Family outbreaks of tuberculosis in South Moravia, a low incidence area of the Czech Republic.
OBJECTIVE
To identify suspected family outbreaks of tuberculosis in South Moravia, an area with the lowest notification rates in the Czech Republic.


METHODS
The insertion sequence IS6110-based RFLP analysis of Mycobacterium tuberculosis was applied in isolates collected from 17 indigenous excretors giving the same family name and/or domicile. The fingerprints were matched with a database of 184 RFLP profiles of Czech M. tuberculosis isolates originating from remote localities.


RESULTS
The RFLP analysis revealed uniform fingerprints in each of six indigenous outbreaks consisting of two to six family members or relatives. In three of them no matching case has been found in the Czech fingerprint database. The remaining three clusters showed identical patterns with RFLP profiles of 13 Czech M. tuberculosis strains originating from remote areas: five were from patients living in the immediate vicinity and eight were from distant regions.


CONCLUSIONS
Different clustered genotypes of M. tuberculosis were identified in epidemiologically linked family outbreaks of tuberculosis, half of them indigenous and half matching fingerprints of strains from remote areas. It seems that family outbreaks may contribute to the continued occurrence of tuberculosis in South Moravia, which reports the lowest notification values in the Czech Republic.
Kubin
M
M
National Institute of Public Health, Prague, Czech Republic. milankubin@hotmail.com
Mezenský
L
L
Prikazský
V
V
Kremer
K
K
van Soolingen
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D002675:Child, Preschool; D016000:Cluster Analysis; D018153:Czech Republic / Q000453:epidemiology; D004196:Disease Outbreaks; D005192:Family Health; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification*; D012150:Polymorphism, Restriction Fragment Length; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology