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Volume 32, Number 6—June 2026

Research

Characteristics of Plausible Source Cases Responsible for Recent Mycobacterium tuberculosis Transmission, United States, 2018–2022

Steve Kammerer, Daniel Flanagan, Kala Raz, Tambi Shaw, Jonathan Wortham, and Sarah TalaricoComments to Author 
Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Kammerer, K. Raz, J. Wortham, S. Talarico); Emory University, Atlanta (D. Flanagan); California Department of Public Health, Richmond, California, USA (T. Shaw)

Main Article

Table 1

Characteristics of all plausible source TB cases during 2018–2020 responsible for recent Mycobacterium tuberculosis transmission during 2020–2022, United States*

Characteristic Nonplausible source Plausible source p value†
Total cases, n = 19,577
18,684 (95.4)
893 (4.6)

Sex <0.001
M 11,465 (61.4) 631 (70.7)
F 7,216 (38.6) 262 (29.3)
Unknown
3 (0)
0

Age, y <0.001
<5 185 (1.0) 0
5–14 191 (1.0) 13 (1.5)
15–24 1,802 (9.6) 120 (13.4)
25–44 5,521 (29.5) 338 (37.9)
45–64 5,503 (29.5) 337 (37.7)
>65
5,482 (29.3)
85 (9.5)

Origin of birth <0.001
United States 4,829 (25.8) 536 (60.0)
Non-US country 13,826 (74.0) 356 (39.9)
Unknown
29 (0.2)
1 (0.1)

Race and ethnicity‡ <0.001
Hispanic or Latino 5,459 (29.2) 290 (32.5)
American Indian/Alaska Native 161 (0.9) 47 (5.3)
Native Hawaiian/Pacific Islander 215 (1.2) 29 (3.2)
Black 3,377 (18.1) 325 (36.4)
Asian 7,161 (38.3) 86 (9.6)
White 2,115 (11.3) 104 (11.6)
Multiple race 137 (0.7) 6 (0.7)
Unknown
59 (0.3)
6 (0.7)

Resident of a correctional facility at TB diagnosis <0.001
Y 464 (2.5) 49 (5.5)
N 18,154 (97.2) 834 (93.4)
Unknown
66 (0.3)
10 (1.1)

Experiencing homelessness within past 12 mo <0.001
Y 744 (4.0) 138 (15.4)
N 17,776 (95.1) 740 (82.9)
Unknown
164 (0.9)
15 (1.7)

Excess alcohol use within past 12 mo <0.001
Y 1,618 (8.7) 184 (20.6)
N 16,783 (89.8) 687 (76.9)
Unknown
283 (1.5)
22 (2.5)

Noninjection drug use within past 12 mo <0.001
Y 1,213 (6.5) 204 (22.8)
N 17,022 (91.1) 650 (72.8)
Unknown
449 (2.4)
39 (4.4)

Sputum smear <0.001
Positive 8,788 (47.0) 621 (69.5)
Negative 7,759 (41.5) 217 (24.3)
Not done 2,119 (11.3) 55 (6.2)
Unknown
18 (0.1)
0

Cavitary disease§ <0.001
Y 6,638 (35.5) 541 (60.6)
N 9,877 (52.9) 310 (34.7)
Unknown
2,169 (11.6)
42 (4.7)

Contact of infectious tuberculosis patient during past 2 y <0.001
Y 970 (5.2) 122 (13.7)
Unknown/not reported
17,714 (94.8)
771 (86.3)

Median Social Vulnerability Index score (IQR) ¶ 0.73 (0.49–0.86) 0.83 (0.66–0.89) <0.001#
Socioeconomic status 0.65 (0.34–0.86) 0.80 (0.58–0.92) <0.001#
Household characteristics 0.45 (0.23–0.70) 0.56 (0.32–0.74) <0.001#
Racial and ethnic minority status 0.91 (0.78–0.96) 0.92 (0.82–0.97) <0.001#
Housing type and transportation 0.78 (0.61–0.90) 0.83 (0.68–0.91) <0.001#

*Values are no. (%) except as indicated. IQR, interquartile range; TB, tuberculosis. †χ2 test or Fisher exact test when <5 cases expected. ‡Except for Hispanic or Latino, all are non-Hispanic. §Evidence of >1 lung cavities with chest radiograph, chest computerized tomography, or both. ¶Overall Social Vulnerability Index includes 16 US Census indicators from the 5-year American Community Survey grouped into 4 themes: socioeconomic status, household characteristics, racial and ethnic minority status, and housing type and transportation. Ranking values range from 0 to 1, and higher values indicate higher vulnerability and are merged to each case using the patient’s county of residence. #Wilcoxon rank sum test.

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Page created: April 13, 2026
Page updated: May 15, 2026
Page reviewed: May 15, 2026
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