Multidrug-Resistant Tuberculosis Outbreak among Immigrants in Tokyo, Japan, 2019–2021

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  • Kobayashi Yumi
    Health Service Division, Nakano City Health Office, Japan
  • Tateishi Ai
    Health Service Division, Nakano City Health Office, Japan
  • Hiroi Yumi
    Health Service Division, Nakano City Health Office, Japan
  • Minakuchi Toki
    Health Service Division, Nakano City Health Office, Japan
  • Mukouyama Haruko
    Nakano City Health Office, Japan
  • Ota Masaki
    Division of Technical Assistance to Tuberculosis Programmes, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Japan
  • Nagata Yoko
    Division of Technical Assistance to Tuberculosis Programmes, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Japan
  • Hirao Susumu
    Division of Technical Assistance to Tuberculosis Programmes, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Japan
  • Yoshiyama Takashi
    Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Japan
  • Keicho Naoto
    Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Japan

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Abstract

<p>In mid-September 2019, a teenage Chinese male student and part-time waiter in Tokyo was diagnosed with multidrug-resistant (MDR) sputum smear-positive pulmonary tuberculosis (TB). This study describes the outbreak investigation of his friends and colleagues at the restaurant. We investigated 6 friends and 15 colleagues; 5 friends and 13 colleagues underwent interferon-γ release assay (IGRA). Of these, 3 friends (60.0%) and 4 colleagues (30.8%) were IGRA-positive. Each of the friends and colleagues was found to have MDR-TB (20% and 7.7%, respectively). Challenges during the investigation were the unavailability of regimens for latent TB infection (LTBI) for contacts with MDR-TB, budgetary constraints concerning implementing computed tomography (CT) scans for the contacts, frequent address changes of foreign-born patients and contacts, investigation during the coronavirus disease pandemic, and variations of alphabetical expression of the names of the patients and contacts, particularly for those from China. It is recommended that the national government officially adopt prophylaxis regimens for LTBI with MDR-TB, address the budgetary constraints regarding CT scans, and deploy liaison officers for coordinating investigations involving many foreign-born patients and contacts scattered in multiple municipalities. The names of foreign-born persons could more accurately be identified using both the alphabet and Chinese characters.</p>

Journal

  • Japanese Journal of Infectious Diseases

    Japanese Journal of Infectious Diseases 75 (5), 527-529, 2022-09-30

    National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee

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