Tuberculosis Transmission Knows

No Borders: Genotype Clusters Along Texas-Mexico

BorderNicole Evert, MS

Genotyping CoordinatorTexas Department of State Health Services

Collaborators: Ken Jost Jr, Maria Rodriguez, Cindy Tafolla, Ann Tyree and Charles Wallace

No funding sources or relationships to disclose and no conflict of interest to disclose

Background► Three binational programs created to address

the high incidence of TB along Texas-Mexico border by serving TB cases in sister-city communities Services provided include:

►directly observed therapy ►contact investigations ► laboratory services, including genotyping ►TB education►referrals

► Each year an estimated 500 – 750 TB cases require TB case management on both sides of the U.S.-Mexico border (unpublished data)

Genotype Clusters in Texas►7,119 Tuberculosis (TB) cases were

genotyped in Texas from 2005-2010 1,823 (26%) binational TB cases

►1,403 (77%) were clustered 5,296 (74%) Texas (TX) TB cases

►2,777 (52%) were clustered

►Clusters with both Texas and Binational cases were 3 times larger than clusters with only Texas or only Binational cases

Genotype: PCR02252 (Spoligotype: 777777607760731,24-locus MIRU-VNTR: 2242226153321-543324115224)

2008

2009

2010

2011

V

KL M

Jail

H

R

Street A

CStreet B

INHINH

INH

INH

INH

INH RIF

INH EMB

INH RIF EMB

INH RIF EMB

T

B

INH RIF

INH RIF

INH RIF

J N

Q

E

INH RIF EMB

F

INH RIFSM

INH RIF EMB

A D

INH

I

INH RIFPZA

G

INH

O

INH

P

INH RIF

S

INH

INH EMB

UReport Year

Texas

Tamaulipas, MX

Known LinkPossible Link

Genotype: PCR02252 (Spoligotype: 777777607760731, 24-locus MIRU-VNTR: 2242226153321-543324115224)

Conclusion & Next Steps

► Preliminary cluster analysis of PCR02252 suggests that there may be ongoing transmission among Texas and Binational cases across border communities, but more information is needed

► Improving management for patients and interrupting of TB transmission along the border depends on: Consistent formats for data collection Sharing data

►Patient information►Contact investigations

Centralized Data Analysis Joint planning and interventions