PROCAARE: Tuberculosis, Virulent Strain, USA

[procaare@usa.healthnet.org]

[From our sister conference, ProMED-mail. - Mod.]

TUBERCULOSIS, VIRULENT STRAIN - USA (02)
****************************************
A ProMED-mail post

[see:
Tuberculosis, virulent strain - USA (Tenn., Kentucky)  970927120914]

Date:  09-26-97     TIME:  14:15
From: rolmsted@mercyhealth.com
Via: Automatic digest processor <LISTSERV@PEACH.EASE.LSOFT.COM>
APIC Digest - 24 Sep 1997 to 27 Sep 1997


As highlighted on the Oregon/S.W. Washington APIC chapter mailing list,
a report of a possible new strain of _Mycobacterium tuberculosis_ that 
exhibits enhanced transmissibility and virulence was presented at the
35th Annual Meeting of the Infectious Disease Society of America(IDSA)
by Dr. Sarah Valway and colleagues at the Centers for Disease Control
& Prevention. (1)  

In this report a large community outbreak of
tuberculosis(TB) during the years 1994-96 is described.  Extensive
transmission of TB from three cases was found with 337/461(73%) of
contacts having positive a tuberculin skin test (TST).  Laboratory
studies of this strain revealed enhanced growth characteristics,
approximately 4 logs higher within 20 days, compared to the Erdman
strain of _M. tuberculosis_.

This report was also reviewed in the Tuesday, September 23, 1997
issue of the  New York Times(see page B10).  Interestingly, the
population infected were predominately young, healthy individuals born
in the US.  The good news is that standard anti-TB medications are
effective against this strain, and this outbreak appears to be under
control through use of directly observed therapy and other prevention
initiatives.

1. Valway S, Sanchez M, Shinnick T, Orme T, Agerton I, Onorato I.
Extensive transmission of M. tuberculosis due to increased virulence.
Clin Infect Dis 1997;25(No.2):361(abstr. #35).

--
Russell N. Olmsted, MPH,CIC
Epidemiologist, Infection Control Services
St. Joseph Mercy Hospital, Ann Arbor, MI USA
rolmsted@mercyhealth.com
....................................................jw

[This may be a very important opportunistic pathogen for AIDS patients,
particularly when you consider the WHO identifies _M. tuberculosis_ as the
global leading killer of HIV/AIDS patients. - Mod.]

KEYWORDS: Related Epidemics, Tuberculosis, Virulence, Growth Rate,
Transmission,  USA
..............................................................gjn
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