Tuberculosis outbreak in a pre-primary and primary school in Barcelona, Spain


Por: Prieto-García, R, Millet, JP, Broto, C, Lara, E, Espiau, M, Soriano-Arandes, A, de Souza-Galvao, ML, Jiménez-Fuentes, MA, Domingo, C, Vallverdú, RMV, Saludes, V, Bordoy, AE, Hesketh-Best, PJ, Yagüe, DP, Martró, E, Mestre, LG, Torres, ES, Alguacil, HM, Espinilla, ML, Cardona, PJ, Simón, P, Rius, C

Publicada: 1 abr 2026 Ahead of Print: 1 abr 2026
Resumen:
Background In June 2022, a case of non-bacillary pulmonary tuberculosis (TB) was reported in a 10-year-old girl attending a primary school in Barcelona. A second pediatric case from the same school was identified in October 2022, prompting the declaration of a TB outbreak and the initiation of an epidemiological investigation.Methods Contact tracing was conducted using the concentric circles approach, targeting household contacts, classmates, and school staff. Tuberculin skin tests were administered and read 72 h later. Whole genome sequencing of Mycobacterium tuberculosis isolates was performed to identify potential source cases and transmission chains.Results Among 218 individuals screened, 30 TB infections and 4 TB disease cases were diagnosed. The highest prevalence occurred in grades EP4 and EP5 (ages 9-10), with a significantly higher risk compared to other grades. No adult cases linked to the school were identified. Later, a genomic cluster of 15 cases was detected across Catalonia, suggesting a super-spreading event. However, no direct epidemiological link to the school was established.Conclusions This outbreak highlights the challenges of TB detection in pediatric populations and the importance of genomic surveillance in tracing transmission. Despite extensive investigation, the source remains unidentified, underscoring the complexity of TB dynamics in urban settings.

Filiaciones:
Prieto-García, R:
 Univ Pompeu Fabra, Dept Expt Sci & Salut DCEXS, Barcelona, Spain

 Agencia Salut Publ Barcelona ASPB, Serv Epidemiol SEPID, Barcelona, Spain

 Inst Recerca St Pau IIB St Pau, Barcelona, Spain

 Biomed Res Consortium Epidemiol & Publ Hlth Networ, Madrid, Spain

Millet, JP:
 Agencia Salut Publ Barcelona ASPB, Serv Epidemiol SEPID, Barcelona, Spain

 Inst Recerca St Pau IIB St Pau, Barcelona, Spain

 Biomed Res Consortium Epidemiol & Publ Hlth Networ, Madrid, Spain

Broto, C:
 Inst Catala Salut, Ctr Salut Int & Malalties Transmissibles Drassanes, Unitat TB Drassanes Vall Hebron, Barcelona, Spain

Lara, E:
 Inst Catala Salut, Ctr Salut Int & Malalties Transmissibles Drassanes, Unitat TB Drassanes Vall Hebron, Barcelona, Spain

Espiau, M:
 Inst Catala Salut, Ctr Salut Int & Malalties Transmissibles Drassanes, Unitat TB Drassanes Vall Hebron, Barcelona, Spain

 Hosp Univ Vall Hebron, Unitat Patol Infectosa & Immunodeficiencies Pediat, Barcelona, Spain

Soriano-Arandes, A:
 Inst Catala Salut, Ctr Salut Int & Malalties Transmissibles Drassanes, Unitat TB Drassanes Vall Hebron, Barcelona, Spain

 Hosp Univ Vall Hebron, Unitat Patol Infectosa & Immunodeficiencies Pediat, Barcelona, Spain

de Souza-Galvao, ML:
 Inst Catala Salut, Ctr Salut Int & Malalties Transmissibles Drassanes, Unitat TB Drassanes Vall Hebron, Barcelona, Spain

Jiménez-Fuentes, MA:
 Inst Catala Salut, Ctr Salut Int & Malalties Transmissibles Drassanes, Unitat TB Drassanes Vall Hebron, Barcelona, Spain

Domingo, C:
 Agencia Salut Publ Barcelona ASPB, Serv Epidemiol SEPID, Barcelona, Spain

