bovine tuberculosis treatment in humansbovine tuberculosis treatment in humans

*Correspondence: Christina Meiring, cmeiring@sun.ac.za, Bovine Tuberculosis International Perspectives on Epidemiology and Management, View all Rieder HL. Our systematic literature search on the occurrence of zoonotic TB provided no data for the WHO region of Southeast Asia, including major cattle producing middle- and low-income countries (e.g., India, Bangladesh, Pakistan, Myanmar, Indonesia) (Technical Appendix 1) (33). French scientist Jean-Antoine Villemin, studying the disease, found evidence that tuberculosis is an infectious disease. Three of 5 studies reporting proportions >10% were conducted in settings with very low incidences of human TB (<20 cases/year on a countrywide level) (27). Learn what mycobacterium bovis is, what it causes, and more - WebMD Houben RM, Dodd PJ. The assumptions used include maximum coverage, no imported infections due to travel and migration, and application of an additional 4% annual decrease. Our own academic department has reached out to schools and communities in multiple activities in 2018 alone. Centers for Disease Control and Prevention. Unfortunately, there is little clear-cut data on whether three or four states apply to the multiple animal hosts of M. bovis, nor clear-data regarding progression between states. Statistical analyses were performed in IC Stata 10.0 (StataCorp LP, College Station, TX, USA). Miller M, Michel A, van Helden P, Buss P. Tuberculosis in Rhinoceros: an underrecognized threat? doi: 10.1136/thoraxjnl-2015-207999, 21. Mycobacterium bovis (M. bovis), the causative agent of bovine tuberculosis (BTB), has perhaps the broadest host range of the pathogenic mycobacteria ( 1 ). Patients are therefore often misdiagnosed and may receive ineffective treatment. The current study was mandated by the World Health Organization (WHO) Foodborne Disease Burden Epidemiology Reference Group with the aim to determine, on the basis of previously published literature, the global occurrence of zoonotic TB and its contribution to the overall TB prevalence in affected settings. A study including data from 41 states of the United States suggested that 90% of all TB cases caused by M. bovis affect persons of Hispanic ethnicity (8). In many countries, the incidence is now low and declining, but control and eradication remain a distant view. For example, in the Hispanic community in the United States, zoonotic TB appeared to be a considerable proportion of all TB cases (Table 3) and was associated with the consumption of unpasteurized cheese from Mexico (812). The reported occurrence of bovine TB in South African domestic bovine herds is far lower (Table 1), although since full testing coverage is not done the actual numbers are likely to be higher. It is often possible to mitigate against these risks for livestock. Although there are some similarities between TB control in humans and animals, such as the need for diagnosis, there are also very different disease management options, such as antibiotic therapy for humans, in comparison to test and slaughter for domestic cattle. Tuberculosis (TB) is a contagious disease of both animals and humans. Transmission of tuberculosis in a high incidence urban community in South Africa. Different scenarios representing different human TB diagnostic approaches which include the sensitivity of the diagnostic tests and corresponding availability of therapy for individuals. Agreement between assays of cell-mediated immunity utilizing Mycobacterium bovis-specific antigens for the diagnosis of tuberculosis in African buffaloes (Syncerus caffer). In regions outside Africa included in this study, overall median proportions of zoonotic TB of 1.4% in connection with overall TB incidence rates 71/100,000 population/year suggested low incidence rates. (2014). Therefore, in veterinary medicine, the approach taken thus far has been wise, i.e., if any test is positive, take action. Although TB does not have a vector, we can argue that a contaminated environment (soil, water) and multiple hosts may act as reservoirs for infection and therefore also need active management. Tuberculosis in Cattle: What You Need to Know - SDSU Extension Bovine TB is a zoonotic disease and can be passed to humans. Percentages of 30% were reported in 4 regionally based studies in Tanzania and Ethiopia (Figure 3, Table 2) (13,17). Join NPINs new social community to connect, share, and collaborate. Naturally, the occurrence of zoonotic TB is greatly dependent on the presence of TB in cattle. The standard treatment for TB in humans is antibiotic therapy (22), which with the exception of