Mycobacterium tuberculosis Transmission among Elderly Persons, Yamagata Prefecture, Japan, 2009–2015

• Published in: Emerging infectious diseases Vol. 23; no. 3; pp. 448 - 455
• Main Authors: Seto, Junji, Wada, Takayuki, Suzuki, Yu, Ikeda, Tatsuya, Mizuta, Katsumi, Yamamoto, Taro, Ahiko, Tadayuki
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.03.2017; Centers for Disease Control and Prevention
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; contact investigation; contact tracing; Elderly; elderly persons; Female; Humans; Japan - epidemiology; Male; Middle Aged; Multivariate Analysis; Mycobacterium tuberculosis; Odds Ratio; Risk Factors; Transmission among Elderly Persons, Yamagata Prefecture, Japan, 2009–2015; Tuberculosis; Tuberculosis - epidemiology; Tuberculosis - transmission; tuberculosis and other mycobacteria; Japan; China; molecular epidemiology; bacteria; variable-number tandem-repeat analysis; contact tracing; Japan; contact investigation; reactivation; latent infection; TB; respiratory infections; epidemiology; elderly persons; transmission; Mycobacterium tuberculosis; tuberculosis and other mycobacteria; VNTR
• ISSN: 1080-6040; 1080-6059; 1080-6059
• DOI: 10.3201/eid2303.161571

In many countries with low to moderate tuberculosis (TB) incidence, cases have shifted to elderly persons. It is unclear, however, whether these cases are associated with recent Mycobacterium tuberculosis transmission or represent reactivation of past disease. During 2009-2015, we performed a population-based TB investigation in Yamagata Prefecture, Japan, using in-depth contact tracing and 24-loci variable-number tandem-repeat typing optimized for Beijing family M. tuberculosis strains. We analyzed 494 strains, of which 387 (78.3%) were derived from elderly patients. Recent transmission with an epidemiologic link was confirmed in 22 clusters (70 cases). In 17 (77.3%) clusters, the source patient was elderly; 11 (64.7%) of the 17 clusters occurred in a hospital or nursing home. In this setting, the increase in TB cases was associated with M. tuberculosis transmissions from elderly persons. Prevention of transmission in places where elderly persons gather will be an effective strategy for decreasing TB incidence among predominantly elderly populations.