Tuberculosis can be found in the lungs, but it can also be spread to the bones and cause damage.
Tuberculosis has been found to cause damage to the spine in ancient Egyptian mummies. Less than 2% of Tuberculosis cases in the United States involve Pott's Disease.
There was an outbreak of Tuberculosis in North Carolina in the late-2000s. The person who was at the center of the outbreak was from Vietnam.
There was a disease in the workplace. Four of the six people with Tuberculosis were able to reach the bones.
"That's more than two percent, that's right," says an infectious disease doctor.
The chance of this happening was very high.
"I am an epidemiologist and clinical trial specialist and I was left scratching my head."
A chance meeting with Duke University geneticist David Tobin revealed an opportunity for the scientific puzzle to be solved.
Some samples were taken from people who were affected by the Tuberculosis epidemic.
The immune cells that protect the body from diseases are invaded by the bacterium that causes Tuberculosis. Some types of Tuberculosis are more mobile in the human body than other types of Tuberculosis.
The researchers compared the genetic sequence of the strain that caused the North Carolina outbreak with other strains of the disease.
The outbreak was caused by one of the earliest strains of the disease.
The strain that is responsible for a large burden of disease is restricted to countries that border the indian ocean.
The EsxM variant is present in full in the North Carolina outbreak strain, but truncated in the modern strains.
A previous study from the UK of over 1,600 people suggested that lineage 1 was associated with higher rates of skeletons than the modern ones.
In order to confirm that the full-length EsxM variant was necessary and sufficient to cause the macrophages to travel further, the researchers examined how far the macrophages traveled.
There was a group of zebrafish that had been exposed to a different strain of Tuberculosis. Those with the full-length EsxM variant had travel distances that were two-fold shorter.
The researchers showed that the mobility gene speeded up the movement to the site of the tail fin wound.
The silenced EsxM gene was found in all modern strains, as well as 3,224 other strains. This shows that the mutations has an advantage.
The team suspects that the Mutation has allowed modern Tuberculosis strains to spread more widely by staying in the lungs and giving it more concentrated air dispersal abilities.
The paper was published in a journal.
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