animals in captivity is not feasible in animals. About Us Mycobacterium bovis (M. bovis), the causative agent of bovine tuberculosis (BTB), has perhaps the broadest host range of the pathogenic mycobacteria (1). (2014) 160:1338. This perspective will consider some of the critical control steps we now know to be important for the control of TB from M. tuberculosis in humans living in South Africa, where the incidence of TB is the highest currently experienced. To Join the NPIN community Sign In or Join. Information on the global distribution and prevalence of bovine TB is scarce, but available data suggest that TB in cattle is prevalent in virtually all major livestock-producing countries of the developing world and Africa, specifically (2,3,7). x-axis values are median proportions. By far the majority of the human TB diagnostic tests based on GeneXpert, are done at no cost to clients utilizing public clinics, since laboratory-based tests are done by the National Health Laboratory Service (NHLS, funded by the National Department of Health) which has many laboratories scattered in a network across the country (8). Warren RM, Gey van Pittius NC, Barnard M, Hesseling A, Engelke E, de Kock M, et al. We previously considered four possible states: (1) not exposed, (2) exposed and infected, no response detectable, no sign of disease, (3) infected, bacilli present, no active disease (latent TB), (4) infected, active disease. Interventions for Tuberculosis Control and Elimination. This is an important step and often not done in human TB management in higher incidence areas owing to sheer volume of work and resource limitations. (2013). 10. How is the disease transmitted and spread? Data is collected weekly and does not include downloads and attachments. Despite the high incidence of human TB, South Africa has been able to reduce this incidence remarkably in the past few years, despite limited resources and high HIV prevalence. (2004) 33:3517. Claassens M, Schalkwyk C, van Haan L, den Floyd S, Dunbar R, van Helden P, et al. Zoonotic Mycobacterium bovisinduced Tuberculosis in Humans. Zoonotic TB poses special challenges for patient treatment and recovery. (2010) 185:1522. (2012) 19:34651. J Clin Microbiol. Additionally, in the case of Mycobacterium bovis, the spread of bovine tuberculosis (TB) to countries previously free of the disease could cause significant economic losses in cattle and dairy farming. This is a vital activity, which is not generally possible with humans and therefore presents veterinarians with an enormous advantage to prevent ongoing disease transmission. This implies many animal cases and neglect now will mean high future costs. For Mexico, the median percentage of M. bovis cases was 7.6% (range 0%31.6%); proportions >10% were detected in 3 independent studies (2022). Among all studies included from Africa, a median of 2.8% (range 0%37.7%) of all TB cases in humans were caused by M. bovis (Figure 2). Theron G, Peter J, van Zyl-Smit R, Mishra H, Streicher E, Murray S, et al. Uys PW, Warren R, Helden PD, van Murray M, Victor TC. The bacteria can also enter the respiratory system. It also affects other domesticated animals such as sheep, goats, equines, pigs, dogs and cats, and wildlife . Similarly, the prevalence of bovine TB caused by Mycobacterium bovis (M. bovis), varies significantly across regions, although unlike for M. tuberculosis, data are sparse. Therefore, non-lethal diagnostics for animals are needed. For each of these analyses, duplicated data, present in >1 report was removed from the core dataset (Figure 1). Contact Us USDA APHIS | National Tuberculosis Eradication Program Likewise for free-ranging wildlife. No assessment of the global consequences of zoonotic TB has yet been done. Calves and humans can also become infected by ingesting raw milk from infected cows. Vet Med Int. Waters WR, Thacker TC, Nonnecke BJ, Palmer MV, Schiller I, Oesch B, et al. The data were stratified by multiple variables, if possible (e.g., country or province, HIV status). doi: 10.1017/S0950268813000708, 7. le Roex N, Cooper D, van Helden PD, Hoal EG, Jolles AE. Insufficient research has been done to show whether or not this disease will impact species to affect the ecosystem and which species are maintenance or end-stage hosts. With the exception of Europe, data were acquired for only a few countries of the regions represented in this analysis (Technical Appendix 1 Table 1). Treatment typically involves a combination of antibiotics, such as isoniazid, rifampin, and ethambutol, for a period of several months to a year or more. Some of these are discussed further below. Figure 2. . doi: 10.1371/journal.pmed.1002152, 29. Available online at: https://www.cabdirect.org/cabdirect/abstract/20023083276 (Accessed June 18, 2018). 