Tuberculosis

Tuberculosis is a term that encompasses various diseases caused by bacteria of the Mycobacterium tuberculosis complex, including M tuberculosis, M bovis, M africanum, and other mycobacterial species. Whereas M tuberculosis infection is largely spread from human to human, M bovis infection has been identified as a zoonotic disease with most cases of human infection attributable to animal sources. The mycobacteria other than tuberculosis complex (MOTT), which includes M avium subsp avium and M avium subsp intracellulare isolated from animals, has been isolated from immune-compromised humans (ie, those with human immunodeficiency virus [HIV] infection), but seldom from immunocompetent humans. Recently, there has been increased interest among public health officials in drug-resistant strains of M tuberculosis, M bovis, and M avium because several have been isolated from HIV-infected and nonimmuno-compromised humans.

VS - Bovine Tuberculosis (Mycobacterium bovis) Surveillance Standards 11/2001

Bovine tuberculosis (TB) is an infectious and communicable granulomatous disease caused by the acidfast bacilli bacteria of Mycobacterium bovis (M. bovis). It is commonly a chronic, debilitating disease, but occasionally may assume an acute, rapidly progressive course. M. bovisis a widespread zoonosis that is global in magnitude and affects nearly all species of vertebrates (cattle, sheep, goats, pigs, bison, buffalo, and camelids.) Disease is spread by direct contact, inhalation of infected droplets expelled from infected lungs, and ingestion of contaminated feed or milk. In most countries, TB is a notifiable disease. Overall, TB has an important world-wide impact on animal industries and human health. Control measures are based on prevention and eradication. Surveillance is a key element for management of preventions and control programs. Surveillance for TB serves the purpose of enabling Veterinary Services to obtain an accurate picture of the scope of the disease in the US livestock populations; in the event of a disease outbreak, the course TB follows in livestock and wildlife populations for a given area over time; and permits timely intervention if the trend observed deviates from what is expected.

Efficacy of Oral and Parenteral Routes of Mycobacterium bovis Bacille Calmette-Guerin Vaccination Against Experimental Bovine Tuberculosis in White-Tailed Deer (Odocoileus virginianus): A Feasibility Study

We investigated the efficacy of oral and parenteral Mycobacterium bovis bacille Calmette-Guerin Danish strain 1331 (BCG) in its ability to protect white-tailed deer (Odocoileus virginianus) against disease caused by M. bovis infection. Twenty-two white-tailed deer were divided into four groups. One group (n=5) received 109 colony-forming units (cfu) BCG via a lipid-formulated oral bait; one group (n=5) received 109 cfu BCG in culture directly to the oropharynx, one group (n=6) was vaccinated with 106 cfu BCG subcutaneously, and one group served as a control and received culture media directly to the oropharynx (n=6). All animals were challenged 3 mo after vaccination. Five months postchallenge the animals were examined for lesions. Results indicate that both oral forms of BCG and parenterally administerd BCG offered significant protection against M. bovis challenge as compared to controls. This study suggests that oral BCG vaccination may be a feasible means of controlling bovine tuberculosis in wild white-tailed deer populations.

Humoral Immune Responses of White-Tailed Deer (Odocoileus virginianus) to Mycobacterium bovis BCG Vaccination and Experimental Challenge with M. bovis

Monitoring of the kinetics of production of serum antibodies to multiple mycobacterial antigens can be useful as a diagnostic tool for the detection of Mycobacterium bovis infection as well as for the characterization of disease progression and the efficacy of intervention strategies in several species. The humoral immune responses to multiple M. bovis antigens by white-tailed deer vaccinated with BCG orally via a lipid-formulated bait (n = 5), orally in liquid form (n = 5), and subcutaneously (n = 6) were evaluated over time after vaccination and after experimental challenge with virulent M. bovis and were compared to the responses by unvaccinated deer (n = 6). Antibody responses were evaluated by using a rapid test (RT), a multiantigen print immunoassay (MAPIA), a lipoarabinomannan enzyme-linked immunosorbent assay (LAM-ELISA), and immunoblotting to whole-cell sonicate and recombinant antigen MPB83. MAPIA and RT detected minimal to no antibody responses over those at the baseline to multiple M. bovis antigens in vaccinated white-tailed deer after challenge. This was in contrast to the presence of more readily detectable antibody responses in nonvaccinated deer with more advanced disease. The LAM-ELISA results indicated an overall decrease in the level of production of detectable antibodies against lipoarabinomannan-enriched mycobacterial antigen in vaccinated animals compared to that in nonvaccinated animals after challenge. Immunoblot data were inconsistent but did suggest the occurrence of unique antibody responses by certain vaccinated groups to Ag85 and HSP70. These findings support further research toward the improvement and potential use of antibody-based assays, such as MAPIA, RT, and LAM-ELISA, as tools for the antemortem assessment of disease progression in white-tailed deer in both experimental and field vaccine trials.

