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Free Content Tuberculosis in Mexican-born persons in San Francisco: reactivation, acquired infection and transmission

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SETTING: San Francisco, California.

OBJECTIVE: To determine the relative contributions of infection acquired in San Francisco and reactivation of tuberculous infection acquired elsewhere in Mexican-born persons who developed tuberculosis in San Francisco, and to determine the frequency of transmission leading to secondary cases of tuberculosis in other persons.

DESIGN: The study population consisted of all Mexican-born tuberculosis patients reported in San Francisco from 1991 through June 1995. All patients had positive cultures for Mycobacterium tuberculosis and DNA fingerprinting of isolates using IS6110 with more than two bands. Patients were classified as infected in San Francisco or infected elsewhere based on pre-defined criteria that included a second DNA fingerprinting technique (polymorphic guanine-cytosine-rich sequence), chart reviews, and selected patients interviews.

RESULTS: Of the 43 Mexican-born patients studied, nine (21%) met the definition of infection acquired in San Francisco and 34 (79%) met the definition of reactivation of infection acquired elsewhere. Only one of the 43 cases results in two secondary cases in US-born persons.

CONCLUSION: One-fifth of the Mexican-born patients who developed tuberculosis in San Francisco acquired their tuberculous infection in San Francisco; transmission from Mexican-born persons leading to tuberculosis in other persons is uncommon.

Keywords: DNA fingerprint; M. tuberculosis; RFLP analysis; immigration; molecular epidemiology; transmission; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital Medical Center, San Francisco, California, USA; and Department of Medicine, University of California, San Francisco, California, USA 2: Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA 3: Department of City and Regional Planning, University of California, Berkeley, California, USA 4: Department of Epidemiology and Biostatistics, San Francisco General Hospital, and University of California, San Francisco, California, USA 5: Department of Public Health, Division of Tuberculosis Control, City and County of San Francisco, California, USA

Publication date: December 1, 1997

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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