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Detection, survival and infectious potential of Mycobacterium tuberculosis in the environment: a review of the evidence and epidemiological implications.

Abstract
Much remains unknown about Mycobacterium tuberculosis transmission. Seminal experimental studies from the 1950s demonstrated that airborne expulsion of droplet nuclei from an infectious tuberculosis (TB) patient is the primary route of transmission. However, these findings did not rule out other routes of M. tuberculosis transmission. We reviewed historical scientific evidence from the late 19th/early 20th century and contemporary studies investigating the presence, persistence and infectiousness of environmental M. tuberculosis We found both experimental and epidemiological evidence supporting the presence and viability of M. tuberculosis in multiple natural and built environments for months to years, presumably following contamination by a human source. Furthermore, several studies confirm M. tuberculosis viability and virulence in the environment using guinea pig and mouse models. Most of this evidence was historical; however, several recent studies have reported consistent findings of M. tuberculosis detection and viability in the environment using modern methods. Whether M. tuberculosis in environments represents an infectious threat to humans requires further investigation; this may represent an untapped source of data with which to further understand M. tuberculosis transmission. We discuss potential opportunities for harnessing these data to generate new insights into TB transmission in congregate settings.
AuthorsLeonardo Martinez, Renu Verma, Julio Croda, C Robert Horsburgh Jr, Katharine S Walter, Nicholas Degner, Keren Middelkoop, Anastasia Koch, Sabine Hermans, Digby F Warner, Robin Wood, Frank Cobelens, Jason R Andrews
JournalThe European respiratory journal (Eur Respir J) Vol. 53 Issue 6 (06 2019) ISSN: 1399-3003 [Electronic] England
PMID31048345 (Publication Type: Historical Article, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
CopyrightCopyright ©ERS 2019.
Chemical References
  • Aerosols
  • Dust
Topics
  • Aerosols
  • Animals
  • Cough (microbiology)
  • Disease Models, Animal
  • Dust
  • Guinea Pigs
  • History, 19th Century
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Mice
  • Mycobacterium tuberculosis (isolation & purification)
  • Research (trends)
  • Sputum (microbiology)
  • Tuberculosis, Pulmonary (history, transmission)

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