Wildlife Tuberculosis in South African Conservation Areas: Implications and Challenges

Tuberculosis, caused by Mycobacterium bovis, was first diagnosed in African buffalo in South Africa’s Kruger National Park in 1990. Over the past 15 years the disease has spread northwards leaving only the most northern buffalo herds unaffected. Evidence suggests that 10 other small and large mammalian species, including large predators, are spillover hosts. Wildlife tuberculosis has also been diagnosed in several adjacent private game reserves and in the Hluhluwe-iMfolozi Park, the third largest game reserve in South Africa. The tuberculosis epidemic has a number of implications, for which the full effect of some might only be seen in the long-term. Potential negative long-term effects on the population dynamics of certain social animal species and the direct threat for the survival of endangered species pose particular problems for wildlife conservationists. On the other hand, the risk of spillover infection to neighboring communal cattle raises concerns about human health at the wildlife–livestock–human interface, not only along the western boundary of Kruger National Park, but also with regards to the joint development of the Greater Limpopo Transfrontier Conservation Area with Zimbabwe and Mozambique. From an economic point of view, wildlife tuberculosis has resulted in national and international trade restrictions for affected species. The lack of diagnostic tools for most species and the absence of an effective vaccine make it currently impossible to contain and control this disease within an infected free-ranging ecosystem. Veterinary researchers and policy-makers have recognized the need to intensify research on this disease and the need to develop tools for control, initially targeting buffalo and lion.

Animal-side serologic assay for rapid detection of Mycobacterium Bovis infection in multiple species of free-ranging wildlife

Numerous species of mammals are susceptible to Mycobacterium bovis, the causative agent of bovine tuberculosis (TB). Several wildlife hosts have emerged as reservoirs of M. bovis infection for domestic livestock in different countries. In the present study, blood samples were collected from Eurasian badgers (n = 1532), white-tailed deer (n = 463), brushtail possums (n = 129), and wild boar (n = 177) for evaluation of antibody responses to M. bovis infection by a lateral-flow rapid test (RT) and multiantigen print immunoassay (MAPIA). Magnitude of the antibody responses and antigen recognition patterns varied among the animals as determined by MAPIA; however, MPB83 was the most commonly recognized antigen for each host studied. Other seroreactive antigens included ESAT-6, CFP10, and MPB70. The agreement of the RT with culture results varied from 74% for possums to 81% for badgers to 90% for wild boar to 97% for white-tailed deer. Small numbers of wild boar and deer exposed to M. avium infection or paratuberculosis, respectively, did not cross-react in the RT, supporting the high specificity of the assay. In deer, whole blood samples reacted similarly to corresponding serum specimens (97% concordance), demonstrating the potential for field application. As previously demonstrated for badgers and deer, antibody responses to M. bovis infection in wild boar were positively associated with advanced disease. Together, these findings suggest that a rapid TB assay such as the RT may provide a useful screening tool for certain wildlife species that may be implicated in the maintenance and transmission of M. bovis infection to domestic livestock.

