Use of Tuberculosis Genotyping for Post-Outbreak Monitoring
Published Date:2012 Jul-Aug
Source:J Public Health Manag Pract. 18(4):375-378.
Centers For Disease Control And Prevention (U.S.)
Emigration And Immigration
Polymorphism, Restriction Fragment Length
Sensitivity And Specificity
Substance Abuse, Intravenous
Pubmed Central ID:PMC4612591
Funding:CC999999/Intramural CDC HHS/United States
Review of routinely collected tuberculosis genotyping results following a known outbreak is a potential mechanism to examine the effectiveness of outbreak control measures.
Assess differences in characteristics between outbreak and post-outbreak tuberculosis cases.
All tuberculosis cases identified as a result of ≥5-person outbreaks investigated by the Centers for Disease Control and Prevention during 2003–2007 (original outbreak cases), and subsequent culture-positive TB cases with matching M. tuberculosis genotypes reported in the same county during 2004–2008 (post-outbreak cases).
Main Outcome Measure
Proportion of demographic, social, and clinical characteristics of tuberculosis outbreak cases compared to post-outbreak cases. Secondary: Proportion of demographic, social, and clinical characteristics of epidemiologically linked versus nonlinked cases.
Six outbreaks with 111 outbreak cases and 110 post-outbreak cases were identified. Differences between outbreak and post-outbreak cases were gender (69% male versus 85%; p<0.01), birth origin (3% foreign-born versus 11% ; p=0.02), disease severity (48% sputum smear-positive versus 62%; p=0.04), homelessness (38% versus 51%; p=0.05), and injection drug use (4% versus 11%; p=0.04). For five of the six outbreaks, the status of epidemiologic relationships among post-outbreak cases was available (n=89). The post-outbreak cases with a known epidemiologic link to the original outbreak were in younger persons (age 39 versus 47; p<0.01), and a larger proportion reported injection drug use (18% versus 4%; p=0.04) or noninjection drug use (44% versus 18%; p<0.01) than those without a reported link.
Health jurisdictions can utilize genotyping data to monitor and define the characteristics of post-outbreak cases related to the original outbreak.
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