Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 1270-1276 |
| Number of pages | 7 |
| Journal | The Lancet |
| Volume | 369 |
| Issue number | 9569 |
| DOIs | |
| Publication status | Published - 14 Apr 2007 |
Bibliographical note
Funding Information:We thank staff of all Microbiology laboratories that refer samples to the Midlands Regional Centre for Mycobacteriology, local tuberculosis services, and health protection units for their work in case finding and contact tracing, Ibrahim Abubakar and Paul Fine for constructive reviewing of the manuscript, Dilys Morgan for directing investigation of possible zoonotic transmission, and the staff at the Midlands Regional Centre for Mycobacteriology for undertaking isolation, identification, and typing of the isolates. Part of the work was supported by a grant from the UK Department of Health and the Department for the Environment, Food and Rural Affairs (Defra).