Reducing the Public Health Impact of Bovine Tuberculosis by Controlling Disease Transmission Between Cattle and White-Tailed Deer in Northwestern Minnesota

Bovine tuberculosis, caused by infection with Mycobacterium bovis, is a re-emerging zoonotic disease. It has staged a comeback by establishing infections in wildlife and cattle, creating the potential for human disease in locations where it was thought to be under control. In northwestern Minnesota, infected cattle and white-tailed deer were first discovered in 2005. A major bovine tuberculosis eradication campaign is underway in the state, with multiple efforts employed to control M. bovis infection in both cattle and deer populations. In order to effectively eradicate bovine tuberculosis in Minnesota, there is a need for better understanding of the factors that increase the risk of deer and cattle interacting in a way that facilitates tuberculosis transmission. By reducing the risk of disease transmission within the animal populations, we will also reduce the risk that bovine tuberculosis will again become a common disease in human populations. The purpose of this study is to characterize the risk of interactions between cattle and white-tailed deer in northern Minnesota in order to prevent M. bovis transmission. A survey originally developed to assess deer-cattle interactions in Michigan was modified for use in Minnesota, introducing a scoring method to evaluate the areas of highest priority at risk of potential deer-cattle interaction. The resulting semi-quantitative deer-cattle interaction risk assessment was used at 53 cattle herds located in the region adjacent to the bovine tuberculosis “Core Area”. Two evaluators each scored the farm separately, and then created a management plan for the farm that prioritized the areas of greatest risk for deer-cattle interactions. Herds located within the “Management Zone” were evaluated by Minnesota Board of Animal Health staff, and results from these surveys were used as a point of comparison.

Estimating the extent of spatial association of Mycobacterium bovis infection in badgers in Ireland

Mycobacterium bovis infects the wildlife species badgers Meles meles who are linked with the spread of the associated disease tuberculosis (TB) in cattle. Control of livestock infections depends in part on the spatial and social structure of the wildlife host. Here we describe spatial association of M. bovis infection in a badger population using data from the first year of the Four Area Project in Ireland. Using second-order intensity functions, we show there is strong evidence of clustering of TB cases in each the four areas, i.e. a global tendency for infected cases to occur near other infected cases. Using estimated intensity functions, we identify locations where particular strains of TB cluster. Generalized linear geostatistical models are used to assess the practical range at which spatial correlation occurs and is found to exceed 6 in all areas. The study is of relevance concerning the scale of localized badger culling in the control of the disease in cattle.

Environmental and Farm Management Factors Associated with Tuberculosis on Cattle Farms in Northeastern Michigan

Objective—To identify major environmental and farm management factors associated with the occurrence of tuberculosis (TB) on cattle farms in northeastern Michigan. Design—Case-control study. Sample Population—17 cattle farms with infected cattle and 51 control farms. Procedure—Each case farm (laboratory confirmed diagnosis of Mycobacterium bovis infection) was matched with 2 to 4 control farms (negative whole-herd test results within previous 12 months) on the basis of type of farm (dairy or beef) and location. Cattle farm data were collected from in-person interviews and mailed questionnaires. Wildlife TB data were gathered through state wildlife surveillance. Environmental data were gathered from a satellite image-based geographic information system. Multivariable conditional logistic regression for matched analysis was performed. Results—Major factors associated with increased farm risk of TB were higher TB prevalence among wild deer and cattle farms in the area, herd size, and ponds or creeks in cattle housing areas. Factors associated with reduced farm risk of TB were greater amounts of natural open lands in the surrounding area and reducing deer access to cattle housing areas by housing cattle in barns, barnyards, or feedlots and use of electrified wire or barbed wire for livestock fencing. Conclusions and Clinical Relevance—Results suggest that certain environmental and management factors may be associated with risk of TB on cattle farms.

Hidden Effects of Chronic Tuberculosis in African Buffalo

Infectious diseases can bring about population declines and local host extinctions, contributing significantly to the global biodiversity crisis. Nonetheless, studies measuring population-level effects of pathogens in wild host populations are rare, and taxonomically biased toward avian hosts and macroparasitic infections. We investigated the effects of bovine tuberculosis (bTB), caused by the bacterial pathogen Mycobacterium bovis, on African buffalo (Syncerus caffer) at Hluhluwe-iMfolozi Park, South Africa. We tested 1180 buffalo for bTB infection between May 2000 and November 2001. Most infections were mild, confirming the chronic nature of the disease in buffalo. However, our data indicate that bTB affects both adult survival and fecundity. Using an age-structured population model, we demonstrate that the pathogen can reduce population growth rate drastically; yet its effects appear difficult to detect at the population level: bTB causes no conspicuous mass mortalities or fast population declines, nor does it alter host-population age structure significantly. Our models suggest that this syndrome—low detectability coupled with severe impacts on population growth rate and, therefore, resilience—may be characteristic of chronic diseases in large mammals.

