Implications and challenges of tuberculosis in wildlife ungulates in Portugal: a molecular epidemiology perspective

Mycobacterium bovis and, more rarely, Mycobacterium caprae, may cause zoonotic bovine tuberculosis (bTB) in an extensive range of animal species. In Portugal, during 2009, a remarkable raise of bTB incidence was registered in cattle along with an increase of new cases in wildlife. In this work, we reassess and update the molecular epidemiology of bTB in wild ungulates by including 83 new M. bovis and M. caprae isolates from wild boar and red deer obtained during 2008-2009. Spoligotyping identified 27 patterns in wild ungulates, including 11 patterns exclusive from deer and five from wild boar. The genetic relatedness of wildlife and livestock isolates is confirmed. However, the relative prevalence of the predominant genotypes is different between the two groups. Contrasting with the disease in livestock, which is widespread in the territory, the isolation of bTB in wildlife is, apparently, geographically localized and genotypic similarities of strains are observed at the Iberian level.     

Comparative genomics and proteomics to study tissue-specific response and function in natural Mycobacterium bovis infections

Bovine tuberculosis (bTB) is an established zoonotic disease which affects cattle and wildlife worldwide and new strategies are required to control and eradicate the disease. The European wild boar (Sus scrofa) is a major reservoir of bTB in Spain. The objective of this paper was to review tissue-specific response and function of mandibular lymph nodes (MLN) and oropharyngeal tonsils (OT) in European wild boar naturally infected with Mycobacterium bovis. Genomics and proteomics data were used to compare differential gene expression and global protein patterns in OT and MLN of M. bovis-infected and uninfected European wild boar and the results were analyzed considering previous reports of experimental infections in laboratory and domestic animals. The results showed tissue-specific differences in OT and MLN in response to M. bovis infection. Tissue-specific differences in gene expression and protein profiles suggested different functions for OT and MLN during mycobacterial infection and provided information to characterize the pathobiology of M. bovis infection in European wild boar with important implications for the control of bTB in Spain. The characterization of molecular events in tissues that play different roles during mycobacterial infection in naturally infected individuals may be relevant to understand the pathobiology of M. bovis infection and to design effective strategies for the control of bTB in wildlife reservoirs.     

Progress in the control of bovine tuberculosis in Spanish wildlife

Despite the compulsory test and slaughter campaigns in cattle, bovine tuberculosis (bTB) is still present in Spain, and the role of wildlife reservoirs is increasingly recognized. We provide an update on recent progress made in bTB control in Spanish wildlife, including aspects of epidemiology, surveillance, host-pathogen interaction and wildlife vaccination. At the high densities and in the particular circumstances of Mediterranean environments, wild ungulates, mainly Eurasian wild boar and red deer, are able to maintain Mycobacterium bovis circulation even in absence of domestic livestock. Infection is widespread among wild ungulates in the south of the country, local infection prevalence being as high as 52% in wild boar and 27% in red deer. Risk factors identified include host genetic susceptibility, abundance, spatial aggregation at feeders and waterholes, scavenging, and social behaviour. An increasing trend of bTB compatible lesions was reported among wild boar and red deer inspected between 1992 and 2004 in Southwestern Spain. Sporadic cases of badger TB have been detected, further complicating the picture. Gene expression profiles were characterized in European wild boar and Iberian red deer naturally infected with M. bovis. The comparative analysis of gene expression profiles in wildlife hosts in response to infection advanced our understanding of the molecular mechanisms of infection and pathogenesis, revealed common and distinctive host responses to infection and identified candidate genes associated with resistance to bTB and for the characterization of host response to infection and vaccination. Ongoing research is producing valuable knowledge on vaccine delivery, safety and efficacy issues. Baits for the oral delivery of BCG vaccine preparations to wild boar piglets were developed and evaluated. The use of selective feeders during the summer was found to be a potentially reliable bait-deployment strategy. Safety experiments yielded no isolation of M. bovis BCG from faeces, internal organs at necropsy and the environment, even after oral delivery of very high doses. Finally, preliminary vaccination and challenge experiments suggested that a single oral BCG vaccination may protect wild boar from infection by a virulent M. bovis field strain.     

