Lessons learned from earthquake-related tuberculosis exposures in a community shelter, Japan, 2011

Background Refugees and displaced populations after natural disasters have been vulnerable to tuberculosis. We report an active pulmonary tuberculosis case at a shelter and the subsequent contact investigation and review lessons learned from the 2011 Great East Japan Earthquake. Methods The contact investigation was conducted to identify latent tuberculosis infection among a total of 95 contact persons, including 78 evacuees at the shelter, who were exposed to the index tuberculosis patient. The association between exposure time of contacts to a patient with active tuberculosis and results of interferon-γ release assay (IGRA) was also examined. Results IGRA was positive in 9 (12.3%) of 73 evacuees at the shelter. Contacts who were exposed to active tuberculosis for more than 25 days were significantly more likely to be IGRA positive, compared with contacts exposed for less than 20 days. All of the 4 evacuees with latent tuberculosis infection who initiated treatment completed the regimen successfully. Conclusion When a disaster strikes and many people are living in shelters, it is essential for health care personnel to first suspect tuberculosis and implement prevention and control in collaboration with referral hospitals and public health centers.