Wildlife-Cattle Interactions in Northern Michigan: Implications for the Transmission of Bovine Tuberculosis

Bovine tuberculosis (Mycobacterium bovis) was discovered in northern Michigan white-tailed deer (Odocoileus virginianus) in 1994, and has been known to exist in Michigan cattle herds since 1998. Despite efforts to eradicate the disease in cattle, infection and re-infection of farms continues to occur, suggesting transmission among cattle, deer, or other wildlife reservoirs. The goals of this study were to document wildlife activity on farms and evaluate the possible role wildlife play in the ecology of bovine tuberculosis (TB) in Michigan. Visual observations were conducted on farms in a 5-county area of northern Michigan to document direct wildlife-cattle interactions (i.e., <5 m between individuals) and indirect interactions (e.g., wildlife visitations to food stores and areas accessible to cattle). Observations were conducted primarily during evening and early morning hours between January and August, 2002, and on a 24-hour schedule between January and August, 2003. Total observation time accumulated through the duration of the study was 1,780 hours. Results indicated that direct interaction between deer and cattle was a rare event; no direct interactions were observed during the first year, and only one direct interaction was observed during the second year. However, through the duration of the study 21 direct interactions were documented between cattle and turkey, and 11 direct interactions were documented between cattle and mammals other than deer. In total, 273 indirect interactions by deer, 112 indirect interactions by turkeys, and 248 indirect interactions by mammals other than deer were observed during the 2 field seasons combined. These data supported the hypothesis that indirect interactions among wildlife and cattle are a potential mechanism for the transmission of TB in Michigan. If direct interactions were important mechanisms of TB transmission to cattle in northern Michigan, my data suggested that feral cats were the species of most concern, even though there were more observations between turkey and cattle. Unlike cats, which can become infected with and transmit TB, there is no evidence for such pathogenesis in turkey.

Naturally Occurring Tuberculosis in White-Tailed Deer

Objective—To determine the distribution of lesions and extent of tissues infected with Mycobacterium bovis in a captive population of white-tailed deer. Design—Cross-sectional study. Animals—116 captive white-tailed deer. Procedure—Deer were euthanatized, and postmortem examinations were performed. Tissues with gross lesions suggestive of tuberculosis were collected for microscopic analysis and bacteriologic culture. Tissues from the head, thorax, and abdomen of deer with no gross lesions were pooled for bacteriologic culture. Tonsillar, nasal, oral, and rectal swab specimens, fecal samples, and samples of hay and pelleted feed, soil around feeding sites, and water from 2 natural ponds were collected for bacteriologic culture. Results—Mycobacterium bovis was isolated from 14 of 116 (12%) deer; however, only 9 of 14 had lesions consistent with tuberculosis. Most commonly affected tissues included the medial retropharyngeal lymph node and lung. Five of 14 tuberculous deer had no gross lesions; however,M bovis was isolated from pooled tissue specimens from the heads of each of these deer. Bacteriologic culture of tonsillar swab specimens from 2 of the infected deer yielded M bovis. Mean (± SEM) age of tuberculous deer was 2.5 ± 0.3 years (range, 0.5 to 6 years). Mycobacterium bovis was not isolated from feed, soil, water, or fecal samples. Conclusions and Clinical Relevance—Examination of hunter-killed white-tailed deer for tuberculosis commonly includes only the lymph nodes of the head. Results of such examinations may underestimate disease prevalence by as much as 57%. Such discrepancy should be considered when estimating disease prevalence.

