Journal Article

Outbreak of Tuberculosis Among Homeless Persons Coinfected with Human Immunodeficiency Virus

Peter D. McElroy, Southwick Karen L., Ellen R. Fortenberry, Elizabeth C. Levine, Lois A. Diem, Charles L. Woodley, Paula M. Williams, Kimberly D. McCarthy, Renée Ridzon and Peter A. Leone

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 10, pages 1305-1312
Published in print May 2003 | ISSN: 1058-4838
Published online May 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/374836
Outbreak of Tuberculosis Among Homeless Persons Coinfected with Human Immunodeficiency Virus

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We investigated a cluster of patients with tuberculosis (TB) in North Carolina and determined the extent of transmission of 1 strain of Mycobacterium tuberculosis. A retrospective cohort study was conducted. Homeless shelter attendance and medical records for 1999 and 2000 were reviewed. The period of exposure to M. tuberculosis was determined, and shelter residents were offered TB screening. DNA fingerprinting was performed on 72 M. tuberculosis isolates. In addition to the initial index cluster of 9 patients, another 16 patients were identified. Isolates of M. tuberculosis from all 25 patients shared a matching DNA fingerprint pattern. All but 1 patient was male, 22 (88%) were African American, and 14 (56%) were human immunodeficiency virus-infected. An epidemiological link to a single shelter was identified for all but 1 patient. Earlier recognition of this shelter as a site of M. tuberculosis transmission could have been facilitated through innovative approaches to contact investigation and through genetic typing of isolates.

Journal Article.  4670 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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