Human Tuberculosis Caused by Mycobacterium bovis in the United States, 2006-2013.
BACKGROUND
Using genotyping techniques that have differentiated Mycobacterium bovis from Mycobacterium tuberculosis since 2005, we review the epidemiology of human tuberculosis caused by M. bovis in the United States and validate previous findings nationally.


METHODS
All tuberculosis cases with a genotyped M. tuberculosis complex isolate reported during 2006-2013 in the United States were eligible for analysis. We used binomial regression to identify characteristics independently associated with M. bovis disease using adjusted prevalence ratios (aPRs) and corresponding 95% confidence intervals (CIs).


RESULTS
During 2006-2013, the annual percentages of tuberculosis cases attributable to M. bovis remained consistent nationally (range, 1.3%-1.6%) among all tuberculosis cases (N = 59 273). Compared with adults 25-44 years of age, infants aged 0-4 years (aPR, 1.9 [95% CI, 1.4-2.8]) and children aged 5-14 years (aPR, 4.0 [95% CI, 3.1-5.3]) had higher prevalences of M. bovis disease. Patients who were foreign-born (aPR, 1.4 [95% CI, 1.2-1.7]), Hispanic (aPR, 3.9 [95% CI, 3.0-5.0]), female (aPR, 1.4 [95% CI, 1.3-1.6]), and resided in US-Mexico border counties (aPR, 2.0 [95% CI, 1.7-2.4]) also had higher M. bovis prevalences. Exclusively extrapulmonary disease (aPR, 3.7 [95% CI, 3.3-4.2]) or disease that was both pulmonary and extrapulmonary (aPR, 2.4 [95% CI, 2.1-2.9]) were associated with a higher prevalence of M. bovis disease.


CONCLUSIONS
Children, foreign-born persons, Hispanics, and females are disproportionately affected by M. bovis, which was independently associated with extrapulmonary disease. Targeted prevention efforts aimed at Hispanic mothers and caregivers are warranted.
Epidemic Intelligence Service, Division of Applied Sciences Division of Global HIV and TB.
Colleen
C
Scott
Division of Global HIV and TB.
Joseph S
JS
Cavanaugh
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
Robert
R
Pratt
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
Benjamin J
BJ
Silk
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
Philip
P
LoBue
Division of Global HIV and TB.
Patrick K
PK
Moonan
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009163:Mycobacterium bovis; D015995:Prevalence; D012307:Risk Factors; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Mycobacterium bovis; epidemiology; trends; tuberculosis