 Inst Recerca St Pau IIB St Pau, Barcelona, Spain

Vallverdú, RMV:
 Serv Vigilancia Epidemiol & Resposta Emergencies S, Tarragona, Spain

Saludes, V:
 Biomed Res Consortium Epidemiol & Publ Hlth Networ, Madrid, Spain

 Inst Recerca & Hosp Germans Trias & Pujol IGTP, Lab Clin Metropolitana Nord, Serv Microbiol, Barcelona, Spain

 Autonomous Univ Barcelona, Dept Genet & Microbiol, Barcelona, Spain

Bordoy, AE:
 Biomed Res Consortium Epidemiol & Publ Hlth Networ, Madrid, Spain

 Inst Recerca & Hosp Germans Trias & Pujol IGTP, Lab Clin Metropolitana Nord, Serv Microbiol, Barcelona, Spain

Hesketh-Best, PJ:
 Inst Recerca & Hosp Germans Trias & Pujol IGTP, Lab Clin Metropolitana Nord, Serv Microbiol, Barcelona, Spain

Yagüe, DP:
 Biomed Res Consortium Epidemiol & Publ Hlth Networ, Madrid, Spain

 Inst Recerca & Hosp Germans Trias & Pujol IGTP, Lab Clin Metropolitana Nord, Serv Microbiol, Barcelona, Spain

 Autonomous Univ Barcelona, Dept Genet & Microbiol, Barcelona, Spain

Martró, E:
 Biomed Res Consortium Epidemiol & Publ Hlth Networ, Madrid, Spain

 Inst Recerca & Hosp Germans Trias & Pujol IGTP, Lab Clin Metropolitana Nord, Serv Microbiol, Barcelona, Spain

 Autonomous Univ Barcelona, Dept Genet & Microbiol, Barcelona, Spain

Mestre, LG:
 Dept Salut Generalitat Catalonia, Secretary Publ Hlth, Serv Prevencio Control TB & Programes Especif, Subdireccio Gen Vigilancia & Resposta Emergencies, Barcelona, Spain

Torres, ES:
 Dept Salut Generalitat Catalonia, Secretary Publ Hlth, Serv Prevencio Control TB & Programes Especif, Subdireccio Gen Vigilancia & Resposta Emergencies, Barcelona, Spain

Alguacil, HM:
 Dept Salut Generalitat Catalonia, Secretary Publ Hlth, Serv Prevencio Control TB & Programes Especif, Subdireccio Gen Vigilancia & Resposta Emergencies, Barcelona, Spain

Espinilla, ML:
 Dept Salut Generalitat Catalonia, Secretary Publ Hlth, Serv Prevencio Control TB & Programes Especif, Subdireccio Gen Vigilancia & Resposta Emergencies, Barcelona, Spain

Cardona, PJ:
 Inst Recerca & Hosp Germans Trias & Pujol IGTP, Lab Clin Metropolitana Nord, Serv Microbiol, Barcelona, Spain

 Autonomous Univ Barcelona, Dept Genet & Microbiol, Barcelona, Spain

 Carlos III Hlth Inst, CIBER Resp Dis CIBERES, Madrid, Spain

Simón, P:
 Agencia Salut Publ Barcelona ASPB, Serv Epidemiol SEPID, Barcelona, Spain

 Inst Recerca St Pau IIB St Pau, Barcelona, Spain

 Biomed Res Consortium Epidemiol & Publ Hlth Networ, Madrid, Spain

Rius, C:
 Univ Pompeu Fabra, Dept Expt Sci & Salut DCEXS, Barcelona, Spain

 Agencia Salut Publ Barcelona ASPB, Serv Epidemiol SEPID, Barcelona, Spain

 Inst Recerca St Pau IIB St Pau, Barcelona, Spain

 Biomed Res Consortium Epidemiol & Publ Hlth Networ, Madrid, Spain
ISSN: 22962565





Frontiers in Public Health
Editorial
FRONTIERS MEDIA SA, AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND, Suiza
Tipo de documento: Article
Volumen: 14 Número:
Páginas:
WOS Id: 001740292400001
ID de PubMed: 41994511
imagen Green Submitted, gold

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