Anne T Black1, Esther L Hamblion2, Helen Buttivant3, Sarah R Anderson2, Madeline Stone4, Nicola Casali4, Francis Drobniewski4, Francisca Nwoguh5, Ben G Marshall6, Linda Booth1. 1. Public Health England Wessex Centre, Whiteley, Hampshire, UK. 2. Public Health England, Field Epidemiology Service (Victoria), London, UK. 3. Health Education Wessex, Wessex School of Public Health, Winchester, Hampshire, UK. 4. National Mycobacterium Reference Laboratory, London, UK. 5. Solent NHS Trust, Southampton, UK. 6. University Hospital of Southampton, Faculty of Southampton, Life Sciences Building, Highfield Campus, University of Southampton, Southampton, UK.
Abstract
Background: We describe an outbreak that contributed to a near doubling of the incidence of tuberculosis in Southampton, UK. We examine the importance of 24 locus mycobacterial interspersed repetitive unit variable number tandem repeat (MIRU-VNTR) genotyping in its identification and management and the role of whole genome sequencing (WGS) in tracing the spread of the strain. Methods: Outbreak cases were defined as those diagnosed between January and December 2011 with indistinguishable 24 locus-MIRU-VNTR genotypes or, cases linked epidemiologically. A cluster questionnaire was administered by TB nurses to identify contacts and social settings. Results: Overall, 25 patients fulfilled the case definition. No cases with this MIRU-VNTR genotype had been detected in the UK previously. Connections were found between all cases through household contacts or social venues including a football club, Internet cafe and barber's shop. Public health actions included extended contact tracing, venue screening and TB awareness-raising. The outbreak resulted in a high rate of transmission and high incidence of clinical disease among contacts. Conclusions: This outbreak illustrates the value of combining active case-finding with prospective MIRU-VNTR genotyping to identify settings to undertake public health action. In addition WGS revealed that the VNTR-defined cluster was a single outbreak and that active TB transmission not reactivation was responsible for this outbreak in non-UK born individuals.
Background: We describe an outbreak that contributed to a near doubling of the incidence of tuberculosis in Southampton, UK. We examine the importance of 24 locus mycobacterial interspersed repetitive unit variable number tandem repeat (MIRU-VNTR) genotyping in its identification and management and the role of whole genome sequencing (WGS) in tracing the spread of the strain. Methods: Outbreak cases were defined as those diagnosed between January and December 2011 with indistinguishable 24 locus-MIRU-VNTR genotypes or, cases linked epidemiologically. A cluster questionnaire was administered by TB nurses to identify contacts and social settings. Results: Overall, 25 patients fulfilled the case definition. No cases with this MIRU-VNTR genotype had been detected in the UK previously. Connections were found between all cases through household contacts or social venues including a football club, Internet cafe and barber's shop. Public health actions included extended contact tracing, venue screening and TB awareness-raising. The outbreak resulted in a high rate of transmission and high incidence of clinical disease among contacts. Conclusions: This outbreak illustrates the value of combining active case-finding with prospective MIRU-VNTR genotyping to identify settings to undertake public health action. In addition WGS revealed that the VNTR-defined cluster was a single outbreak and that active TB transmission not reactivation was responsible for this outbreak in non-UK born individuals.
Authors: Taher Azimi; Mohammad Javad Nasiri; Samin Zamani; Ali Hashemi; Hossein Goudarzi; Abbas Ali Imani Fooladi; Mohammad Mehdi Feizabadi; Fatemeh Fallah Journal: J Clin Tuberc Other Mycobact Dis Date: 2018-01-31
Authors: J L Guthrie; L Strudwick; B Roberts; M Allen; J McFadzen; D Roth; D Jorgensen; M Rodrigues; P Tang; B Hanley; J Johnston; V J Cook; J L Gardy Journal: Epidemiol Infect Date: 2020-02-04 Impact factor: 2.451