RESUMO
Human infection with Mycobacterium bovis is reported infrequently in the United Kingdom. Most cases involve previous consumption of unpasteurized milk. We report a rare occurrence of 2 incidents of cat-to-human transmission of M. bovis during a cluster of infection in cats.
Assuntos
Mycobacterium bovis , Tuberculose/epidemiologia , Tuberculose/transmissão , Zoonoses/epidemiologia , Zoonoses/transmissão , Adolescente , Adulto , Animais , Gatos , Genoma Bacteriano , Genômica/métodos , Genótipo , Humanos , Mycobacterium bovis/classificação , Mycobacterium bovis/genética , Filogenia , Tuberculose/diagnóstico , Tuberculose/microbiologia , Adulto Jovem , Zoonoses/diagnóstico , Zoonoses/microbiologiaRESUMO
Background: We describe an outbreak that contributed to a near doubling of the incidence of tuberculosis in Southampton, UK. We examine the importance of 24 locus mycobacterial interspersed repetitive unit variable number tandem repeat (MIRU-VNTR) genotyping in its identification and management and the role of whole genome sequencing (WGS) in tracing the spread of the strain. Methods: Outbreak cases were defined as those diagnosed between January and December 2011 with indistinguishable 24 locus-MIRU-VNTR genotypes or, cases linked epidemiologically. A cluster questionnaire was administered by TB nurses to identify contacts and social settings. Results: Overall, 25 patients fulfilled the case definition. No cases with this MIRU-VNTR genotype had been detected in the UK previously. Connections were found between all cases through household contacts or social venues including a football club, Internet cafe and barber's shop. Public health actions included extended contact tracing, venue screening and TB awareness-raising. The outbreak resulted in a high rate of transmission and high incidence of clinical disease among contacts. Conclusions: This outbreak illustrates the value of combining active case-finding with prospective MIRU-VNTR genotyping to identify settings to undertake public health action. In addition WGS revealed that the VNTR-defined cluster was a single outbreak and that active TB transmission not reactivation was responsible for this outbreak in non-UK born individuals.
Assuntos
Mycobacterium tuberculosis/genética , Tuberculose/epidemiologia , Tuberculose/genética , Adolescente , Adulto , Criança , Pré-Escolar , Surtos de Doenças , Feminino , Genótipo , Humanos , Lactente , Masculino , Inquéritos e Questionários , Reino Unido/epidemiologia , Sequenciamento Completo do Genoma , Adulto JovemRESUMO
In 2008, acute hepatitis E infection was confirmed in 4 passengers returning to the United Kingdom after a world cruise. Epidemiologic investigation showed that of 789 persons who provided blood samples, 195 (25%) were seropositive, 33 (4%) had immunoglobulin [Ig] M levels consistent with recent acute infection (11 of these persons were symptomatic), and 162 (21%) had IgG only, consistent with past infection. Passenger mean age was 68 years. Most (426/789, 54%) passengers were female, yet most with acute infection (25/33, 76%) were male. Sequencing of RNA from 3 case-patients identified hepatitis E virus genotype 3, closely homologous to genotype 3 viruses from Europe. Significant association with acute infection was found for being male, drinking alcohol, and consuming shellfish while on board (odds ratio 4.27, 95% confidence interval 1.23-26.94, p = 0.019). This was probably a common-source foodborne outbreak.