Epidemiology of Mycobacterium bovis disease in San Diego County, 1994-2000.

SETTING

Local public health department.

OBJECTIVE

To examine the current epidemiology of Mycobacterium bovis disease in San Diego County and to compare patient characteristics to those of patients with M. tuberculosis disease.

DESIGN

Retrospective review of surveillance and epidemiologic data.

RESULTS

Between 1994 and 2000, 1,931 evaluable cases of culture-positive TB were identified; 129 were infected with M. bovis and 1,802 were infected with M. tuberculosis. More than 90% of M. bovis cases occurred in Hispanic persons. About 25% of patients were children, and the main site of disease was extra-pulmonary in 53% of patients. Twenty-three per cent had concurrent HIV infection. Compared to patients with M. tuberculosis, patients with M. bovis were more likely to be Hispanic, aged 0-14 years, have extra-pulmonary disease, or have HIV co-infection in a multivariate model. They were less likely to be born in countries outside of the US or Mexico.

CONCLUSION

While human disease due to M. bovis has essentially been eliminated in many parts of the US and other industrialized countries, it persists in certain demographic groups, including Hispanic children and HIV-infected adults, in San Diego County.