OBJECTIVES: From May 2006 to August 2008, the Southern Nevada Health District identified eight tuberculosis (TB) cases in six adults and two children in a Hispanic community. We conducted an outbreak investigation to determine the extent of TB transmission and prevent additional cases. METHODS: We investigated TB cases in Nevada and Arizona with the outbreak genotype or cases with suspected epidemiologic links to this cluster but without genotyping data. We reviewed medical records and interviewed patients and contacts. Subsequently, genotype surveillance was conducted for approximately four years to monitor additional outbreak-related cases. RESULTS: Eight outbreak cases were identified among six adults and two children. All patients were Hispanic and five were U.S.-born. The index patient was diagnosed while detained in Immigration and Customs Enforcement custody but deported before treatment completion. He was lost to follow-up for two years, during which time he served as the source for six secondary TB cases, including his own child. Along with the index patient, five patients reportedly engaged in the sale or use of methamphetamine. Follow-up surveillance in the two states identified eight additional cases with the outbreak genotype; three had epidemiologic links to the index case. CONCLUSIONS: We found that incomplete TB treatment led to extensive TB transmission. We recommend thorough discharge planning and active measures to ensure continuity of care and TB treatment completion for people in custody at higher risk for loss to follow-up, which likely includes those engaged in the sale or use of illicit substances.
OBJECTIVES: From May 2006 to August 2008, the Southern Nevada Health District identified eight tuberculosis (TB) cases in six adults and two children in a Hispanic community. We conducted an outbreak investigation to determine the extent of TB transmission and prevent additional cases. METHODS: We investigated TB cases in Nevada and Arizona with the outbreak genotype or cases with suspected epidemiologic links to this cluster but without genotyping data. We reviewed medical records and interviewed patients and contacts. Subsequently, genotype surveillance was conducted for approximately four years to monitor additional outbreak-related cases. RESULTS: Eight outbreak cases were identified among six adults and two children. All patients were Hispanic and five were U.S.-born. The index patient was diagnosed while detained in Immigration and Customs Enforcement custody but deported before treatment completion. He was lost to follow-up for two years, during which time he served as the source for six secondary TB cases, including his own child. Along with the index patient, five patients reportedly engaged in the sale or use of methamphetamine. Follow-up surveillance in the two states identified eight additional cases with the outbreak genotype; three had epidemiologic links to the index case. CONCLUSIONS: We found that incomplete TB treatment led to extensive TB transmission. We recommend thorough discharge planning and active measures to ensure continuity of care and TB treatment completion for people in custody at higher risk for loss to follow-up, which likely includes those engaged in the sale or use of illicit substances.
Authors: Larry D Teeter; Padmaja Vempaty; Duc T M Nguyen; Jane Tapia; Sharon Sharnprapai; Smita Ghosh; J Steven Kammerer; Roque Miramontes; Wendy A Cronin; Edward A Graviss Journal: BMC Infect Dis Date: 2016-10-21 Impact factor: 3.090
Authors: Jennifer L Guthrie; Alex Marchand-Austin; Kirby Cronin; Karen Lam; Daria Pyskir; Clare Kong; Danielle Jorgensen; Mabel Rodrigues; David Roth; Patrick Tang; Victoria J Cook; James Johnston; Frances B Jamieson; Jennifer L Gardy Journal: PLoS One Date: 2019-04-03 Impact factor: 3.240
Authors: Tara Carney; Jennifer A Rooney; Nandi Niemand; Bronwyn Myers; Danie Theron; Robin Wood; Laura F White; Christina S Meade; Novel N Chegou; Elizabeth Ragan; Gerhard Walzl; Robert Horsburgh; Robin M Warren; Karen R Jacobson Journal: PLoS One Date: 2022-02-15 Impact factor: 3.752