14. doi: 10.3390/su4113124. 4. Looking for a place to discuss TB best practices, resources, and challenges? 23. A list of all identified 1,203 potentially relevant reports and the core dataset is available as supplemental material (. An overview of disease-free buffalo breeding projects with reference to the different systems used in South Africa. TB is a mycobacterial disease that is spread via contact with infected materials. Surveys in San Diego County, California indicated a steady increase in the incidence of TB caused by M. bovis and a decrease in TB incidence caused by M. tuberculosis infection (9,12). Mycobacterium bovis is the causative agent of the disease. However, these cases did not represent cases of zoonotic TB, because transmission occurred from humans to humans. Epidemiologa molecular de las tuberculosis bovina y humana en una zona endmica de Quartaro, Mxico. 9. While a steadily increasing proportion of TB caused by M. bovis was observed in New Zealand, trends were decreasing in Australia (Technical Appendix 2). bTb has been successfully eradicated from many developed countries including, Australia, most EU Member States, Switzerland, Canada and all but a few states in the USA ( de la Rua-Domenech, 2006 ). Similar think tank initiatives could be developed for other settings including bovine TB control to support evidence-based policy development and disease control and lobby for the finances to support such efforts. High prevalence of tuberculosis and insufficient case detection in two communities in the Western Cape, South Africa. Bovine tuberculosis: an old disease but a new threat to Africa. The nature of TB, whether human or animal form, makes eradication in the short term impossible. Global Control of Tuberculosis: Current Status and Future Prospects doi: 10.1093/ije/dyh021, 26. Figure 5. . Each circle represents a study with the circle diameter being proportional to Studies from Austria, Germany, Greece, and Spain included in this analysis identified M. caprae as a causative agent of zoonotic TB in addition to M. bovis (2326). Emerging source of infection - Mycobacterium tuberculosis in rescue Goosen WJ, Cooper D, Warren RM, Miller MA, van Helden PD, Parsons SDC. We draw from our experience to ascertain whether we may learn useful lessons from control efforts for both diseases in order to suggest effective control measures for bovine TB. For 100 randomly selected reports of the 1,203 potentially relevant reports, availability and eligibility was assessed independently by 3 operators. Owners are not compensated for their animals which will result in a reluctance to test animals. 2013 . Bovine Tuberculosis and the Establishment of an Eradication Program in (2017) 21:196201. This observed reduction in incidence is perhaps remarkable because the reduction alone exceeds by far the incidence rate seen in most countries (3). Scanty smears associated with initial loss to follow-up in South African tuberculosis patients. M. bovis . This model suggests that a TB incidence of <1/100,000 will only be achieved about 50 years after implementation of LTBI screening and prophylactic treatment (33). Objective. Emerg Infect Dis. However, there are inadequate numbers of state veterinarians to do regular TB testing, including for dairy herds where compulsory testing every 2 years is required. This body has promoted evidence-based decision-making, and in addition, lobbied successfully for increased funding for TB management (human) in South Africa. Mycobacterium bovis ( M. bovis) is a bacterium belonging to the Mycobacterium tuberculosis group that causes bovine tuberculous disease in humans and animals. When autocomplete results are available use up and down arrows to review and enter to select. Bovine TB has been tested for in Bovidae by skin testing and more recently by in vitro blood-based interferon gamma (IFN-) release assays (IGRA) or other biomarkers (1419). Lastly, our results are influenced by the technical constraints of the studies included. Proportion of zoonotic tuberculosis (TB) among all TB cases stratified by country: A) Eastern Mediterranean; B) Western Pacific. Status of Mycobacterium bovis-derived zoonotic tuberculosis (TB). No use, distribution or reproduction is permitted which does not comply with these terms. It is encouraging that even culling of limited infected animals in a free-ranging wildlife system can reduce prevalence rate (7). However, there is little awareness of bovine TB. Epidemiology of Mycobacterium bovis Disease in Humans, the Netherlands