title: Tuberculosis Beijing strain outbreak in an Israeli Arab rural community linked to an incarcerated immigrant.
abstract: A tuberculosis (TB) outbreak with six definite and four probable cases, caused by a Beijing strain isolate, occurred in an Arab rural community in north Israel. Using epidemiological investigation and strain genotyping, we identified the source case as an incarcerated immigrant. This outbreak illustrates how a systematic breakdown in TB prevention and control measures at multiple levels, within prisons and upon exiting prison, can result in rapid, cross-ethnic transmission of TB to a low-risk population. The close social bonds in this rural community and downsizing of the regional TB clinic staff may also have contributed to the magnitude of this outbreak.
authors.affiliation: Nazareth Tuberculosis Clinic, Nazareth Hospital, Faculty of Medicine in Galilee Bar-Ilan University, Nazareth, Israel.
authors.forename: H
authors.initials: H
authors.lastname: Bishara
authors.affiliation: National Public Health Laboratory, Ministry of Health, Tel Aviv, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Rorman
authors.affiliation: Ramla Department of Health, Ramla, Israel.
authors.forename: Z
authors.initials: Z
authors.lastname: Mor
authors.affiliation: Public Health Department, Akko Subdistrict, Ministry of Health, Akko, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Shechter-Amram
authors.affiliation: Nazareth Tuberculosis Clinic, Nazareth Hospital, Faculty of Medicine in Galilee Bar-Ilan University, Nazareth, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Weiler-Ravell
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D018912:Arabs; D001431:Bacteriological Techniques; D002675:Child, Preschool; D016358:Contact Tracing; D004196:Disease Outbreaks; D054242:Emigrants and Immigrants; D005190:Family; D005260:Female; D033062:Friends; D005838:Genotype; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000472:pathogenicity; D011329:Prisoners; D012423:Rural Health; D012919:Social Behavior; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology / Q000382:microbiology / Q000635:transmission*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents