Tuberculosis Contact Investigations Conducted in New York City Adult Day Care and Senior Centers, 2011-2018

Abstract

Objectives: Multiple tuberculosis (TB) exposures have been reported in New York City (NYC) adult day care and senior centers. Strategies to identify TB transmission at such locations are needed.

Method: Review of the NYC TB Registry identified 12 contact investigations (CIs) at adult day care or senior centers (2011-2018).

Results: Median age of the 12 index patients was 81 years. Of 148 contacts identified who had no history of TB infection or disease, 141 (95%) were tested for TB, primarily with interferon gamma release assays; 46 (33%) tested positive. Transmission was probable (n = 3) or possible (n = 1) at 4 (33%) centers; at all of these, the index patient had an acid-fast bacilli-positive sputum smear. Transmission was not found from index patients with negative sputum smears.

Discussion: We found evidence of transmission of smear-positive respiratory TB disease to contacts in adult day care or senior centers, underscoring the importance of CI.

Keywords: adult day care; aging; geriatric; prevention; transmission.