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Diversity within individuals

We have explored how genomics can help identify clusters of TB linked by recent transmission (in the school outbreak and in some of the individuals in the midlands cluster) and also how it can help to rule out transmission and by doing so prevent unnecessary contact tracing and investigation (among other individuals who were potentially implicated in the midlands cluster).

We know that people are capable of carrying TB bacteria over long time periods and that TB genomes change slowly over time.

Look again at the diversity plot and in particular at the within-individual diversity both cross-sectional and longitudinal; this can help us to consider how genomics may be useful to better understand the potential for individuals to transmit multiple strains of TB and if this changes over time in a lengthy infection.

You can see that three individuals have isolates that differ by > 400 SNP’s and that there are five cases where isolates are separated by 6 to 11 SNPs.

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