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Mycobacterium tuberculosis outbreak strain of Danish origin spreading at worrying rates among greenland-born persons in Denmark and Greenland.

https://arctichealth.org/en/permalink/ahliterature107042
Source
J Clin Microbiol. 2013 Dec;51(12):4040-4
Publication Type
Article
Date
Dec-2013
Author
T. Lillebaek
A B Andersen
E M Rasmussen
Z. Kamper-Jørgensen
M K Pedersen
K. Bjorn-Mortensen
K. Ladefoged
V O Thomsen
Author Affiliation
International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark.
Source
J Clin Microbiol. 2013 Dec;51(12):4040-4
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Denmark - epidemiology
Disease Outbreaks
Ethnic Groups
Female
Genotype
Greenland - epidemiology
Humans
Incidence
Infant
Infant, Newborn
Male
Middle Aged
Molecular Typing
Mycobacterium tuberculosis - classification - isolation & purification
Retrospective Studies
Tuberculosis - epidemiology - microbiology - transmission
Young Adult
Abstract
Transmission of Mycobacterium tuberculosis continues at high rates among Greenland-born persons in Greenland and Denmark, with 203 and 450 notified cases per 10(5) population, respectively, in the year 2010. Here, we document that the predominant M. tuberculosis outbreak strain C2/1112-15 of Danish origin has been transmitted to Greenland-born persons in Denmark and subsequently to Greenland, where it is spreading at worrying rates and adding to the already heavy tuberculosis burden in this population group. It is now clear that the C2/1112-15 strain is able to gain new territories using a new population group as the "vehicle." Thus, it might have the ability to spread even further, considering the potential clinical consequences of strain diversity such as that seen in the widely spread Beijing genotype. The introduction of the predominant M. tuberculosis outbreak strain C2/1112-15 into the Arctic circumpolar region is a worrying tendency which deserves attention. We need to monitor whether this strain already has, or will, spread to other countries.
Notes
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PubMed ID
24068008 View in PubMed
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Non-specific effects of BCG vaccination on morbidity among children in Greenland: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature289846
Source
Int J Epidemiol. 2016 12 01; 45(6):2122-2130
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-01-2016
Author
S Haahr
S W Michelsen
M Andersson
K Bjorn-Mortensen
B Soborg
J Wohlfahrt
M Melbye
A Koch
Author Affiliation
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Source
Int J Epidemiol. 2016 12 01; 45(6):2122-2130
Date
12-01-2016
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
BCG Vaccine - therapeutic use
Child, Preschool
Female
Greenland - epidemiology
Hospitalization - statistics & numerical data
Humans
Infant
International Classification of Diseases
Male
Registries
Regression Analysis
Respiratory Tract Infections - epidemiology
Retrospective Studies
Tuberculosis - epidemiology - prevention & control
Vaccination - statistics & numerical data
Abstract
The potential non-specific effects of BCG (Bacillus Calmette-Guérin) vaccination, with reported reduction of infectious disease morbidity among vaccinated children, in addition to the protective effect against tuberculosis (TB), are highly debated. In Greenland, BCG vaccination was introduced in 1955, but temporarily discontinued from 1991 to 1996 due to nationwide policy changes. Using the transient vaccination stop, we aimed to investigate possible non-specific effects of BCG vaccination by measuring nation-wide hospitalization rates due to infectious diseases other than TB among vaccinated and unvaccinated children.
A retrospective cohort study including all children born in Greenland aged 3 months to 3 years from 1989 to 2004. A personal identification number assigned at birth allowed for follow-up through national registers. Information on hospitalization due to infectious diseases was obtained from the Greenlandic inpatient register using ICD-8 and ICD-10 codes. Participants with notified TB were censored. Incidence rate ratios (IRR) were estimated using Poisson regression.
Overall, 19 363 children, hereof 66% BCG-vaccinated, were followed for 44 065 person-years and had 2069 hospitalizations due to infectious diseases. IRRs of hospitalization in BCG-vaccinated as compared with BCG-unvaccinated children were 1.07 [95% confidence interval (CI) 0.96-1.20] for infectious diseases overall, and specifically 1.10 (95% CI 0.98-1.24) for respiratory tract infections. Among BCG-vaccinated children aged 3 to 11 months, the IRR of hospitalization due to infectious diseases was 1.00 (95% CI 0.84-1.19) as compared with BCG-unvaccinated children.
Our results do not support the hypothesis that neonatal BCG vaccination reduces morbidity in children caused by infectious diseases other than TB.
Notes
CommentIn: Int J Epidemiol. 2016 Dec 1;45(6):2131-2133 PMID 27856606
PubMed ID
28338723 View in PubMed
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Tracing Mycobacterium tuberculosis transmission by whole genome sequencing in a high incidence setting: a retrospective population-based study in East Greenland.

https://arctichealth.org/en/permalink/ahliterature292531
Source
Sci Rep. 2016 09 12; 6:33180
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-12-2016
Author
K Bjorn-Mortensen
B Soborg
A Koch
K Ladefoged
M Merker
T Lillebaek
A B Andersen
S Niemann
T A Kohl
Author Affiliation
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Source
Sci Rep. 2016 09 12; 6:33180
Date
09-12-2016
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Child
Female
Genotype
Greenland - epidemiology
Humans
Incidence
Male
Molecular Typing
Mycobacterium tuberculosis - genetics
Retrospective Studies
Tuberculosis, Pulmonary - epidemiology - microbiology - transmission
Whole Genome Sequencing
Young Adult
Abstract
In East Greenland, a dramatic increase of tuberculosis (TB) incidence has been observed in recent years. Classical genotyping suggests a genetically similar Mycobacterium tuberculosis (Mtb) strain population as cause, however, precise transmission patterns are unclear. We performed whole genome sequencing (WGS) of Mtb isolates from 98% of culture-positive TB cases through 21?years (n?=?182) which revealed four genomic clusters of the Euro-American lineage (mainly sub-lineage 4.8 (n?=?134)). The time to the most recent common ancestor of lineage 4.8 strains was found to be 100?years. This sub-lineage further diversified in the 1970s, and massively expanded in the 1990s, a period of lowered TB awareness in Greenland. Despite the low genetic strain diversity, WGS data revealed several recent short-term transmission events in line with the increasing incidence in the region. Thus, the isolated setting and the uniformity of circulating Mtb strains indicated that the majority of East Greenlandic TB cases originated from one or few strains introduced within the last century. Thereby, the study shows the consequences of even short interruptions in TB control efforts in previously TB high incidence areas and demonstrates the potential role of WGS in detecting ongoing micro epidemics, thus guiding public health efforts in the future.
Notes
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PubMed ID
27615360 View in PubMed
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