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Abstract
In 1998–1999, the Baltimore TB control program detected a cluster of 21 tuberculosis (TB) cases. Patients reported frequent travel to various East Coast cities. An investigation was conducted to determine whether transmission of the same Mycobacterium tuberculosis strain was occurring in these other localities. A collaborative investigation among federal, state, and local TB controllers included TB record reviews, interviews of patients, and restriction fragment length polymorphism (RFLP) analysis of selected M. tuberculosis isolates from diagnosed TB patients in several cities in 1996–2001. A national TB genotyping database was searched for RFLP patterns that matched the outbreak pattern. Eighteen additional outbreak-related cases were detected outside of Baltimore—the earliest diagnosed in New Jersey in 1996, and the most recent in New York City in late 2001. The outbreak demonstrates the need for strategies to detect links among patients diagnosed with TB across multiple TB control jurisdictions.
Highlights
Tuberculosis (TB) rates have been declining in the United States since 1993; they reached a low of 5.6 cases per 100,000 population in 2001 [1]
The earliest matching restriction fragment length polymorphism (RFLP) pattern came from an isolate cultured in November 1996 from a 17-year-old woman, the sister of a culture-negative 7-year-old girl with clinical TB that had been diagnosed earlier that year (Figure)
Ongoing transmission of M. tuberculosis in this outbreak occurred in multiple jurisdictions for at least 4 years (1996– 1999)
Summary
Tuberculosis (TB) rates have been declining in the United States since 1993; they reached a low of 5.6 cases per 100,000 population in 2001 [1]. To continue this downward trend and eventually achieve the national goal of TB elimination (
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