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Neglected disease in mentally ill patients: Major tuberculosis outbreak in a psychiatric hospital

Published:October 18, 2016DOI:https://doi.org/10.1016/j.ajic.2016.09.004

      Highlights

      • Mentally ill patients are at increased risk of tuberculosis.
      • Maintaining awareness of tuberculosis in psychiatric patients is necessary to avoid diagnostic delay.
      • Active approach is necessary in adopting infection control measures in psychiatric institutions.
      As tuberculosis incidence decreases, the possibility of overlooking the disease increases, especially in vulnerable populations. We describe here a major tuberculosis outbreak among mentally ill patients in Croatia, focusing on 1 regional hospital where most patients were hospitalized. The outbreak emphasizes the vulnerability of mentally ill patients to tuberculosis infection and the complexity of infection control measures in psychiatric institutions. The awareness of tuberculosis in these settings should be maintained to interrupt prolonged exposure and avoid unnecessary infection.

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      References

        • Croatian Health Service Yearbook 2014
        Epidemiology of tuberculosis.
        Croatian National Institute of Public Health, Zagreb, Croatia2015
        • Farhat M.
        • Greenaway C.
        • Pai M.
        • Menzies D.
        False-positive tuberculin skin tests: what is the absolute effect of BCG and non-tuberculous mycobacteria?.
        Int J Tuberc Lung Dis. 2006; 10: 1192-1204
        • Cavanaugh J.S.
        • Powell K.
        • Renwick O.J.
        • Davis K.L.
        • Hilliard A.
        • Benjamin C.
        • et al.
        An outbreak of tuberculosis among adults with mental illness.
        Am J Psychiatry. 2012; 169: 569-575
        • Kuo S.C.
        • Chen Y.T.
        • Li S.Y.
        • Lee Y.T.
        • Yang A.C.
        • Chen T.L.
        • et al.
        Incidence and outcome of newly-diagnosed tuberculosis in schizophrenics: a 12-year, nationwide, retrospective longitudinal study.
        BMC Infect Dis. 2013; 13: 351
        • Ohta Y.
        • Nakane Y.
        • Mine M.
        • Nakama I.
        • Michitsuji S.
        • Araki K.
        • et al.
        The epidemiological study of physical morbidity in schizophrenics—2. Association between schizophrenia and incidence of tuberculosis.
        Jpn J Psychiatry Neurol. 1988; 42: 41-47
        • DE Hert M.
        • Correll C.U.
        • Bobes J.
        • Cetkovich-Bakmas M.
        • Cohen D.
        • Asai I.
        • et al.
        Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care.
        World Psychiatry. 2011; 10: 52-77
        • Druss B.G.
        Improving medical care for persons with serious mental illness: challenges and solutions.
        J Clin Psychiatry. 2007; 68: 40-44
        • Leonard S.
        • Adler L.E.
        • Benhammou K.
        • Berger R.
        • Breese C.R.
        • Drebing C.
        • et al.
        Smoking and mental illness.
        Pharmacol Biochem Behav. 2001; 70: 561-570