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Volume 19, Number 3—March 2013

Dispatch

Prioritizing Tuberculosis Clusters by Genotype for Public Health Action, Washington, USA

Scott LindquistComments to Author , Sheanne Allen, Kim Field, Smita Ghosh, Maryam B. Haddad, Masahiro Narita, and Eyal Oren
Author affiliations: Author affiliations: Kitsap County Health District, Bremerton, Washington, USA (S. Lindquist); Washington State Department of Health, Olympia, Washington, USA (S. Lindquist, S. Allen, K. Field); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Ghosh, M.B. Haddad); Public Health–Seattle & King County Tuberculosis Control Program, Seattle, Washington, USA (M. Narita, E. Oren).

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Table

Comparison of geospatial analysis results and expert panel priority status rankings for county-level genotype clusters of TB cases, Washington, USA, 2005–2010*

County Spoliogtype 12-locus MIRU-VNTR Period 1†
Period 2†
Key epidemiologic features‡
No. cases LLR Expert priority No. cases LLR Expert priority
A 000000000003771 223321153643 32 31.8 High 19 18.3 High H, SA
000000000003771 223325173533 17 0.1 High 8 0.4 Low FB
677777477413771 254326223432 14 0.2 Low 14 0.1 Low FB
703377400001771 227425113434 4 1.2 Low 6 2.9 Low FB, H
000000000003771 223325153533 3 0.5 Low 1 <0.01 Low FB
000000000003771 223325163533 3 0.2 Low 7 1.7 Low FB, SA
677777477413771 254326223422 6 1.3 Low 4 0.4 Low FB
777000377760771 225125113322 3 0.6 Low 3 1.0 Low FB
000000000003771 222325173543 9 2.4 High 3 0.1 High H, SA
777777777760771 225125113322 3 0.7 Low 2 0.4 Low FB
000000000003771 222325173533 7 2.6 High 8 2.3 High
000000000003771 223325173433 3 1.5 Low 1 0.2 Low FB
000000000003771 223325133533 3 1.4 Low 0 <0.01 Low FB
000000000000000 223325123534 4 9.2 High 0 <0.01 Low H, SA

777776777620601
224325153323
3
4.4
High

0
0.03
Low
H, SA
B
000000000003771
223425173563
13
19.5
High

8
13
High
H, SA
C 677777477413771 254326223432 6 1.3 Low 3 <0.01 Low FB, SA

777776777760771
125325153225
7
9.8
High

2
1.8
High
H, SA
D 677777477413771 254326223432 5 0.8 Low 4 0.4 Low FB

777776757760771
223325143324
6
8.7
High

1
1.2
Low

E 677777477413771 254326223432 3 1.0 Low 2 0.9 Low FB

*LLRs >5.0 (boldface) indicate greater possibility that the cluster represents geographically concentrated TB cases, a proxy for recent TB transmission). TB, tuberculosis; MIRU-VNTR, mycobacterial interspersed repetitive unit–variable number tandem repeat; LLR, log-likelihood ratio, a measure of geospatial concentration; H, homelessness; FB, foreign born; SA, substance abuse.
†Period 1, January 1, 2005–December 31, 2007; period 2, January 1, 2008–December 31, 2010.
‡Blank cells indicate none present.

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