Transmission Network Analysis to Complement Routine Tuberculosis Contact Investigations
McKenzie Andre, MD,
Kashef Ijaz, MD,
Jon D. Tillinghast, MD,
Valdis E. Krebs, MLIR,
Lois A. Diem, BS,
Beverly Metchock, DrPH,
Theresa Crisp, MPH and
Peter D. McElroy, PhD
Kashef Ijaz, Lois A. Diem, and Beverly Metchock are with the Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Ga. At the time of this investigation, McKenzie Andre was with the Epidemic Intelligence Service Program and Peter D. McElroy was with the Division of Tuberculosis Elimination, both at the Centers for Disease Control and Prevention. Valdis E. Krebs is with Orgnet.com, Cleveland, Ohio. Jon D. Tilling-hast and Theresa Crisp are with the Tuberculosis Division, Oklahoma State Department of Health, Oklahoma City.
FIGURE 1——Visualization of the identified links among the first 35 tuberculosis patients during an outbreak investigation in southwest Oklahoma, 2002.
Note. This diagram was compiled using only the existing contact investigation records obtained before or during the Centers for Disease Control and Prevention on-site investigation. Tuberculosis patients are represented by black boxes. Gray lines represent the links between patients. Decreasing thicknesses of gray lines represent the strength of relationship between patients: close, casual, or undetermined, respectively.
FIGURE 2——Visualization of the first 35 tuberculosis (TB) patients and their 1039 contacts, southwest Oklahoma, 2002.
Note. TB patients are represented by black boxes. Contacts are represented by white boxes. Gray lines represent the links between TB patients and contacts. Decreasing thicknesses of gray lines represent the strength of the relationship between patients and type of contacts: close, casual, or undetermined, respectively.
FIGURE 3——Visualization of the first 35 tuberculosis (TB) patients and all contacts in need of clinical evaluation for TB and latent TB infection in southwest Oklahoma, 2002.
Note. Critical contacts with high betweenness and reach centrality metrics are indicated. TB patients are represented by black boxes with 1- or 2-digit numbers. Gray boxes with 4-digit numbers represent unevaluated contacts at the time of CDC investigation. White boxes with 4-digit numbers represent priority contacts. Contacts surrounded by dashed boxes are those with high betweenness. Gray lines represent the links between contacts and patients. Decreasing thicknesses of gray lines represent the strength of the relationship between patients and type of contacts: close, casual, or undetermined, respectively.