Development of a Model of Natural Infection with Mycobacterium bovis in White-Tailed Deer

The objective of this study was to develop a suitable experimental model of natural Mycobacterium bovis infection in white-tailed deer (Odocoileus virginianus), describe the distribution and character of tuberculous lesions, and to examine possible routes of disease transmission. In October 1997, 10 mature female white-tailed deer were inoculated by intratonsilar instillation of 2 3 103 (low dose) or 2 3 105 (high dose) colony forming units (CFU) of M. bovis. In January 1998, deer were euthanatized, examined, and tissues were collected 84 to 87 days post inoculation. Possible routes of disease transmission were evaluated by culture of nasal, oral, tonsilar, and rectal swabs at various times during the study. Gross and microscopic lesions consistent with tuberculosis were most commonly seen in medial retropharyngeal lymph nodes and lung in both dosage groups. Other tissues containing tuberculous lesions included tonsil, trachea, liver, and kidney as well as lateral retropharyngeal, mandibular, parotid, tracheobronchial, mediastinal, hepatic, mesenteric, superficial cervical, and iliac lymph nodes. Mycobacterium bovis was isolated from tonsilar swabs from 8 of 9 deer from both dosage groups at least once 14 to 87 days after inoculation. Mycobacterium bovis was isolated from oral swabs 63 and 80 days after inoculation from one of three deer in the low dose group and none of four deer in the high dose group. Similarly, M. bovis was isolated from nasal swabs 80 and 85 days after inoculation in one of three deer from the low dose group and 63 and 80 days after inoculation from two of four deer in the high dose group. Intratonsilar inoculation with M. bovis results in lesions similar to those seen in naturally infected white-tailed deer; therefore, it represents a suitable model of natural infection. These results also indicate that M. bovis persists in tonsilar crypts for prolonged periods and can be shed in saliva and nasal secretions. These infected fluids represent a likely route of disease transmission to other animals or humans.

Evaluation of Blood Assays for Detection of Mycobacterium bovis in White-Tailed Deer (Odocoileus virginianus) in Michigan

Surveillance and control activities related to bovine tuberculosis (TB) in free-ranging, Michigan white-tailed deer (Odocoileus virginianus) have been underway for over a decade, with significant progress. However, foci of higher TB prevalence on private lands and limited agency ability to eliminate them using broad control strategies have led to development and trial of new control strategies, such as live trapping, testing, and culling or release. Such strategies require a prompt, accurate live animal test, which has thus far been lacking. We report here the ability of seven candidate blood assays to determine the TB infection status of Michigan deer. Our aims were twofold: to characterize the accuracy of the tests using field-collected samples and to evaluate the feasibility of the tests for use in a test-and-cull strategy. Samples were collected from 760 deer obtained via five different surveys conducted between 2004 and 2007. Blood samples were subjected to one or more of the candidate blood assays and evaluated against the results of mycobacterial culture of the cranial lymph nodes. Sensitivities of the tests ranged from 46% to 68%, whereas specificities and negative predictive values were all .92%. Positive predictive values were highly variable. An exploratory analysis of associations among several host and sampling-related factors and the agreement between blood assay and culture results suggested these assays were minimally affected. This study demonstrated the capabilities and limitations of several available blood tests for Mycobacterium bovis on specimens obtained through a variety of field surveillance methods. Although these blood assays cannot replace mass culling, information on their performance may prove useful as wildlife disease managers develop innovative methods of detecting infected animals where mass culling is publicly unacceptable and cannot be used as a control strategy.

Shared Feed as a Means of Deer-to-Deer Transmission of Mycobacterium bovis

To determine the ability of experimentally inoculated white-tailed deer (Odocoileus virginianus) to transmit Mycobacterium bovis to naive deer through the sharing of feed, four deer were intratonsillarly inoculated with 4x105 colony-forming units of M. bovis. On a daily basis, feed not consumed by inoculated deer after approximately 8 hr was offered to four naıve deer maintained in a separate pen, where direct contact, aerosol transmission, or transmission through personnel were prevented. After 150 days, naıve deer were euthanized and examined. All naıve deer had lesions consistent with tuberculosis and M. bovis was isolated from various tissues. The most commonly affected tissues were lung, tracheobronchial lymph nodes, and mediastinal lymph nodes. This study demonstrates the potential for indirect transmission of M. bovis through the sharing of feed. Intentional or unintentional feeding of deer by wildlife or agricultural interests in regions where M. bovis infection is endemic should be avoided because both direct and indirect transmission through sharing of feed are enhanced.