2019年臺灣東部某山地鄉家庭結核病聚集事件

A Tuberculosis Family Cluster in an Aboriginal Township, Eastern Taiwan, 2019

2019年4月3日至4月11日，花蓮縣某山地鄉陸續通報確診3名結核病個案，均為高傳染力之重開案，經衛生單位調查發現為家庭結核病聚集事件。後續進行接觸者檢查，於三個月內陸續通報並確診4名5歲以下幼兒。本案共計7名結核病確診個案，其中5名有陽性菌株經基因分型比對結果為相同基因型。本事件具高傳染力之重開案、拒絕社區巡檢、有共病史及遵從性差、經濟弱勢、居家環境通風不佳及低年齡層發病等高風險因子。衛生單位除依專案會議決議進行社區及高風險對象擴大篩檢、潛伏結核感染治療及加強衛教等相關防治作為外，並運用社福團體、環保單位改善個案經濟及居家環境通風問題，落實結核病防治措施遏止疫情未擴大，截至2021年4月止本案未再有結核病個案。

During April 3 to 11, 2019, three confirmed tuberculosis (TB) cases were reported from a township in Hualien County. All three were retreatment cases and were highly infectious. Epidemiologic investigation determined these cases to be a family cluster. Through contact investigation, four children aged < 5 years were diagnosed with TB. A total of seven cases were confirmed in this cluster; five were of identical genotype. Risk factors contributing to this TB family cluster included high infectivity, refusal of screening, having comorbidities, poor compliance with medication, low socioeconomic status, poor home ventilation, and young age. High infectivity, refusal of screening, having comorbidities, poor compliance with medication, low socioeconomic status, poor ventilation at home, and young age were risk factors that contributed to this TB family cluster. Control strategies included expanding screening among high-risk groups, treating latent tuberculosis infections, and enhancing health education. Assistance was sought from non-governmental organizations and social welfare groups to address the economic problems of the cases and improve sanitation and ventilation of the family’s residence. As of April 2021, there have been no additional TB cases in this family.