Diagnosis of bovine tuberculosis in animals and humans typically involves laboratory testing, such as skin testing, blood testing, or imaging studies. This should arguably continue to be the case and is probably the reason for the low prevalence of bovine TB in domestic stock in South Africa. Authors W Ray Waters 1 , Mayara F Maggioli 2 Systematic molecular characterization of multidrug-resistant, [Epidemiology of resistance to antituberculosis drugs in, Uniting for Ukraine TB Screening Experience, Pulmonary Nontuberculous Mycobacteria, Canada, http://www.vri.cz/docs/vetmed/52-8-317.pdf, http://whqlibdoc.who.int/hq/1994/WHO_CDS_VPH_94.137.pdf, http://www.redalyc.org/pdf/423/42330303.pdf, Zoonotic Mycobacterium bovisinduced Tuberculosis in Humans, U.S. Department of Health & Human Services, Mller B, Drr S, Alonso S, Hattendorf J, Laisse C, Parsons S, et al. Notably, for the Eastern Mediterranean and the Western Pacific regions, respectively, data from only 2 and 3 countries were obtained. doi: 10.1016/j.prevetmed.2015.04.005. In 1882, Robert Koch declared that the tubercle bacilli from humans and cattle were one and the same, and accordingly, human and bovine . Occurrence of tuberculosis among people exposed to cattle in Bangladesh It results in important economic losses and trade barriers with a major impact on the livelihoods of poor and marginalized communities. Proportion of zoonotic tuberculosis (TB) among all TB cases stratified by country: Europe. The South African tuberculosis care cascade: estimated losses and methodological challenges. Olea-Popelka F, Muwonge A, Perera A, Dean AS, Mumford E, Erlacher-Vindel E, et al. Mycobacterium avium: Affects mostly poultry but can cross-infect cattle. Field application of immunoassays for the detection of Mycobacterium bovis infection in the African buffalo (Syncerus caffer). Figure 4. . The reason for this activity is that even under ideal conditions and with proper adherence, some individuals will experience recurrent disease. In San Diego County, during 19942003 and 20012005, respectively, M. bovis accounted for 25 and 19 deaths, corresponding to 27% and 17% of all TB deaths and a mortality rate of 0.1/100,000 population/year (9,10). In the veterinary field, there is a network of state veterinary services as well as private veterinarians who can deal with bovine TB. In a third hypothetical scenario (scenario C), an Xpert MTB/RIF test is conducted (PoC) where indicated, therapy can be initiated immediately. Individual studies from various regions reported high proportions of zoonotic TB for specific population groups and settings (Figures 36). (2016) 13:e1002152. Most countries have a test and slaughter policy in place for bovine TB in domestic stock (6, 7). Serum-based biomarker research in humans shows promise for a diagnostic, but as yet, although sensitivity is high (94%), specificity (73%) is inadequate for implementation (20). Clin Vaccine Immunol. Int. Risks may be unexpected, especially when the incidences of different zoonotic diseases or antibiotic resistance rates differ significantly . Comment submitted successfully, thank you for your feedback. The lack of large-scale, population-based data did not allow for an identification of specific risk groups associated with M. bovis infections. Bovine TB is caused by a bacterium called Mycobacterium bovis, (M. bovis) which is closely related to the bacterium that causes human and avian tuberculosis. Mycobacterium bovis (M. bovis) is another mycobacterium that can cause TB disease in people. Elephant-to-human transmission of tuberculosis, 2009. Mycobacterium tuberculosis transmission is not related to household genotype in a setting of high endemicity. Zoonotic Mycobacterium bovis -induced Tuberculosis in Humans This practice should always be followed. Bovine Tuberculosis | Cornell Wildlife Health Lab Dr Mller is affiliated with the Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa, and the Swiss Tropical and Public Health Institute, Basel, Switzerland, which is associated with the University of Basel. Bovine Tuberculosis: Causes, Transmission, Signs, Treatment, and Control The current study is affected by several biases. The problem with giving inadequate attention to current TB using as the excuse we can't afford it, will leave us with the situation we currently have. Behr MA, Edelstein PH, Ramakrishnan L. Revisiting the timetable of tuberculosis. The meta-analysis of 52 clinical studies measured the prevalence and severity of psychological disorders in over 20,000 young cancer survivors. Understanding latent tuberculosis: a moving target. CDC twenty four seven. Bovine tuberculosis - WOAH - World