Unlike HIV, TB spread is limited, study shows
Unlike HIV, TB spread is limited, study shows
New Jersey strains not same as New York's
Fingerprinting analysis of tuberculosis strains found in cities in New Jersey and New York City show that few cases seem to have crossed from one area to the other, indicating that outbreaks outside large urban areas are home-grown rather than invasions from outside sources.
In a study presented at the First International Conference on Emerging Infectious Diseases in Atlanta, researchers at New York University Medical School and the nonprofit Public Health Research Institute (PHRI) in Newark found that, unlike AIDS, which spreads rapidly along transportation routes and population clusters, tuberculosis is relatively contained within political and geographical areas.
A team of researchers at PHRI, lead by Barry Kreiswirth, MD, selected the five most prevalent strains of TB among the 6,000 or more strains the institute has identified in New York City. The strains, accounting for 20% of the city's TB cases, were then compared to strains responsible for TB in four counties of northern New Jersey closest to New York City. If TB followed transmission patterns like HIV, most of the successful TB strains should have shown up in New Jersey via the George Washington Bridge or Lincoln Tunnel. Instead, Kreisworth found only 3.8% of TB cases in northern New Jersey were caused by common New York strains - cases that looked more like random "fallout" from the city's epidemic rather than domestic New Jersey outbreaks.
"These findings mean that outside invasion by successful TB strains might play a relatively small role in the occurrence of TB in any area, with home-grown outbreaks accounting for much more of the problem," the authors conclude. "They also suggest that the political boundaries that determine where people will be hospitalized, incarcerated, or institutionalized are powerful barriers to the diffusion of TB."
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