2019年臺灣東部某鄉鎮社區結核病聚集事件

A Tuberculosis Outbreak in a Community, Eastern Taiwan, 2019

2018年起，東部某鄉A村結核病新案發生率上升且多集中於a社區，至2019年已確診5人。於衛生所個案討論會及輔導訪查時發現案三及案四有流病關係，適逢衛生福利部疾病管制署檢驗及疫苗研製中心例行檢驗基因型別同為C00320，衛生福利部疾病管制署東區管制中心回溯社區同型別者共計4人，多數個案不曾參加社區篩檢且傳染力強，活躍於社區，需戮力推動防治措施阻斷社區傳播。故責請衛生局成立聚集事件，召開專家會議擬定防治策略，同時比對鄰村近3年確診個案基因型別，釐清疫情規模。初期衛生所囿於其他潛伏結核感染(latent tuberculosis infection, LTBI)專案及COVID-19疫情，無力兼顧結核病防治工作。為顧及原民社區居民健康權益，衛生福利部疾病管制署東區管制中心及衛生局共同輔導衛生所修訂執行策略，在中央與地方合作下，於2021年9月終結本次聚集事件，迄2023年上半年，社區未有同基因型別確診個案。

Since 2018, the incidence of new tuberculosis cases in Village A of eastern Taiwan had been increasing, with most cases concentrated in“Community a”. By 2019, 5 cases were confirmed. A case discussion meeting was held in the local health center to address the abnormal increase. It was discovered that Cases 3 and 4 were epidemiologically linked, and both cases had been infected by genotype C00320. Tracing back revealed four people in“Community a”were infected with the same genotype. Most cases had not participated in community chest X-ray screenings and were highly infectious.
Therefore, the County Health Bureau convened an expert meeting to formulate prevention and control strategies to control this outbreak. Meanwhile, genotypes of tuberculosis cases in neighboring villages over the three years past were compared to determine the scale of the outbreak. Because the local health center was nearly burnt out due to the COVID-19 response and the latent tuberculosis infection (LTBI) project, they were struggling to implement regular tuberculosis prevention and control measures. In response, the Eastern Regional Center of the Taiwan Centers for Disease Control and the County Health Bureau worked together to assist the local health center in devising tuberculosis control strategies to ensure the health rights and interests of indigenous community residents.
Through the collaboration between the central and local governments, the outbreak ended in September 2021. As of the first half of 2023,“Community a”had not diagnosed tuberculosis cases of the same genotype.