Solid Organ Transplant–Transmitted Tuberculosis Linked to a Community Outbreak — California, 2015

Alexander Kay, MD; Pennan M. Barry, MD; Pallavi Annambhotla, DrPH; Carol Greene; Martin Cilnis, MS, MPH; Peter Chin-Hong, MD; Nicholas Arger, MD; Louise McNitt, MD; Nikole Neidlinger, MD; Neha Shah, MD; Sridhar V. Basavaraju, MD; Matthew Kuehnert, MD; Tambi Shaw, MPH


Morbidity and Mortality Weekly Report. 2017;66(30):801-805. 

In This Article

Abstract and Introduction


In the spring of 2015, a local health department (LHD) in county A notified the California Department of Public Health (CDPH) about three adults with close ties to one another and a congregate community site who had received diagnoses of tuberculosis (TB) disease within a 3-month period. Subsequent review revealed matching TB genotypes indicating that the cases were likely part of a chain of TB transmission. Only three TB cases in California in the preceding 2 years shared this same genotype. One of those three previous cases occurred in a lung-transplant recipient who had no identified epidemiologic links to the outbreak. CDPH, multiple LHDs, and CDC conducted an investigation and determined that the lung-transplant donor (patient 1) was epidemiologically linked to the three outbreak cases and had a tuberculin skin test (TST) conversion detected in 2012 upon reentry at a local jail. Three other solid organ recipients from this donor were identified; none had developed TB disease. This investigation suggests that review of organ donors' medical records from high-risk environments, such as jails, might reveal additional information about TB risk. The evaluation of TB in organ recipients could include genotyping analysis[1] and coordination among local, state, and national partners to evaluate the potential for donor-derived TB.