Evidence of the role of European wild boar as a reservoir of Mycobacterium tuberculosis complex

Bovine tuberculosis (bTB) is caused by Mycobacterium bovis and closely related mycobacteria of the Mycobacterium tuberculosis complex. They have an extensive host range and may cause zoonotic TB. A major obstacle to bTB eradication in livestock is the implication of wildlife in the natural cycle of the pathogen. The identification of wildlife reservoir hosts is crucial for the implementation of effective control measures. The European wild boar (Sus scrofa) is frequently considered a spillover or dead end host rather than a true reservoir, and scientific evidence is conflicting outside Mediterranean Spain. The aim of this review is to update current scientific evidence of the wild boar as a TB reservoir and to underline those aspects that need further research. Evidences supporting that wild boar is a TB reservoir host include: (i) presence of common M. tuberculosis complex genotypes in wild boar, domestic and wild animals and humans, (ii) high prevalence of M. bovis among wild boar in estates fenced for decades in complete absence of contact with domestic livestock, and other wild ungulates (iii) TB lesions are frequently seen in thoracic lymph nodes and lungs, suggesting that respiratory infection and excretion may occur, and (iv) extensive tuberculous lesions in more than one anatomical region occur in a high proportion of juvenile wild boar that probably represents the main source of mycobacterial excretion. Hence, epidemiological, pathological and microbiological evidence strongly suggests that, at least in Spanish Mediterranean ecosystems, wild boar are able to maintain TB infection in the wild and are most probably able to transmit the disease to other species, acting as a true wildlife reservoir. These results expand the list of wildlife species that act as natural reservoirs of TB in different parts of the world and suggest the need to control the infection in wild boar populations for the complete eradication of the disease in Spain.     

Maintenance, spillover and spillback transmission of bovine tuberculosis in multi-host wildlife complexes: a New Zealand case study

The causative agent of bovine tuberculosis (bTB; Mycobacterium bovis) has a broad host range. The role of each animal species in spreading the disease depends on how transmission occurs, on the abundance of each host, and on the interactions between hosts. This paper explores differences in the roles individual host species can play in allowing M. bovis infection to persist and spread within a multi-species complex, using New Zealand as a case study. In New Zealand, four wild mammal species are frequently infected. Of these the brushtail possum is now regarded as the only true "maintenance" host. Red deer and ferrets can become maintenance hosts where their densities are exceptionally high, but more often they are "spillover" hosts, with most infection arising from moderately frequent inter-species transmission from possums. The latter situation is even more strongly the case for feral pigs. Spillover hosts may occasionally play a crucial epidemiological role by transmitting infection back to a potential maintenance host (spillback). Three key factors make spillback transmission far more epidemiologically important than its low frequency of occurrence might suggest--amplification of the reservoir of bTB, far greater spatial spread than by the maintenance host, and greater persistence of bTB in long-lived spillover hosts extending the risk of spillback far into the future. The risk of spillback is undoubtedly low, but it nonetheless determines the nature, scale and duration of management required. Eradication of the disease may require management of both the infection in maintenance hosts and reduction or elimination of any risk of spillback.     

牛结核病诊断用特异性抗原的研究进展

本文综述了牛结核病诊断中几种特异性结核蛋白的研究进展。牛结核病的诊断方法主要是基于细胞免疫的皮肤变态反应和基于抗原抗体反应的血清学方法。目前牛结核病的主要诊断试剂为牛型提纯结核菌素(PPD),由于PPD与卡介苗及环境分枝杆菌存在交叉反应,导致特异性较低。根据这一情况,各种特异性抗原不断被发现并用于诊断。     

Advances in understanding disease epidemiology and implications for control and eradication of tuberculosis in livestock: the experience from New Zealand

A deteriorating tuberculosis problem in cattle and deer in New Zealand has been halted and then reversed over the last decade. Mycobacterium bovis infection in both wild and domestic animal populations has been controlled. This has been achieved by applying a multi-faceted science-based programme. Key features of this have been a comprehensive understanding of the epidemiology of tuberculosis in animals, confidence in sampling wild animal populations, effective application of diagnostic tests in cattle and deer, and the ability to map M. bovis genotypes.     

