RT Journal Article
SR Electronic
T1 Transmission of tuberculosis in bars in Stroud: A cluster of 19 cases linked by MIRU-VNTR and/or epidemiology over a 30 year period
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1699
VO 44
IS Suppl 58
A1 Andrew White
A1 Stephen Moore
A1 Sharon Sturney
A1 Philippa Moore
A1 Rhonwen Morris
A1 White Lewis
A1 Hunt David
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/1699.abstract
AB In areas with low prevalence of tuberculosis (TB) most cases arise through reactivation of infection acquired many years ago or in immigrants from high prevalence areas. However, there may be pockets of ongoing transmission, identification of which is essential if TB is to be controlled. We report evidence of TB transmission associated with bars in Stroud.Stroud is a town in Gloucestershire (GLOS) with a population of 107,900: 96.4% white British, 0.28% Indian Subcontinent and 0.05% Sub-Saharan African. The incidence of TB is estimated to be 2.1 per 100,000 vs. a UK average of 14. Against this background, 8 cases of pulmonary TB (PTB) were identified and linked to a bar in the mid 1990s. Following DNA profiling, 6 of the 8 cases were found to be very closely linked. All cases were white and born locally. In 2012 3 new cases were found to have exact matches on molecular typing (MIRU-VNTR). The cases were linked to another bar. Following review of the known DNA profile held regionally, 10 further cases between 2003 and 2013 were found to match and national reference showed no other linked cases. All but one were residents of GLOS with some links to Stroud. 4 of the post 2003 DNA linked cluster had direct links to the pub at the centre of the original cluster, one of which was identified as a contact at the time and lost to follow-up.DNA profiling has linked 19 temporally separated cases of TB and provide evidence of the need for further investigations into a high risk group in a low prevalence area. Routine use of this technology will enable earlier identification of these clusters and more targeted TB control activities than previously possible.