The role of ventilation in preventing tuberculosis (TB) transmission has been widely proposed in infection control guidance. However, conclusive evidence is lacking. Modeling suggested the threshold of ventilation rate to reduce effective reproductive ratio (ratio between new secondary infectious cases and source cases) of TB to below 1 is corresponding to a carbon dioxide (CO₂) level of 1000 parts per million (ppm). Here, we measured the effect of improving ventilation rate on a TB outbreak involving 27 TB cases and 1665 contacts in underventilated university buildings. Ventilation engineering decreased the maximum CO₂ levels from 3204 ± 50 ppm to 591‐603 ppm. Thereafter, the secondary attack rate of new contacts in university dropped to zero (mean follow‐up duration: 5.9 years). Exposure to source TB cases under CO₂ >1000 ppm indoor environment was a significant risk factor for contacts to become new infectious TB cases (P < .001). After adjusting for effects of contact investigation and latent TB infection treatment, improving ventilation rate to levels with CO₂ <1000 ppm was independently associated with a 97% decrease (95% CI: 50%‐99.9%) in the incidence of TB among contacts. These results show that maintaining adequate indoor ventilation could be a highly effective strategy for controlling TB outbreaks.

中文翻译：

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通风不良的大学建筑内的结核病暴发期间通风改善的效果。

在感染控制指南中，广泛提出了通气在预防结核病（TB）传播中的作用。但是，缺乏确凿的证据。模型表明通气速率阈值可将结核病的有效繁殖率（新发继发感染病例与源病例的比率）降低至1以下，这对应于二氧化碳（CO ₂）含量为百万分之1000（ppm）。在这里，我们测量了通风状况改善对通风不良的大学建筑中27例TB病例和1665例接触者的TB爆发的影响。通风工程降低了最大CO ₂浓度从3204±50 ppm到591-603 ppm。此后，大学新联系人的二次攻击率降为零（平均随访时间：5.9年）。在室内CO ₂ > 1000 ppm的情况下，源结核病病例的暴露是接触者成为新的传染性结核病病例的重要危险因素（P  <.001）。调整接触者调查和潜在结核感染治疗的效果后，将通气率提高至CO ₂ <1000 ppm的水平与接触者之间TB发生率降低97％（95％CI：50％-99.9％）相关。 。这些结果表明，保持充足的室内通风可能是控制结核病暴发的有效策略。