Assessment of Mycobacterium tuberculosis transmission in Oxfordshire, UK, 2007-12, with whole pathogen genome sequences: an observational study.
BACKGROUND
Patients born outside the UK have contributed to a 20% rise in the UK's tuberculosis incidence since 2000, but their effect on domestic transmission is not known. Here we use whole-genome sequencing to investigate the epidemiology of tuberculosis transmission in an unselected population over 6 years.


METHODS
We identified all residents with Oxfordshire postcodes with a Mycobacterium tuberculosis culture or a clinical diagnosis of tuberculosis between Jan 1, 2007, and Dec 31, 2012, using local databases and checking against the national Enhanced Tuberculosis Surveillance database. We used Illumina technology to sequence all available M tuberculosis cultures from identified cases. Sequences were clustered by genetic relatedness and compared retrospectively with contact investigations. The first patient diagnosed in each cluster was defined as the index case, with links to subsequent cases assigned first by use of any epidemiological linkage, then by genetic distance, and then by timing of diagnosis.


RESULTS
Although we identified 384 patients with a diagnosis of tuberculosis, country of birth was known for 380 and we sequenced isolates from 247 of 269 cases with culture-confirmed disease. 39 cases were genomically linked within 13 clusters, implying 26 local transmission events. Only 11 of 26 possible transmissions had been previously identified through contact tracing. Of seven genomically confirmed household clusters, five contained additional genomic links to epidemiologically unidentified non-household members. 255 (67%) patients were born in a country with high tuberculosis incidence, conferring a local incidence of 109 cases per 100,000 population per year in Oxfordshire, compared with 3·5 cases per 100,000 per year for those born in low-incidence countries. However, patients born in the low-incidence countries, predominantly UK, were more likely to have pulmonary disease (adjusted odds ratio 1·8 [95% CI 1·2-2·9]; p=0·009), social risk factors (4·4 [2·0-9·4]; p<0·0001), and be part of a local transmission cluster (4·8 [1·6-14·8]; p=0·006).


CONCLUSIONS
Although inward migration has contributed to the overall tuberculosis incidence, our findings suggest that most patients born in high-incidence countries reactivate latent infection acquired abroad and are not involved in local onward transmission. Systematic screening of new entrants could further improve tuberculosis control, but it is important that health care remains accessible to all individuals, especially high-risk groups, if tuberculosis control is not to be jeopardised.


BACKGROUND
UK Clinical Research Collaboration (Wellcome Trust, Medical Research Council, National Institute for Health Research [NIHR]), and NIHR Oxford Biomedical Research Centre.
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Timothy M
TM
Walker
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Maeve K
MK
Lalor
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Agnieszka
A
Broda
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Luisa Saldana
LS
Ortega
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Marcus
M
Morgan
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Lynne
L
Parker
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Sheila
S
Churchill
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Karen
K
Bennett
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Tanya
T
Golubchik
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Adam P
AP
Giess
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Carlos
C
Del Ojo Elias
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Katie J
KJ
Jeffery
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Ian C J W
ICJW
Bowler
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Ian F
IF
Laurenson
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Anne
A
Barrett
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Francis
F
Drobniewski
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Noel D
ND
McCarthy
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Laura F
LF
Anderson
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Ibrahim
I
Abubakar
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
H Lucy
HL
Thomas
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Philip
P
Monk
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
E Grace
EG
Smith
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
A Sarah
AS
Walker
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Derrick W
DW
Crook
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Tim E A
TEA
Peto
(T M Walker MRCP, T Golubchik PhD, A P Giess MSc, C Del Ojo Elias MSc, A S Walker PhD, Prof D W Crook FRCPath, Prof T E A Peto FRCP, C P Conlon FRCP); (T M Walker, M Morgan MSc, K J Jeffery FRCPath, I C J W Bowler FRCPath, Prof D W Crook, Prof T E A Peto, C P Conlon); (M K Lalor PhD, L F Anderson PhD, Prof I Abubakar FRCP, H L Thomas MFPH); (A Broda MRes Prof F Drobniewski FRCPath); (L Saldana Ortega MSc, N D McCarthy (DPhil); (L Parker BA, S Churchill BSc, K Bennett BA); (I F Laurenson FRCPath); (A Barrett BSc); (P Monk FFPHM); (E G Smith FRCPath); (A S Walker, Prof D W Crook, Prof T E A Peto); (Prof I Abubakar); (Prof F Drobniewski, A Broda).
Christopher P
CP
Conlon
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D016680:Genome, Bacterial; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D012307:Risk Factors; D014376:Tuberculosis / Q000208:ethnology / Q000235:genetics* / Q000635:transmission; D055815:Young Adult