Emerging Infectious Disease ISSN: 1080-6059

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Statewide Molecular Epidemiology of Mycobacterium tuberculosis Transmission in a Moderate- to Low-Incidence State: Are Contact Investigations Enough?

Wendy A. Cronin*

, Jonathan E. Golub*, Monica J. Lathan†, Leonard N. Mukasa*, Nancy Hooper*, Jafar H. Razeq*, Nancy G. Baruch*, Donna Mulcahy‡, William H. Benjamin§, Laurence S. Magder¶, G. Thomas Strickland¶, and William R. Bishai#

Author affiliations: *Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USA; †American Public Health Association, Washington, D.C., USA; ‡Alabama Department of Public Health, Montgomery, Alabama, USA; §University of Alabama at Birmingham, Birmingham, Alabama, USA; ¶University of Maryland—Baltimore, Maryland, USA; #The Johns Hopkins University, Baltimore, Maryland, USA;

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Table 1

Estimated time of infection and disease acquisition among Mycobacterium tuberculosis culture-positive patients by DNA cluster status^a

DNA cluster status of patients’ isolates	No. patients with recent TB	No. patients with probable recent TB	No. patients with reactivated TB	No. patients with unknown time of TB acquisition	Totals
Clustered strains with >6 IS6110 copies	89	82	56^b	42^c	269
Clustered strains with <6 IS6110 copies	22	0	0	145	167
Nonclustered strains	4^d	0	732	0	736
Total	115	82	788	187	1,172

^aTB, tuberculosis.
^bHistory of previous positive tuberculin skin test or extensive past exposure to a patient.
^cFirst patient in a cluster by estimated date of symptom onset and no identified source patient.
^dKnown link to another patient outside the study area or timeframe whose isolate had the same DNA fingerprint.

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