Common use of Setting Clause in Contracts

Setting. In November 2004, a 25-year old male, Dutch-born supermarket employee in the city of Zeist (approx. 60,000 inhabitants) in The Netherlands was diagnosed with sputum- positive cavitary TB. From 19 November to 2 December, 12 close contacts including his family and close friends (median age 25 years, range 13-80) were examined using TST and CXR. Of these 12, three (25%) were diagnosed with active TB and seven (58%) with LTBI. Subsequently, 80 occupational contacts were examined from 6 to 9 December. TBI was diagnosed in 39/67 (58%) current and in 8/13 (61%) former supermarket employ- ees. One of the current employees had developed TB disease and the Mycobacterium tuberculosis isolate later turned out to have the same IS6110 restriction fragment length polymorphism (RFLP) pattern as the index case. [▇.▇▇▇▇▇▇, unpublished data]. From positive TST results in colleagues who had stopped working in that supermarket at dif- ferent time points, it was deduced that the infectious period of the index case had lasted from February 2004 until identification in mid-November 2004. During this period, he had performed varying tasks in the supermarket that involved contact with customers. In view of a high rate of transmission, it was decided to investigate all customers who had visited the supermarket during the infectious period. The interval between last possible contact with the source patient and TST placement and blood sampling was 10 weeks. A TST was offered to all customers except persons born before 1945, BCG vaccinated per- sons or those with a history of a positive TST or TB disease, following Dutch guidelines. An anteroposterior CXR was performed on all individuals born before 1945 and on indi- viduals with BCG vaccination, or with a history of TB or positive TST. Nested within this large-scale contact investigation we aimed to recruit 500 subjects on the two days of TST administration by random selection (pre-TST inclusion group). In order to include sufficient numbers of subjects with probable LTBI, we aimed to also include 500 subjects on the reading days who had a TST result ≥ 1 mm (post-TST inclu- sion group). In the pre-TST group and post-TST group, blood was collected, respectively immediately after, and 72 ± 8 hours after the TST was administered. Written informed consent was obtained from all participants. The Ethical Review Board of Hospital Dia- konessenhuis Utrecht/Zeist, The Netherlands approved the study (protocol nr. 2004.23).