Tuberculosis fromMycobacterium bovisin Binational Communities, United States

Abstract

The epidemiology of tuberculosis (TB) in the United States is changing as the incidence of disease becomes more concentrated in foreign-born persons. Mycobacterium bovis appears to be contributing substantially to the TB incidence in some binational communities with ties to Mexico. We conducted a retrospective analysis of TB case surveillance data from the San Diego, California, region from 1994 through 2005 to estimate incidence trends, identify correlates of M. bovis disease, and evaluate risk factors for deaths during treatment. M. bovis accounted for 45% (62/138) of all culture-positive TB cases in children (<15 years of age) and 6% (203/3,153) of adult cases. T he pattern of tuberculosis (TB) in the United States is changing as the incidence of TB disease becomes more concentrated in foreign-born persons. Of the annual total US TB cases, >54% are now concentrated in persons born outside of the United States (1); in communities with high immigration, the proportion can exceed 70% (2). TB prevention and treatment strategies, particularly those in communities on the border with Mexico, will need to be adapted to accommodate the changing epidemiology of TB (3).San Diego, California, together with its sister city Tijuana-Tecate, Mexico, is the largest binational metropolitan region in the United States, accounting for 34% of the southern border population (4). In San Diego County, the Hispanic population has grown from 20% to 29% in the past 15 years (5). Of the total annual TB cases in San Diego, >70% occurred among foreign-born persons, of whom nearly half originated from Mexico (2). A review of culture-positive TB cases in San Diego County in the late 1990s indicated that 6.6% of all adult TB cases and 39% of all pediatric (<15 years of age) TB cases from this region were not caused by Mycobacterium tuberculosis, the most common TB pathogen in the United States, but were instead caused by M. bovis, a pathogen more often associated with TB in cattle (6). This fi nding represented the highest reported proportional incidence of TB from M. bovis among industrialized countries (7).M. bovis is a pathogen in the complex of bacteria that includes M. tuberculosis, which causes TB in humans and animals. TB from M. bovis has been generally considered rare in the United States after its successful eradication from cattle in the mid-1900s (8), but wider use of laboratory tools for species-level diagnosis of TB pathogens has started to shed light on an unexpected regional presence of M. bovis in communities with large Hispanic populations. While M. bovis TB has been most often documented in Hispanic communities with close proximity to Mexico (6,9), a recent review of M. bovis cases in New York City indicates that the problem is not limited to US regions that border Mexico (10).The clinical and pathologic characteristics of M. bovis TB is indistinguishable from M. tuberculosis TB in most cases, but there are relevant considerations for prevention and treatment strategies in communities where M. bovis contributes to TB incid...

Genetic diversity of Mycobacterium bovis in Jalisco, Mexico: Tracing back sources of infection

“…Spoligotype SB0140 has infected cattle, deer, badgers and people in Source: http://spoltools.emi.unsw.edu.au/ Ireland (de la McLernon et al, 2010), and cattle in the United Kingdom (de la RuaDomenech et al, 2006;McLernon et al, 2010). It has also been reported as the most frequent spoligotype in pigs (Barandiaran et al, 2011), cattle and cats in Argentina (Zumárraga et al, 2009), and humans in the United States (Rodwell et al, 2008) and Mexico (Bobadilla-del Valle et al, 2015). Spoligotype SB0140 has been studied profoundly in the United Kingdom (Smith et al, 2003).…”

Paradoxical conservation of a set of three cellulose-targeting genes in Mycobacterium tuberculosis complex organisms

“…Likewise, we have recently shown that living M. tuberculosis organisms can be detected in the stools of patients with pulmonary tuberculosis (El Khechine et al, 2009). M. bovis, however, is also efficiently transmitted directly by the aerosol route, being responsible for outbreaks of tuberculosis (Rodwell et al, 2008) and bovine tuberculosis (Wilkins et al, 2008). It has also been demonstrated that M. bovis can survive ingestion by amoebae, which suggests that protozoa could significantly enhance the survival of M. bovis in the soil and hence may be instrumental in the transmission of bovine tuberculosis (Taylor et al, 2003).…”

Evaluation of a Single-Tube Multiplex Real-Time PCR for Differentiation of Members of the Mycobacterium tuberculosis Complex in Clinical Specimens

“…A recent report on the incidence of M. bovis in San Diego, CA, highlighted the importance of routine species-level identification in U.S. tuberculosis (TB) surveillance. That investigation reported the growing incidence of TB caused by M. bovis (45% of all culture-positive TB cases in children between 1994 and 2005), which may be representative of other communities in the United States (17). In New York, 3 to 7% of the MTBC specimens that our laboratory receives each year are identified as species other than M. tuberculosis.…”