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Editorials |

Who Dunnit? : The Changing Face of Tuberculosis Control Utilizing Restriction Fragment Length Polymorphism

Michael Lauzardo, MD; Elena S. Hollender, MD; Masahiro Narita, MD; David Ashkin, MD, FCCP
Author and Funding Information

Affiliations: Lantana, FL 
 ,  Drs. Lauzardo, Hollender, Narita, and Ashkin are from A. G. Holley State Tuberculosis Hospital, the Florida Department of Health. In addition, Drs. Ashkin and Narita are Clinical Assistant Professors, Division of Pulmonary and Critical Care Medicine, University of Miami School of Medicine, and Dr. Lauzardo is an Adjunct Instructor, Division of Pulmonary and Critical Care Medicine, University of Florida School of Medicine.

Correspondence to: David Ashkin, MD, FCCP, A. G. Holley State Hospital, 1199 W Lantana Rd, Lantana, FL 33462; e-mail: David_Ashkin@doh.state.fl.us



Chest. 2001;120(6):1765-1768. doi:10.1378/chest.120.6.1765
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For some, there is nothing more thrilling than watching an old black-and-white movie in which the object of the film is to solve the mystery. In these movies, people faced with a dilemma pounded the pavement, often until the soles of their shoes revealed holes, searching for the answers to their quandary. For those who do the detective work of tuberculosis (TB) control, this scenario seems very familiar.

Traditional “shoe leather” TB contact investigations consist of interviewing individuals with TB and finding out with whom they have been in contact or what places they have visited. This practice has been the cornerstone of contact investigations for > 40 years and has remained a priority of TB control. Recent reports, however, have suggested that this cornerstone may have cracks, as was suggested by a study by Small et al1 from San Francisco. In their study, it was found that traditional contact investigations only identified 10% of individuals who, later, were linked by molecular analysis. As was apparent in the old movies, the sleuth was only as good as his magnifying glass, and sometimes new tools were necessary.

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