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November 18, 1998

Reducing Ongoing Transmission of Tuberculosis

Author Affiliations

From the Center for Pulmonary and Infectious Disease Control, Departments of Cell Biology and Medicine, University of Texas Health Center, Tyler.

JAMA. 1998;280(19):1702-1703. doi:10.1001/jama.280.19.1702

Restriction fragment length polymorphism (RFLP) analysis to identify specific Mycobacterium tuberculosis strains, in combination with epidemiologic investigation, has shattered old dogmas and yielded new insights into the transmission dynamics of tuberculosis. In several cities in the United States, RFLP studies and epidemiologic analysis have shown that 19% to 54% of tuberculosis cases probably result from recent infection.14 Effective tuberculosis control measures should reduce this percentage. Yet, in this issue of THE JOURNAL, Bishai and colleagues5 suggest that recent transmission accounted for 32% of tuberculosis cases in Baltimore, Md, where an excellent tuberculosis control program has used community-based directly observed therapy (DOT) since 1981.

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