Organisation for Animal Health Possible outcomes of exposure from cattle to M. bovis are believed to be in line with that of humans. Although zoonotic TB causes minor consequences of disease in the Americas, available data corroborate the finding that M. bovis infections can be a substantial cause of deaths from TB among humans in certain population groups and settings. Tuberculosis (TB) is among the most devastating human infectious diseases worldwide. Lienhardt C, Lnnroth K, Menzies D, Balasegaram M, Chakaya J, Cobelens F, et al. All publications/reportsdocumented in the various databasesand published until March 2010 wereconsidered (Table 1; Technical Appendix 1, 2). Sci. The last bovine TB incident in Canada was in the British Columbia Interior in 2018 . Diagnosis and treatment. There are many others which are likely to be restricted to humans or animals only, such as substance abuse in humans and environmental contamination in animals. (2018) 196:4852. Although the most commonly affected species are members of the Bovidae, even humans can be affected. Woman Jailed for Refusing TB Treatment or Isolation. (2009) 47:148490. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Infection of red deer, cattle, and humans with, Evaluation of the GenoType MTBC assay for differentiating 120 clinical. J Immunol. Nationwide surveillance data were almost exclusively available for high-income countries that have programs in place for bovine TB control and regular milk pasteurization (Table 1). Ascertaining the factors contributing to an association between HIV and zoonotic TB in some regions will require more in-depth research, thus eliminating potential confounders such as socioeconomic status, education level, national origin, and other factors. Thus, far no effective plan has been made to combat it in an open system in South Africa, although some limited culling has been done in one park (7). Vet. (2017) 216:S70213. Vet Med Int. A successful response leads to the clearance of the infection with no delayed-type hypersensitivity responses (skin test and whole blood gamma interferon release assay negativity), or failure leads to active disease (skin test and IFN- release assay positivity) (29). If accessible, additional population estimates and official TB notifications were included in the database. De Garine-Wichatitsky M, Caron A, Kock R, Tschopp R, Munyeme M, Hofmeyr M, et al. Traditionally and commonly stated: approximately half of those who will develop active disease will do so within 2 years after infection and the other half sometime after that, owing to reactivation of latent infection (LTBI) (28). The score is derived from an automated algorithm, and represents a weighted count of the amount of attention Altmetric picked up for a research output. Bovine tuberculosis (bTB) is a bacterial disease caused by Mycobacterium bovis. Also, only reports available online and written in English, French, German, Spanish, or Portuguese were included. Disease control in wildlife: evaluating a test and cull programme for bovine tuberculosis in African buffalo. Translational research for tuberculosis elimination: priorities, challenges, and actions. (2002) 163:11527. Active and latent cases must be dealt with before eradication can be considered. If any of the reports included referred to relevant external data or eligible reports that were not identified during the earlier steps of our literature search, the respective data were also included in this analysis. Frontiers | TB Control in Humans and Animals in South Africa: A Vet Immunol Immunopathol. WHO Systematic. Tuberculosis Interventions. Countries or regions should take the threat of bovine TB seriously. (2012) 2012:621210. doi: 10.1155/2012/621210, 6. SU Language Centre, editor. 35. The most common cause of human TB is Mycobacterium tuberculosis, while bovine TB is caused by Mycobacterium bovis.. Human Mycobacterium bovis Infection and Bovine Tuberculosis Outbreak Mycobacterium bovis: Affects cattle and many other species, including people and wildlife. Therefore, in low-income countries, facilities to identify the causative agent of TB are largely absent (2,3,7). Thorax (2016) 71:78594. Although information from many parts of the world was not available, data from 61 countries suggested a low global disease incidence. 