Exploiting tuberculosis 'superspreading niches' to curb transmission by Boston University School of Medicine has been reviewed. The study, published in The Lancet Infectious Diseases, examines both historical and contemporary evidence for M. tuberculosis superspreading. It argues that understanding these superspreading niches could lead to innovative prevention strategies.
The concept of superspreading became familiar during the COVID-19 pandemic, where some individuals were found to transmit infections to an unusually large number of others. Similarly, studies on tuberculosis (TB) have identified certain individuals who are more highly infectious and cause many more secondary infections among their contacts. However, most individuals with TB cause very few secondary infections.
In a new perspective piece, researchers from Boston University and the University of Colorado Anschutz School of Medicine propose that identifying superspreading niche characteristics could allow for targeted interventions to disrupt transmission early between highly infectious source cases and their susceptible contacts. This approach could offer an opportunity for new strategies in the global fight against TB.
Senior author Karen Jacobson, MD, MPH, associate professor of medicine at Boston University, emphasizes that while multiple factors contribute to superspreading, our understanding remains vague. She notes that mathematical modeling studies suggest preventing superspreading can have large impacts on infectious disease epidemics, including TB.
The researchers highlight several reasons why TB may be particularly responsive to superspreading-focused prevention strategies. Unlike directly transmitted respiratory viruses, where infections typically last only days, TB is a more slowly progressive disease, providing a larger window for intervention. Additionally, individuals receiving effective antibiotic therapy become non-infectious within days, and preventive therapy can halt M. tuberculosis superspreading.
Understanding these superspreading niches could lead to interventions that target specific parts of community contact networks where highly infectious individuals intersect with susceptible contacts. This approach has the potential to significantly impact TB transmission by disrupting early stages of infection spread.
While superspreading is a key feature in TB epidemiology, it remains poorly understood and underexplored for prevention strategies. By focusing on identifying these superspreading niches, public health efforts could be more effectively directed towards reducing TB transmission globally.
