Elephant-to-Human Transmission of Tuberculosis, 2009

In 2009, the Tennessee Department of Health received reports of 5 tuberculin skin test (TST) conversions among employees of an elephant refuge and isolation of Mycobacterium tuberculosis from a resident elephant. To determine the extent of the outbreak and identify risk factors for TST conversion, we conducted a cohort study and onsite assessment. Risk for conversion was increased for elephant caregivers and administrative employees working in the barn housing the M. tuberculosis–infected elephant or in offices connected to the barn (risk ratio 20.3, 95% confidence interval 2.8–146.7). Indirect exposure to aerosolized M. tuberculosis and delayed or inadequate infection control practices likely contributed to transmission. The following factors are needed to reduce risk for M. tuberculosis transmission in the captive elephant industry: increased knowledge about M. tuberculosis infection in elephants, improved infection control practices, and specific occupational health programs

Black race, sex, and extrapulmonary tuberculosis risk: an observational study

Abstract Background Extrapulmonary tuberculosis is likely a marker of underlying immune compromise. Our objective was to determine race and sex differences in extrapulmonary tuberculosis risk in order to identify the optimal population in which to assess for host factors associated with extrapulmonary tuberculosis. Methods We performed an observational study of all tuberculosis cases reported to the Tennessee Department of Health, January 1, 2000 to December 31, 2006. We compared the incidence of extrapulmonary tuberculosis by race and sex. We also examined risk factors associated with extrapulmonary disease among all persons with tuberculosis. Results Extrapulmonary tuberculosis incidence per 100,000 population was 5.93 in black men, 3.21 in black women, 1.01 in non-black men, and 0.58 in non-black women. Among those with tuberculosis, black women were most likely to have extrapulmonary disease (38.6%), followed by black men (28.1%), non-black women (24.6%) and non-black men (21.1%). In multivariate logistic regression among persons with tuberculosis, black women (OR 1.82 (95% CI 1.24-2.65), p = 0.002), black men (OR 1.54 (95% CI 1.13-2.09, p = 0.006), foreign birth (OR 1.55 (95% CI 1.12-2.14), p = 0.009), and HIV infection (OR 1.45 (95% CI 0.99-2.11), p = 0.06) were associated with extrapulmonary tuberculosis. Conclusions Black men and black women had the highest incidence of extrapulmonary tuberculosis, and high odds of extrapulmonary disease among persons with tuberculosis. These data suggest that factors in addition to tuberculosis exposure contribute to extrapulmonary tuberculosis risk in blacks.</p

Local actors in global politics

Globalization and the new information and communication technologies(ICTs) have enabled a variety of local political actors to enter inter-national arenas once exclusive to national states. Multiple types of claim-making and oppositional politics articulate these developments. Going global has been partly facilitated and conditioned by the infrastructure of the global economy, even as the latter is often the object of those oppositional politics. Further, and in my analysis, very importantly, the possibility of global imag-inaries has enabled even those who are geographically immobile to become part of global politics. NGOs and indigenous peoples, immigrants and refugees who become subjects of adjudication in human rights decisions, human rights and environmental activists, and many others are increasingly becoming actors in global politics. That is to say, non-state actors can enter and gain visibility in inter-national fora or global politics as individuals and as collectivities, emerging from the invisibility of aggregate membership in a nation-state exclusively represented by the sovereign. One way of interpreting this is in terms of a

Sidney, Religious Syncretism, and Henry VIII

This article was published in Studia Neophilologia