Identifying the sources of tuberculosis in young children: a multistate investigation

Abstract

To better understand the molecular epidemiology of tuberculosis (TB) transmission for culture-confirmed patients <5 years of age, data were analyzed from a population-based study conducted in seven U.S. sites from 1996 to 2000. Mycobacterium tuberculosis isolates were genotyped with IS6110-based restriction fragment length polymorphism analysis and spoligotyping. Case-patient data were obtained from the Centers for Disease Control and Prevention s national tuberculosis registry and health department records. Routine public health investigations conducted by local health departments identified suspected source patients for 57 (51%) of 111 culture-confirmed patients <5 years of age. For 8 (15%) of 52 culture-confirmed patients <5 years of age and their suspected source patients with complete genotyping results, genotypes suggested infection with different TB strains. Potential differences between sources for patients <5 years of age and source patients that transmitted TB to adolescent and adult patients were identified.

Figure 1

Results of public health investigations for culture-confirmed tuberculosis patients <5 years of age, 1996–2000.

Figure 2

Comparison of genotypes for isolates from suspected source and secondary patient pairs identified through public health investigations, 1996–2000. Culture-confirmed children <5 years of age and their sources versus culture-confirmed patients ≥15 years of age and their sources.