Large Tuberculosis Contact Investigation Involving Two Hospitals — Okaloosa County, Florida, 2014

On the basis of a review of annual TST testing results, including zero staff member conversions among 70 random TSTs performed during the first quarter of 2014, the hospital A ICP concluded that tuberculosis transmission had probably recently occurred on the unit where the four nurses worked. The ICP determined from employee screening records that one of the four nurses had tested negative upon hire in August 2013, and had converted by May 2014. This 9-month window represented the shortest period within which to research potential exposure to undiagnosed tuberculosis. The ICP used nurse staff schedules to review medical records of patients cared for by all four nurses, and identified a US-born, HIV-negative male patient in his early 60s with chronic obstructive pulmonary disease and a history of alcohol and substance abuse as the possible index patient.