Local and Travel-Associated Transmission of Tuberculosis at Central Western Border of Brazil, 2014–2017

• Main Authors: Katharine S. Walter, Mariana Bento Tatara, Kesia Esther da Silva, Flora Martinez Figueira Moreira, Paulo Cesar Pereira dos Santos, Dândrea Driely de Melo Ferrari, Eunice Atsuko Cunha, Jason R. Andrews, Julio Croda
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2021-03-01
• Series: Emerging Infectious Diseases
• Subjects: tuberculosis and other mycobacteria; transmission; genomic epidemiology; migration; borders; incarceration
• Online Access: https://wwwnc.cdc.gov/eid/article/27/3/20-3839_article

International migrants are at heightened risk for tuberculosis (TB) disease. Intensified incarceration at international borders may compound population-wide TB risk. However, few studies have investigated the contributions of migration, local transmission, or prisons in driving incident TB at international borders. We conducted prospective population-based genomic surveillance in 3 cities along Brazil’s central western border from 2014–2017. Although most isolates (89/132; 67%) fell within genomic transmission clusters, genetically unique isolates disproportionately occurred among participants with recent international travel (17/42; 40.5%), suggesting that both local transmission and migration contribute to incident TB. Isolates from 40 participants with and 76 without an incarceration history clustered together throughout a maximum-likelihood phylogeny, indicating the close interrelatedness of prison and community epidemics. Our findings highlight the need for ongoing surveillance to control continued introductions of TB and reduce the disproportionate burden of TB in prisons at Brazil’s international borders.