TY - JOUR AU - Cronin, Wendy A. AU - Golub, Jonathan E. AU - Lathan, Monica J. AU - Mukasa, Leonard N. AU - Hooper, Nancy AU - Razeq, Jafar H. AU - Baruch, Nancy G. AU - Mulcahy, Donna AU - Benjamin, William H. AU - Magder, Laurence S. AU - Strickland, G. Thomas AU - Bishai, William R. T1 - Statewide Molecular Epidemiology of Mycobacterium tuberculosis Transmission in a Moderate- to Low-Incidence State: Are Contact Investigations Enough? T2 - Emerging Infectious Disease journal PY - 2002 VL - 8 IS - 11 SP - 1271 SN - 1080-6059 AB - To assess the circumstances of recent transmission of tuberculosis (TB) (progression to active disease <2 years after infection), we obtained DNA fingerprints for 1,172 (99%) of 1,179 Mycobacterium tuberculosis isolates collected from Maryland TB patients from 1996 to 2000. We also reviewed medical records and interviewed patients with genetically matching M. tuberculosis strains to identify epidemiologic links (cluster investigation). Traditional settings for transmission were defined as households or close relatives and friends; all other settings were considered nontraditional. Of 436 clustered patients, 114 had recently acquired TB. Cluster investigations were significantly more likely than contact investigations to identify patients who recently acquired TB in nontraditional settings (33/42 vs. 23/72, respectively; p<0.001). Transmission from a foreign-born person to a U.S.-born person was rare and occurred mainly in public settings. The time from symptom onset to diagnosis was twice as long for transmitters as for nontransmitters (16.8 vs. 8.5 weeks, respectively; p<0.01). Molecular epidemiologic studies showed that eliminating diagnostic delays can prevent TB transmission in nontraditional settings, which elude contact investigations. KW - molecular epidemiology KW - tuberculosis KW - recent transmission KW - DNA fingerprinting KW - Brazil DO - 10.3201/eid0811.020261 UR - https://wwwnc.cdc.gov/eid/article/8/11/02-0261_article ER - End of Reference