TY - JOUR
T1 - Cluster of human tuberculosis caused by Mycobacterium bovis
T2 - evidence for person-to-person transmission in the UK
AU - Evans, Jason T.
AU - Smith, E. Grace
AU - Banerjee, Ashis
AU - Smith, Robert MM
AU - Dale, James
AU - Innes, John A.
AU - Hunt, David
AU - Tweddell, Alan
AU - Wood, Annette
AU - Anderson, Charlotte
AU - Hewinson, R. Glyn
AU - Smith, Noel H.
AU - Hawkey, Peter M.
AU - Sonnenberg, Pam
PY - 2007/4/14
Y1 - 2007/4/14
N2 - Background: Despite a recent resurgence in the incidence of bovine tuberculosis in UK cattle herds, no associated rise in the number of cases in man has been noted. Disease due to human Mycobacterium bovis infection usually occurs in older patients, in whom drinking unpasteurised milk in the past is the probable source of infection. Person-to-person transmission is very rare. Methods: After identification of two epidemiologically-linked cases of human M bovis infection through routine laboratory and surveillance activities, all patients identified with M bovis infection in the Midlands from 2001-05 (n=20) were assessed by DNA fingerprinting (MIRU-VNTR and spoligotyping), with additional interviews for patients with a clustered strain. Findings: A cluster of six cases was identified. All clustered cases were young and UK-born; five patients had pulmonary disease, and one patient died due to M bovis meningitis, with four patients possessing factors predisposing to tuberculosis. All patients had common social links through visits to bars in two different areas. With the exception of the first case, there was an absence of zoonotic links or consumption of unpasteurised dairy products, suggesting that person-to-person transmission had occurred. Interpretation: This report of several instances of M bovis transmission between people in a modern urban setting emphasises the need to maintain control measures for human and bovine tuberculosis. Transmission and subsequent disease was probably due to a combination of host and environmental factors. Prospective surveillance and DNA fingerprinting identified the cluster, enabling health protection teams to set up control measures and prevent further transmission.
AB - Background: Despite a recent resurgence in the incidence of bovine tuberculosis in UK cattle herds, no associated rise in the number of cases in man has been noted. Disease due to human Mycobacterium bovis infection usually occurs in older patients, in whom drinking unpasteurised milk in the past is the probable source of infection. Person-to-person transmission is very rare. Methods: After identification of two epidemiologically-linked cases of human M bovis infection through routine laboratory and surveillance activities, all patients identified with M bovis infection in the Midlands from 2001-05 (n=20) were assessed by DNA fingerprinting (MIRU-VNTR and spoligotyping), with additional interviews for patients with a clustered strain. Findings: A cluster of six cases was identified. All clustered cases were young and UK-born; five patients had pulmonary disease, and one patient died due to M bovis meningitis, with four patients possessing factors predisposing to tuberculosis. All patients had common social links through visits to bars in two different areas. With the exception of the first case, there was an absence of zoonotic links or consumption of unpasteurised dairy products, suggesting that person-to-person transmission had occurred. Interpretation: This report of several instances of M bovis transmission between people in a modern urban setting emphasises the need to maintain control measures for human and bovine tuberculosis. Transmission and subsequent disease was probably due to a combination of host and environmental factors. Prospective surveillance and DNA fingerprinting identified the cluster, enabling health protection teams to set up control measures and prevent further transmission.
UR - http://www.scopus.com/inward/record.url?scp=34047244736&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(07)60598-4
DO - 10.1016/S0140-6736(07)60598-4
M3 - Article
C2 - 17434402
AN - SCOPUS:34047244736
SN - 0140-6736
VL - 369
SP - 1270
EP - 1276
JO - Lancet
JF - Lancet
IS - 9569
ER -