Bloss Emily, Newbill Kimberly, Peto Heather, Rice Michael J, Ainsworth Gail, Travnicek Robert, Holcombe Mike, Haddad Maryam B, Oeltmann John E
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
South Med J. 2011 Nov;104(11):731-5. doi: 10.1097/SMJ.0b0.3e318232679e.
Between December 2005 and November 2007, a cluster of 11 tuberculosis (TB) cases emerged in Jackson County, Mississippi. We investigated the potential sources of disease transmission and epidemiologic links in this cluster to prevent future transmission in the community.
Cases of TB reported in Jackson County from December 2005 to November 2007 having matching genotypes or social links to patients with matching genotypes were included in the investigation. We interviewed patients, reviewed medical records, and performed contact investigations.
The combined genotyping and epidemiologic data pointed to ongoing TB transmission in this rural community. A combination of patient-specific and programmatic factors, including substance use, delays in TB diagnosis, nonadherence, and TB program staffing cuts, contributed to this outbreak in the context of the 2004 and 2005 Atlantic hurricane seasons.
To eliminate Mycobacterium tuberculosis transmission in this setting, recommendations for the TB program include enhanced coordination with substance abuse programs, community and provider education, and increased outreach capacity.
2005年12月至2007年11月期间，密西西比州杰克逊县出现了11例结核病病例群。我们调查了该病例群中疾病传播的潜在来源和流行病学联系，以防止未来在社区内传播。
调查纳入了2005年12月至2007年11月在杰克逊县报告的结核病病例，这些病例与具有匹配基因型的患者具有匹配的基因型或社会联系。我们对患者进行了访谈，查阅了病历，并进行了接触者调查。
基因分型和流行病学数据相结合表明，这个农村社区存在结核病的持续传播。在2004年和2005年大西洋飓风季节的背景下，包括药物使用、结核病诊断延迟、不依从以及结核病防治项目人员削减等患者特定因素和项目因素共同导致了此次疫情爆发。
为了在这种情况下消除结核分枝杆菌的传播，对结核病防治项目的建议包括加强与药物滥用项目的协调、社区和医疗服务提供者教育以及提高外展能力。
