Comments by David Alland, Montefiore Medical Center, Albert Einstein College of Medicine, Yeshiva University, New York; and Peter Small, Stanford University School of Medicine
These two independent studies describe the changing epidemiology of tuberculosis (TB) transmission in New York City and San Francisco. Both combined standard epidemiological techniques with DNA fingerprinting- specifically restriction-fragment-length polymorphism (RFLP) analysis-to better understand the recent upsurge in tuberculosis cases in both cities.
EAST-COAST EVIDENCE: In New York, half of the recent TB transmissions were also drug-resistant strains, says David Alland.
The San Francisco study also found a high incidence of recent transmission, but few drug-resistant strains, say Alland and Peter M. Small, an assistant professor in the division of infectious diseases and geographic medicine at the Stanford University School of Medicine. "In San Francisco, it was a more puzzling situation because about 97 percent of our cases completed therapy within a year and yet our ...