22. Mycobacterium tuberculosis (M. tb) remains one of the most globally serious infectious agents for human morbidity and mortality, but with significant differences in prevalence across the globe. doi: 10.1371/journal.pone.0058689, 27. In general, there has not been much media attention, there is no large or even small-scale campaign, no rallying cry, no catch phrases, and essentially it is left to private and state veterinarians and technicians to work with farmers as they see fit. Briefly, following exposure to bacilli, the innate immune response can either clear the infection or fail to do so. Data obtained from eligible reports covered 5 of 6 WHO regions (Table 2; Technical Appendix 1 Table 3, Figure 1), namely Africa, the Americas, Europe, the Eastern Mediterranean and the Western Pacific. The herd of origin was tested in May, reactor animals slaughtered and two cases of bovine TB confirmed June 19. Many risk factors in humans relate to poverty and are very difficult to address. The authors work was supported by the South African Medical Research Council and National Research Foundation of South Africa. Nonetheless, it seems unlikely that our conclusions were fundamentally affected by these biases. However, the treatment for these two infections is different, due to 70 the natural resistance of . Although the steps discussed above are arguably critical for TB control, there are many other factors that are important and will impact on any control measures undertaken. The objective of this study was to determine the frequency of TB in individuals with occupational exposure to cattle and to detect Mycobacterium bovis among cattle in . Herd-level risk factors for bovine tuberculosis: a literature review. All mammalian species, including. Where to go for the ABCs of viral hepatitis prevention? Innovation is crucial for TB control and prevention. Among these studies, only studies from the United States showed a significantly higher proportion of TB caused by M. bovis for HIV co-infected TB patients (Table 4). Background. Paris: International Union Against Tuberculosis and Lung Disease (1999). If this is not the case, then perhaps we can learn from one initiative started in South Africa recently to try to improve TB control. doi: 10.1128/JCM.02490-08, 25. Sometimes physical isolation is also practiced, i.e., the TB case is placed in a treatment facility to isolate them from the general populace. doi: 10.5588/ijtld.17.0485, Keywords: tuberculosis, Mycobacterium bovis, bovine TB, infectious diseases, zoonotic TB, Citation: Meiring C, van Helden PD and Goosen WJ (2018) TB Control in Humans and Animals in South Africa: A Perspective on Problems and Successes. The disease affects both humans and animals caused by a group of bacteria called Mycobacterium tuberculosis complex of different species, including Mycobacterium tuberculosis and Mycobacterium bovis (Thoen et al., 2009). Infected animals with progressive disease shed the bacteria in respiratory secretions and aerosols, feces, milk, and sometimes in urine, vaginal secretions, or semen. In order to circumvent this logistics problem, serum-based diagnostics are being researched. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. x-axis values are median proportions. The disease now mainly infects immigrants from Morocco and elderly Dutch citizens. Steingart KR, Schiller I, Horne DJ, Pai M, Boehme CC, Dendukuri N. Xpert MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Learn about it here. Consequently, the majority of the human population is at risk for exposure to bovine TB; and globally, the occurrence of zoonotic TB likely mirrors TB prevalence in cattle. Verver S, Warren RM, Munch Z, Vynnycky E, van Helden PD, et al. doi: 10.1111/tbed.12329, 8. The implication (Figure 1 scenario A) is that only a small percentage of patients initiated proper therapy, which allowed ongoing disease and transmission events (8). More research is needed to identify the main transmission drivers in these areas. However, reservoirs of TB in wildlife populations have been linked to the persistence or increase of the incidence of bovine TB in some countries, most notably the United Kingdom (UK) (6). Vet Immunol Immunopathol. This failure then leads to the need for intervention by the host's adaptive immune response. Bovine TB case traced back to Sask. | The Western Producer Clearly, adequate distance must be maintained to avoid ongoing transmission. Therefore, attention should be given to the potential for a contaminated environment, and there should be space and free airflow such that transmission may be minimized. Transbound Emerg Dis. A clear understanding of the relationship between M. tuberculosis, M. bovis, and disease in humans and animals has historically been a source of debate. Bernitz N, Clarke C, Roos EO, Goosen WJ, Cooper D, van Helden PD, et al. These generally low incidence rates notwithstanding, available data indicated substantial consequences of this disease for some population groups and settings.