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20 Oct 2016

#Risk #Assessment: #XDR #TB - multi-country #cluster, #Romania, October 2016 (@ECDC_EU, Oct. 20 ‘16, summary)


Title: #Risk #Assessment: #XDR #TB - multi-country #cluster, #Romania, October 2016.

Subject: Antibiotics Resistance Tuberculosis, cluster of cases, Romania.

Source: European Centre for Disease Prevention and Control (ECDC), full PDF file: (LINK).

Code: [     ]



XDR tuberculosis - multi-country cluster, Romania, October 2016


Suggested citation: European Centre for Disease Prevention and Control. Extensively drug-resistant (XDR) tuberculosis – multi-country cluster, Romania. 19 October 2016. Stockholm: ECDC; 2016.

© European Centre for Disease Prevention and Control, Stockholm, 2016


Main conclusions and options for response

  • A cluster involving four cases of extensively drug-resistant tuberculosis (XDR TB) has been detected in three students attending the University of Medicine and Pharmacy in Oradea Municipality, Bihor County, Romania.
  • A contact case has also been diagnosed.
  • The three cases are students in the same year of study.
  • The presumed index case is an Israeli citizen, who was a student in Romania, and was diagnosed in Israel in June 2015.
  • Two of the cases are UK residents who attended the university in Romania as students; one was diagnosed in Romania in October 2015 (case 2) and the other was diagnosed in the UK in September 2016.
  • An additional case has been diagnosed in a family contact of case 2 in the UK
  • Contact tracing identified 87 contacts who had had exposure, putting them at risk of developing XDR TB disease.
  • These cases are being followed up to identify and adequately treat active TB cases among them as well as testing for latent tuberculosis infection (LTBI) using tuberculin skin tests (TST).
  • Contacts identified with LTBI may receive preventive treatment depending on the drug susceptibility profile of the XDR TB strain and they should be closely monitored with clinical observation to ensure early detection of XDR TB and to prevent further transmission.
  • More cases may be expected in association with this cluster.
  • It will therefore be important to trace all contacts of any such additional cases in order to identify and treat active cases and provide preventive treatment or monitoring for those diagnosed with LTBI.


Keywords: Tuberculosis; XDR-TB; Antibiotics; Drugs Resistance; Romania; UK; Israel; ECDC; European Region; Updates.