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Tuberculosis Outbreaks in State Prisons, United States, 2011-2019
Rebekah J Stewart1, Kala M Raz1, Scott P Burns1
1The authors are with the Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
American Journal of Public Health
|July 13, 2022
Summary
Tuberculosis outbreaks occurred in US state prisons between 2011 and 2019, primarily in Alabama and Texas. Texas state prisons showed ongoing tuberculosis transmission in 2019, necessitating targeted interventions.
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Surveillance
Background:
- Tuberculosis (TB) remains a significant public health concern, particularly within congregate settings like US state prisons.
- Understanding the epidemiology of TB outbreaks in correctional facilities is crucial for effective control strategies.
Purpose of the Study:
- To determine the frequency, scale, geographic distribution, and characteristics of TB outbreaks in US state prisons.
- To identify specific prison systems experiencing significant TB transmission events.
Main Methods:
- Utilized data from the National Tuberculosis Surveillance System (2011-2019) for incarcerated individuals diagnosed with TB.
- Employed whole-genome sequencing to define TB clusters (≥3 cases, ≤2 SNPs, within 3 years) and outbreaks (≥6 cases, within 3 years).
Main Results:
- A total of 566 TB cases were reported across 41 state prison systems.
- Nineteen TB genotype clusters (134 cases) were identified in 6 states, including 5 outbreaks in 2 states.
- Alabama reported 2 outbreaks (20 cases), and Texas reported 3 outbreaks (51 cases) during the study period.
Conclusions:
- Only Alabama and Texas reported TB outbreaks in state prisons between 2011 and 2019.
- Ongoing TB transmission was evident in Texas state prisons in 2019, highlighting the need for immediate and effective control measures.
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