Transmission of Mycobacterium tuberculosis in a Tennessee Prison, 2002-2004

An outbreak investigation was conducted in a Tennessee prison to determine the extent of Mycobacterium tuberculosis transmission and prevent additional tuberculosis (TB) cases. Inmates, staff, visitors, and community contacts were screened. TB disease was diagnosed for eight inmates, including one after release and three people in the community, including two young children. In addition, 59 contacts (47 inmates, 4 staff members, and 8 additional persons in the community) were newly diagnosed with latent TB infection (LTBI). Failure to recognize TB symptoms, delays in TB diagnosis, inconsistent LTBI treatment, and prolonged congregation of inmates with infectious TB propagated this outbreak. Prison incarceration provides an important opportunity to diagnose and treat LTBI and thus prevent TB disease transmission to the community.