H5N1 Avian Influenza, Kampot Province, Cambodia

transmission between the immigrant and autochthonous population has been frequently detected (8), likely indicating a fairly high degree of social permeability between the 2 groups. The transmission of Beijing MTB from a person born in another country to a person born in Spain reported here seems to follow this trend and raises concern about a potential spread of Beijing MTB to the autochthonous population. The isolate from the other Spanish patient (patient 6) shared the genotype of the strain described earlier in the spread of Beijing genotype in Gran Canaria (9); a Liberian was the first case-patient. The patient from Spain in our report had been imprisoned on that island before her arrival in Madrid. These data suggest another way Beijing genotype can be imported into Spain, which is different from the South American route. In summary, we describe TB patients with Beijing genotype strains in Madrid among patients from South America. This geographic origin differs from the predominant Asian origin reported for TB cases in other European countries caused by the Beijing genotype. Our findings suggest an alternate route of transmission between South America and Europe for the Beijing genotype. Furthermore, the recent occurrence of this genotype in a TB patient from Spain, who shared an RFLP type with a South American patient, suggests further transmission of these strains into the local community. Longitudinal studies should monitor the potential impact and establishment of these strains after their introduction.