title: Multidrug-resistant tuberculosis outbreak among US-bound Hmong refugees, Thailand, 2005.
abstract: In January 2005, tuberculosis (TB), including multidrug-resistant TB (MDR TB), was reported among Hmong refugees who were living in or had recently immigrated to the United States from a camp in Thailand. We investigated TB and drug resistance, enhanced TB screenings, and expanded treatment capacity in the camp. In February 2005, 272 patients with TB (24 MDR TB) remained in the camp. Among 17 MDR TB patients interviewed, 13 were found to be linked socially. Of 23 MDR TB isolates genotyped, 20 were similar according to 3 molecular typing methods. Before enhanced screening was implemented, 46 TB cases (6 MDR TB) were diagnosed in the United States among 9,455 resettled refugees. After enhanced screening had begun, only 4 TB cases (1 MDR TB), were found among 5,705 resettled refugees. An MDR TB outbreak among US-bound refugees led to importation of disease; enhanced pre-immigration TB screening and treatment decreased subsequent importation.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. jeo3@cdc.gov
authors.forename: John E
authors.initials: JE
authors.lastname: Oeltmann
authors.forename: Jay K
authors.initials: JK
authors.lastname: Varma
authors.forename: Luis
authors.initials: L
authors.lastname: Ortega
authors.forename: Yecai
authors.initials: Y
authors.lastname: Liu
authors.forename: Thomas
authors.initials: T
authors.lastname: O'Rourke
authors.forename: Maria
authors.initials: M
authors.lastname: Cano
authors.forename: Theresa
authors.initials: T
authors.lastname: Harrington
authors.forename: Sean
authors.initials: S
authors.lastname: Toney
authors.forename: Warren
authors.initials: W
authors.lastname: Jones
authors.forename: Samart
authors.initials: S
authors.lastname: Karuchit
authors.forename: Lois
authors.initials: L
authors.lastname: Diem
authors.forename: Dhanida
authors.initials: D
authors.lastname: Rienthong
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
authors.forename: Kashef
authors.initials: K
authors.lastname: Ijaz
authors.forename: Susan A
authors.initials: SA
authors.lastname: Maloney
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D004269:DNA, Bacterial / Q000032:analysis; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008403:Mass Screening; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D012036:Refugees; D013183:Sputum / Q000382:microbiology; D013785:Thailand / Q000208:ethnology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D014481:United States / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial