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sector_ico_Health_trans Human Health

Microevolution of Mycobacterium tuberculosis in an ongoing outbreak in British Columbia (40 TB Genomes)

  • Project Leaders: Robert Brunham, Fiona Brinkman, Steven Jones
  • Institutions: University of British Columbia (UBC)
  • Budget: $305000
  • Program/Competition: Emerging Issues
  • Genome Centre(s): Genome British Columbia
  • Fiscal Year: 2008
  • Status: Closed

Although one-third of the world’s population is infected with Mycobacterium tuberculosis, the disease garners relatively little investment as it is predominantly a disease of disadvantaged populations. The project was an eminent success, representing a landmark study in the emerging field of “genomic epidemiology” that has attracted significant scientific and media attention after its February 2011 publication in the New England Journal of Medicine (NEJM). This project tracked 41 individuals who developed tuberculosis (TB) in a recent outbreak. The project used ultra-high-throughput sequencing technology to sequence the TB genome to discern subtle genetic differences between different bacterial strains. The project combined an understanding of molecular epidemiology at high genetic resolution, with detailed clinical and epidemiological data in order to identify where the outbreak organism had originated, and how it had moved throughout the community. The project has set a new standard for studying outbreaks of infectious disease by combining advanced genomics with a detailed map of the social relationships between cases. As a result of the project’s novel genomic epidemiology reconstruction of a large TB outbreak, the BCCDC has changed its “contact tracing protocol” in outbreak situations and used the new protocol to successfully perform social network analysis on other difficult to follow outbreaks.