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Volume 18, Number 1—January 2012

Dispatch

Multistate Outbreak of MDR TB Identified by Genotype Cluster Investigation

Pennan M. BarryComments to Author , Tracie J. Gardner, Elizabeth Funk, Eyal Oren, Kimberly Field, Tambi Shaw, and Adam J. Langer
Author affiliations: California Department of Public Health, Richmond, California, USA (P.M. Barry, T. Shaw); Alaska Division of Public Health, Anchorage, Alaska, USA (T.J. Gardner, E. Funk); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (T.J. Gardner, A.J. Langer); Public Health—Seattle and King County, Seattle, Washington, USA (E. Oren); Washington State Department of Health, Olympia, Washington, USA (K. Field)

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Table 2

Results of initial contact investigations of MDR TB cases linked to seafood production work, Alaska, USA, 2006–2008*

Contacts No. contacts, by case-patient
Total no. contacts
AK1† CA1‡ CA4§ WA1¶
Total no. contacts identified 3 33 10 3# 49
Total no. contacts evaluated 3 33 10 1 47
Active TB 0 2** 0 0 2
LTBI 3 18 8 1 30
TST positive †† 3 9 8 1 21
TST conversion‡‡ 0 9 0 0 9
Started on LTBI treatment§§ 0 17 10 1 28
TST negative 0 13 2 0 15

*MDR TB, multidrug-resistant tuberculosis; ID, identification; AFB, acid-fast bacilli; LTBI, latent TB infection; TST, tuberculin skin test.
†Source patient. Patient had positive sputum AFB smear results, and initial chest radiograph did not show cavitary disease.
‡Patient had positive sputum AFB smear results, and initial chest radiograph showed cavitary disease.
§Patient had negative sputum AFB smear results, and initial chest radiograph did not show cavitary disease.
¶Patient had positive sputum AFB smear results, and initial chest radiograph showed cavitary disease.
#An active TB case was later identified; the patient had a matching genotype and an epidemiologic link to WA1, but this tertiary case was not identified during the secondary case-patient’s contact investigation.
**Contacts are children (CA2 and CA3) with negative culture results.
††Includes persons for whom time of conversion was not known (i.e., prior positive or new positive TST).
‡‡Defined as a positive TST following a negative TST performed in preceding 2 y.
§§Includes 2 children <5 y of age with initial negative TSTs started on “window” LTBI treatment while awaiting follow-up TST.

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