbreak in a pre-primary and primary school in Barcelona, Spain

Background In June 2022, a case of non-bacillary pulmonary tuberculosis (TB) was reported in a 10-year-old girl attending a primary school in Barcelona. A second pediatric case from the same school was identified in October 2022, prompting the declaration of a TB outbreak and the initiation of an ep...

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Detalles Bibliográficos
Autores: Prieto-García, R, Millet, JP, Broto, C, Lara, E, Espiau, M, Soriano-Arandes, A, de Souza-Galvao, ML, Jiménez-Fuentes, MA, Domingo, C, Vallverdú, RMV, Saludes, V, Bordoy, AE, Hesketh-Best, PJ, Yagüe, DP, Martró, E, Mestre, LG, Torres, ES, Alguacil, HM, Espinilla, ML, Cardona, PJ, Simón, P, Rius, C
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:dnet:r-iibsantpa_::681b8869a12a6c314b360569b376044a
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21559
Access Level:acceso abierto
Palabra clave:child
contact tracing
disease outbreaks
pulmonary
schools
tuberculosis
whole genome sequencing
Descripción
Sumario:Background In June 2022, a case of non-bacillary pulmonary tuberculosis (TB) was reported in a 10-year-old girl attending a primary school in Barcelona. A second pediatric case from the same school was identified in October 2022, prompting the declaration of a TB outbreak and the initiation of an epidemiological investigation.Methods Contact tracing was conducted using the concentric circles approach, targeting household contacts, classmates, and school staff. Tuberculin skin tests were administered and read 72 h later. Whole genome sequencing of Mycobacterium tuberculosis isolates was performed to identify potential source cases and transmission chains.Results Among 218 individuals screened, 30 TB infections and 4 TB disease cases were diagnosed. The highest prevalence occurred in grades EP4 and EP5 (ages 9-10), with a significantly higher risk compared to other grades. No adult cases linked to the school were identified. Later, a genomic cluster of 15 cases was detected across Catalonia, suggesting a super-spreading event. However, no direct epidemiological link to the school was established.Conclusions This outbreak highlights the challenges of TB detection in pediatric populations and the importance of genomic surveillance in tracing transmission. Despite extensive investigation, the source remains unidentified, underscoring the complexity of TB dynamics in urban settings.