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Does Real Time Molecular Genotyping help Investigate TB Outbreaks?

Does Real Time Molecular Genotyping help Investigate TB Outbreaks?. Mark Temple , Lewis White, Michael Ruddy, Sue Morgan, Jörg Hoffmann. Does reality reflect the promise?. Many “improvements” claim better care Front line questions such claims Genotype fingerprinting

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Does Real Time Molecular Genotyping help Investigate TB Outbreaks?

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  1. Does Real Time Molecular Genotyping help Investigate TB Outbreaks? Mark Temple, Lewis White, Michael Ruddy, Sue Morgan, Jörg Hoffmann CDSC(Wales)

  2. Does reality reflect the promise? • Many “improvements” claim better care • Front line questions such claims • Genotype fingerprinting • using ETA MIRU coding since 2000 • “Real Time Genotyping” used in the field • To inform control decisions • To verify completeness of contact tracing • Did it enhance contact tracing? CDSC(Wales)

  3. Test A • Factory worker is found to be Sputum +ve • 7 of 13 ‘household’ contacts infected (0.53) • 1 of 38 closest workplace contacts infected (0.03) • Should we screen the remaining Workplace contacts? CDSC(Wales)

  4. Test A contacts CDSC(Wales)

  5. Test A casesBy genotype CDSC(Wales)

  6. Transmission contacts type CDSC(Wales)

  7. Test B • Two “separate” outbreaks in same locale • Several sporadic cases in same conurbation • Is this generalised spread in a city? CDSC(Wales)

  8. The outbreak cases CDSC(Wales)

  9. The epidemiological linkage of culture positive cases CDSC(Wales)

  10. And the linkage by Genotype of culture positive cases CDSC(Wales)

  11. Conclusions • Contact tracing is essential • New cases linked to outbreak B still occurring after 7 years • Genotyping helps as • Contact data and genotype are not congruent • Enhances effective contact tracing • Not a replacement for contact tracing CDSC(Wales)

  12. Thanks to • Those who screened & treated the patients • For providing the case information and specimens for culture • All those who did the contact tracing • For collecting the information about contacts CDSC(Wales)

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