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Cited by 386

The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.

An Outbreak Involving Extensive Transmission of a Virulent Strain of Mycobacterium tuberculosis

Open access
Valway, Sarah E., Sanchez, Maria Pia C., Shinnick, Thomas F., Orme, Ian, Agerton, Tracy, Hoy, Debbie, Jones, J. Scott, Westmoreland, Harriet, Onorato, Ida M.·1998·New England Journal of Medicine
DOI 10.1056/nejm199803053381001
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Abstract

BACKGROUND AND METHODS: From 1994 to 1996, there was a large outbreak of tuberculosis in a small, rural community with a population at low risk for tuberculosis. Twenty-one patients with tuberculosis (15 with positive cultures) were identified; the DNA fingerprints of the 13 isolates available for testing were identical. To determine the extent of transmission, we investigated both the close and casual contacts of the patients. Using a mouse model, we also studied the virulence of the strain of Mycobacterium tuberculosis that caused the outbreak. RESULTS: The index patient, in whom tuberculosis was diagnosed in 1995; the source patient, in whom the disease was diagnosed in 1994; and a patient in whom the disease was diagnosed in 1996 infected the other 18 persons. In five, active disease developed after only brief, casual exposure. There was extensive transmission from the three patients to both close and casual contacts. Of the 429 contacts, 311 (72 percent) had positive skin tests, including 81 [corrected] with documented skin-test conversions. Mice infected with the virulent Erdman strain of M. tuberculosis had approximately 1000 bacilli per lung after 10 days and about 10,000 bacilli per lung after 20 days. In contrast, mice infected with the strain involved in the outbreak had about 10,000 bacilli per lung after 10 days and about 10 million bacilli per lung after 20 days. CONCLUSIONS: In this outbreak of tuberculosis, the growth characteristics of the strain involved greatly exceeded those of other clinical isolates of M. tuberculosis. The extensive transmission of tuberculosis may have been due to the increased virulence of the strain rather than to environmental factors or patient characteristics.

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Metadata

Authors
Valway, S. E., Sanchez, M. P. C., Shinnick, T. F., Orme, I., Agerton, T., Hoy, D., Jones, J. S., Westmoreland, H., & Onorato, I. M.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1998-03-05
Volume
338
Issue
10
Pages
633-639
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199803053381001
OpenAlex
W2035579424
Cited by
386
References
11
FWCI
25.94
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: An Outbreak Involving Extensive Transmission of a Virulent Strain of Mycobacterium tuberculosis. https://app.cochat.ai/papers/10.1056/nejm199803053381001
The paper
Valway, S. E., Sanchez, M. P. C., Shinnick, T. F., Orme, I., Agerton, T., Hoy, D., Jones, J. S., Westmoreland, H., & Onorato, I. M. (1998). An Outbreak Involving Extensive Transmission of a Virulent Strain of Mycobacterium tuberculosis. New England Journal of Medicine. https://doi.org/10.1056/nejm199803053381001

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.