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How Is TB Transmitted
How Is TB Transmitted
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The article discusses the surprising findings by Velayati et al., which identify viable Mycobacterium tuberculosis (M. tuberculosis) in 10% of water samples and 1% of soil samples in metropolitan Tehran. This challenges the traditional understanding that M. tuberculosis, unlike nontuberculous mycobacteria, is strictly transmitted between humans via the respiratory route. The author, Eleanor S. Click, suggests laboratory cross-contamination as a possible explanation, although the lack of matching genotypes between human and environmental isolates and the sources of water cultures other than tap water make this less likely.<br /><br />The article highlights the need for further investigation into the genotyping coverage among human cases to interpret the findings. Additionally, considering that animals can be infected with M. tuberculosis, data on its prevalence in animals in the Tehran region would be useful. The authors also consider the possible contamination of water sources through expectoration, stool, or urine as potential sources of environmental M. tuberculosis.<br /><br />The findings of Velayati et al. indicate that M. tuberculosis could potentially be transmitted via routes other than aerosolized droplet nuclei, warranting a reconsideration of the possible transmission schemes of tuberculosis (TB). This has important public health implications if confirmed in other settings.<br /><br />Additionally, the immunological effects of possible oral exposure to environmental sources of M. tuberculosis, whether related to infection and disease, should be further explored. Dr. Click's correspondence emphasizes the need for a broader perspective on potential TB transmission routes and encourages consideration of the implications of these environmental findings. Responses to the correspondence acknowledge this novel route and suggest it necessitates urgent attention in TB research and public health strategies.
Keywords
Mycobacterium tuberculosis
environmental transmission
Tehran water samples
soil samples
genotyping
public health
cross-contamination
tuberculosis transmission
oral exposure
Velayati et al.
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