The Northern Territory Disease Control Bulletin
Disease Control Bulletin
Territory Health Services, Centre for Disease Control
Northern Territory disease control bulletin; E-Journals; PublicationNT; Northern Territory disease control bulletin
Date:2002-03; This publication contains may contain links to external sites. These external sites may no longer be active.; Made available via the Publications (Legal Deposit) Act 2004 (NT).
Communicable diseases; Reporting; Northern Territory; Statistics; Periodicals
Northern Territory Government
Northern Territory disease control bulletin
v. 9 no. 1
Attribution International 4.0 (CC BY 4.0)
Northern Territory Government
The Northern Territory Disease Control Bulletin Vol 9, No.1, March 2002 3 In patients in ICU with melioidosis septic shock, a G-CSF protocol has been associated with decreased mortality. For antibiotic doses see Antibiotic Guidelines, 11th edition 2000, p 193. Recent References from the NT study Acta Tropica 2000;74:121-127 Acta Tropica 2000;74:145-151 Acta Tropica 2000;74:153-158 Trans Roy Soc Trop Med Hyg 2000;94:301-304 Clin Infect Dis 2000;31:981-986 Aust NZ J Med 2000;30:395-396 Int J Antimicrob Agents 2001;17:109-113 Am J Trop Med Hyg 2001;65:177-179 NT Dis Control Bull 2001;8 (1):1-2 ************* TB Community Screening - a new TB threat promotes community action A Preliminary report In the 10 years 1991 to 2000, an Aboriginal community of about 1100 people in the Top End of the Northern Territory (NT), had only 2 cases of active TB diagnosed and notified. Of these 2 cases only one had been sputum smear positive. In November 2001, an adult died in this community from late stage, undiagnosed communicable pulmonary TB. Contact tracing around the case revealed 5 new cases of active TB. At the same time, a second unrelated case with extensive smear positive pulmonary TB and with numerous family contacts in the community, was diagnosed. This patient subsequently died while on TB treatment as there was wide-spread co-infection with an uncommon organism Nocardia which went undetected as it caused disease similar to the TB. In January, a third case of extensive sputum positive TB was diagnosed; unrelated to the other cases and making a total of 8 cases of TB diagnosed in a 4 month period. The sadness of 2 TB related deaths associated with the community and 6 other cases highlighted a new disease threat to the community; one that was communicable, but one that if diagnosed early was totally curable and if screened for was preventable. The NT TB Control Guidelines recommend extended screening be carried out when 2 or more cases of TB are diagnosed in a community within a year. This may include an entire language group, a specific segment of the community or the whole community. Due to the large number of TB cases diagnosed in a short period of time in this community, TB screening of the entire community was planned. This screening included Mantoux testing all children less than 15 years of age to detect those who were infected (reflected by a Mantoux positive skin text). This positive Mantoux group was then given a chest X-ray (CXR) and clinical review to rule out active TB disease. When disease was ruled out treatment for latent TB infection (LTBI) was offered. The aim of LTBI treatment is to eliminate the infection and hence prevent the possibility of the infection ever progressing to active TB disease in the future. All adults 15 years and older were offered CXRs to screen for active TB disease and also given brief (5 minute) reviews which included again assessing their level of TB contact, a nodal examination and brief public health messages, eg discussing smoking or offering pneumococcal and influenza vaccine and education about TB. If adults were found to be close contacts of TB cases not previously identified in the initial contact screening, they were also offered Mantoux testing. The Centre for Disease Control (CDC) staff (2 RNs) along with the community health staff spent 2 preparatory weeks educating the community about TB sickness and Mantoux testing all the children under 15 years of age plus carrying out the routine second round of contact tracing for the November TB cases and initial contact tracing for the recent TB. They explained that the aim of the screening was to identify any undiagnosed cases of TB disease in the community and also to identify any children or close contacts who may be infected but not diseased. These children and contacts would benefit from treatment of their LTBI ie. preventing TB from possibly developing in the
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