Journal Article

Mycobacterium tuberculosis transmission: the importance of precision

Dinkele, Ryan, Warner, Digby F, Khan, Palwasha Y

2024

Overview

[...]the final stage, successful infection of a new host, is impossible to observe: it must be inferred from the development of manifest tuberculosis, an outcome that occurs in a few individuals exposed to M tuberculosis and might be delayed by months.2 Though now considered intuitive, the notion that M tuberculosis infection results in a spectrum of outcomes is new, with early tuberculosis (encompassing latent, incipient, and subclinical states) increasingly recognised as a potential contributor to transmission.3 The implications are considerable, especially in the context of molecular epidemiology studies that suggest that most new and recurrent tuberculosis results from transmission within the preceding two years.4 Since only a few incident infections can be linked to known cases in tuberculosis-endemic regions,5 there must be unrecognised transmitters in these communities. [...]there remain large gaps in our understanding of when and how M tuberculosis infection occurs. Koch and colleagues1 postulated that infectious micro-organisms were only present in people with clinical tuberculosis, prompting early investigators to focus exclusively on sputum-smear-positive pulmonary tuberculosis when studying M tuberculosis transmission.1 Bioaerosol research has enabled the direct quantification of aerosolised M tuberculosis, even in sputum-negative cases, suggesting that developing highly sensitive and standardised methods to work with these samples should be prioritised.

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Aerosols / Bioaerosols / Disease / Epidemiology / Immunology / Infections / Sputum / Transmitters / Tuberculosis