Journal
EPIDEMIOLOGY AND INFECTION
Volume 149, Issue -, Pages -Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0950268821002041
Keywords
epidemiology; tuberculosis (TB)
Funding
- National Institute of General Medical Sciences of the National Institutes of Health [R01GM122876]
- CDC
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Research estimated the reproductive number of tuberculosis in the United States, finding that a minority of source cases disproportionately contribute to transmission.
Heterogeneity in the number of secondary tuberculosis (TB) cases per source case, the effective reproductive number, R, is important in modelling prevention strategies' impact on incidence. We estimated mean R (R-m) and calculate the dispersion parameter of this distribution, k, using surveillance and genotyping data for U.S. cases during 2009-2018. We modelled transmission assuming cases in a cluster have matching genotypes and share characteristics related to geography, temporal proximity (i.e. serial interval) and time since U.S. arrival among non-U.S.-born persons. Complete data were available for 55 330/85 958 cases. Varying the serial interval and geographic proximity used to derive clusters, we consistently estimated R(m)k < 0.08; the low value of k indicates a small number of source cases produce a disproportionate number of secondary cases. U.S. TB reproductive number has a highly skewed distribution, indicating a minority of source cases disproportionately contribute to transmission.
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