Media Releases

Tracking drug-resistant tuberculosis in real-time

June 12, 2013

New Canadian surveillance system monitors tuberculosis and could be used for SARS-like outbreaks

TORONTO, ON – Pro­fes­sor Frances Jamieson at the Uni­ver­si­ty of Toronto’s Depart­ment of Lab­o­ra­to­ry Med­i­cine and Patho­bi­ol­o­gy (LMP), and Med­ical Micro­bi­ol­o­gist, Pub­lic Health Ontario, is lead­ing the way in track­ing poten­tial­ly dead­ly out­breaks of tuber­cu­lo­sis (TB) with a pow­er­ful new Geo­graph­ic Infor­ma­tion Sys­tem (GIS) appli­ca­tion, known as Ontario Uni­ver­sal Typ­ing – Tuber­cu­lo­sis (OUT-TB) Web.

Not just applic­a­ble to TB, this secure web-based sys­tem could be used to mon­i­tor a host of pathogens and dis­eases from E. coli O157:H7 to menin­gi­tis to SARS-like out­breaks across the coun­try. “We can iden­ti­fy and track exist­ing and emerg­ing strains of TB and this pow­er­ful tech­nol­o­gy can be applied to any type of infec­tious dis­ease,” said Prof. Jamieson. “Eighty-five per cent of our TB cas­es in Ontario are for­eign-born, so this sys­tem will allow us to have a glob­al impact.”

This sophis­ti­cat­ed sys­tem com­bines patient data and demo­graph­ics with the geno­type or “fin­ger­print” of each TB strain. It pro­vides health author­i­ties with a unique real-time geo­graph­i­cal view of tuber­cu­lo­sis cas­es and clus­ters and allows them to track poten­tial out­breaks. More specif­i­cal­ly, it can track whether cas­es are linked geno­typ­i­cal­ly, geo­graph­i­cal­ly and epi­demi­o­log­i­cal­ly, and whether a case involves drug-resis­tant strain(s).

Work­ing at the Pub­lic Health Ontario lab­o­ra­to­ry, the largest TB lab­o­ra­to­ry in North Amer­i­ca, Prof. Jamieson rec­og­nized the need for such a sys­tem. “We real­ly are lead­ing the way with OUT-TB. We can com­bine pre-exist­ing patient infor­ma­tion such as loca­tion and oth­er demo­graph­ics with our lab­o­ra­to­ry results. We tell the pub­lic health units what strain type of TB they have, what drug treat­ment is appro­pri­ate and we track whether the strain is drug-resis­tant.”

TB is a glob­al prob­lem and it ranks as the sec­ond lead­ing cause of death from an infec­tious agent world­wide. The World Health Orga­ni­za­tion reports that in 2011, 8.7 mil­lion peo­ple fell ill with the dis­ease and 1.4 mil­lion peo­ple died. While over­all rates have been declin­ing, health author­i­ties are con­cerned about the threat of mul­tidrug-resis­tant tuber­cu­lo­sis (MDR-TB), which is resis­tant to two of the most effec­tive first-line drugs. Even more con­cern­ing is the threat of exten­sive­ly drug-resis­tant tuber­cu­lo­sis (XDR-TB), which is resis­tant to these first-line drugs, at least one of the injectable sec­ond-line drugs and a flu­o­ro­quinolone.

“OUT-TB allows us to under­stand the specifics of a sin­gle case and how it relates to oth­er cas­es in the com­mu­ni­ty, the province and the glob­al move­ment of indi­vid­u­als,” said Prof. Jamieson. OUT-TB will be avail­able to local pub­lic health units as they work with Pub­lic Health Ontario to mon­i­tor, detect and man­age TB in the province. To see a demon­stra­tion of OUT-TB please vis­it our YouTube chan­nel.

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For more infor­ma­tion, please con­tact:

Katie Bab­cock, Web and Com­mu­ni­ca­tions Coor­di­na­tor
The Depart­ment of Lab­o­ra­to­ry Med­i­cine and Patho­bi­ol­o­gy (LMP)
Uni­ver­si­ty of Toron­to
katie.babcock@utoronto.ca
Tel: 416–278-6568
http://www.lmp.utoronto.ca