ArticlePublic health reports (Washington, D.C. : 1974)
Tuberculosis Outbreaks in the United States, 2009-2015.
Article in Public health reports (Washington, D.C. : 1974). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Infectious Diseases Among People Experiencing Homelessness: A Systematic Review of the Literature in the United States and Canada, 2003-2022.Public health reports (Washington, D.C. : 1974)Pooled it
- Characteristics of Plausible Source Cases Responsible for Recent Mycobacterium tuberculosis Transmission, United States, 2018-2022.Emerging infectious diseases · 2026Article
- Trends in Active Tuberculosis Cases Diagnosed in New York City During the COVID-19 Pandemic.Public health reports (Washington, D.C. : 1974) · 2026Article
- Prevalence and Spatial Autocorrelation of Tuberculosis in Indigenous People in Brazil, 2002-2022.Journal of racial and ethnic health disparities · 2025Article
- Model-Based Analysis of Impact, Costs, and Cost-effectiveness of Tuberculosis Outbreak Investigations, United States.Emerging infectious diseases · 2025Article
- WHO's end of TB targets: unachievable by 2035 without addressing under nutrition, forced displacement, and homelessness: trend analysis from 2015 to 2022.BMC public health · 2024Article
- The Challenges of Tuberculosis Management beyond Professional Competence: Insights from Tuberculosis Outbreaks among Ethiopian Immigrants in Israel.Tropical medicine and infectious disease · 2024Article
- A half-century of research on tuberculosis: Successes and challenges.The Journal of experimental medicine · 2023Article
- Smoked drug use in patients with TB is associated with higher bacterial burden.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Tuberculosis Outbreak in a State Prison System - Washington, 2021-2022.MMWR. Morbidity and mortality weekly report · 2023Article
- A clinically-guided unsupervised clustering approach to recommend symptoms of disease associated with diagnostic opportunities.Diagnosis (Berlin, Germany) · 2023Article
- Using Machine Learning Techniques and National Tuberculosis Surveillance Data to Predict Excess Growth in Genotyped Tuberculosis Clusters.American journal of epidemiology · 2022Article
- Molecular surveillance for large outbreaks of tuberculosis in the United States, 2014-2018.Tuberculosis (Edinburgh, Scotland) · 2022Article
- Surveillance for endemic infectious disease outbreaks: Adaptive sampling using profile likelihood estimation.Statistics in medicine · 2022Article
- HIV Cluster and Outbreak Detection and Response: The Science and Experience.American journal of preventive medicine · 2021Review
- Tuberculosis Genotype Clusters and Transmission in the U.S., 2009-2018.American journal of preventive medicine · 2021Article
- Analysis of 605 tuberculosis outbreaks in Japan, 1993-2015: time, place and transmission site.Epidemiology and infection · 2021Article
- Cross-Contamination versus Outbreak: Pre-XDR Mycobacterial Strains Confirmed by Whole-Genome Sequencing.Antibiotics (Basel, Switzerland) · 2021Article
- Article
- Notes from the Field: Effects of the COVID-19 Response on Tuberculosis Prevention and Control Efforts - United States, March-April 2020.MMWR. Morbidity and mortality weekly report · 2020Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe Centers for Disease Control and Prevention provides on-site epidemiologic assistance for outbreak response when the health capacity of state, tribal, local, and territorial health departments has been exceeded. We examined recent outbreaks of tuberculosis (TB) for which health departments needed assistance.
methodsWe defined a TB outbreak as detection of ≥3 TB cases related by transmission, as suggested by routine genotyping and epidemiologic linkages. We conducted retrospective reviews of documentation from all 21 TB outbreak investigations in the United States for which the Centers for Disease Control and Prevention provided on-site assistance during 2009-2015. We abstracted data on patients' demographic characteristics and TB risk factors, as well as factors contributing to the outbreak from trip reports written by on-site investigators, and we compared these with outbreaks investigated during 2002-2008.
resultsThe 21 TB outbreaks during 2009-2015 involved 457 outbreak patients (range, 3-99 patients per outbreak). Of the 21 outbreaks, 16 were first identified through genotype data. In sum, 118 (26%) patients were identified through contact investigations of other patients in the outbreak. Most outbreak patients (n = 363, 79%) were US born. Ninety-two (26%) patients had a mental illness, 204 (45%) had been homeless in the year before diagnosis, and 379 (83%) used alcohol excessively or used illicit substances. The proportion of patients experiencing homelessness doubled between 2002-2008 and 2009-2015; other characteristics were similar between the 2 periods. Delayed TB diagnosis contributed to unmitigated transmission in all but 1 outbreak.
conclusionsTB outbreaks challenge frontline public health resources. Genotyping and contact investigations are important strategies for detecting and controlling TB outbreaks, particularly among people experiencing homelessness or those with mental illness.
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