Bovine tuberculosis in Europe from the perspective of an officially tuberculosis free country: trade, surveillance and diagnostics

Switzerland has been officially free of bovine tuberculosis (OTF) since 1960. Since 1980 the control of bovine tuberculosis (bTB) has been reduced to passive abattoir surveillance. Isolated cases of bTB, partly due to reactivation of human Mycobacterium bovis infections with subsequent transmission to cattle, have been noticed in the last years. In Europe, the overall prevalence of bTB is slightly increasing. Both OTF and non-OTF countries report increases in the proportion of bTB positive cattle herds. Current bTB eradication and control programs in Europe are facing a range of challenges. Whole herd depopulation is becoming a less attractive option for economic reasons and due to animal welfare concerns. Live animal trade is increasing both at national and international levels. Regarding these tendencies and taking into account the chronicity of bTB infection, pre-movement testing is becoming increasingly important as a central tool for eradication and for protection against re-introduction of bTB. Pre-movement testing, however specifically focuses on the infection status in individuals, requiring a high level of diagnostic accuracy to correctly diagnose infected animals. Current screening tests for bTB, however, have been designed to meet demands as herd tests. This illustrates that the modification of existing and/or the development of new diagnostics for bTB might be needed. The tuberculin skin test (TST), the primary screening test for bTB may in certain situations have low sensitivity. The interferon gamma (IFN-γ) assay is accepted to be more sensitive compared to TST. Reduced specificity, however, especially in areas of low bTB prevalence raises concerns. New antigen combinations including Rv3615c, OmpATb and others have been shown to complement ESAT-6 and CFP-10 in the whole blood IFN-γ assay and resulted in improved sensitivity (compared to ESAT-6 and CFP-10) and specificity (compared to tuberculins). Lesion detection after slaughter represents a cost-effective procedure for passive surveillance of bTB, especially in areas of low prevalence or in regions free of bTB; however, its sensitivity is very low. This illustrates that trade is linked with a certain risk to re-introduce bTB in OTF regions or countries and that there may be delays in detecting a re-introduction of bTB. In conclusion, regarding the fact that some parameters linked with bTB programs are changing, the development of improved diagnostic tests with a high reliability for use as individual animal tests will be important for future eradication of bTB, in line with international commitment to high standard animal health programs.     

牛结核病流行特点及防控措施

牛结核病是一种慢性消耗性人兽共患病,是OIE规定必须通报的疫病,在我国属二类动物传染病,并列为检疫扑杀对象,对养牛业发展、食品安全与人类健康构成重大威胁。目前普遍采用检疫和扑杀政策控制牛结核,但各个国家执行该政策的方式差异很大。由于牛分枝杆菌存在野生动物贮主,潜伏感染普遍、无快速高通量诊断方法等原因,控制或根除牛结核病非常困难。少数发达国家成功控制或净化了牛结核,但多耗时在二十年以上,耗资巨大。新型诊断方法如IFN-γ在当代牛结核检疫中发挥日益重要的作用,野生动物与家养牛结核的免疫预防已受关注。制约我国牛结核控制和净化的原因很多,如政策法规、国家财力、技术措施和公众认知水平等,目前尚未设定全国性的牛结核控制与净化目标。     

结核分枝杆菌疫源追踪的基因检测分析

目的探讨牛源性人结核疫源追踪的基因分析方法。方法采用复方PCR结核杆菌快速鉴定技术,针对特征性分枝杆菌标志基因(MTP40基因、α抗原基因和IS6110),对结核病人和患牛的标本,进行检测。结果患者标本结核分枝杆菌阳性;患牛标本牛分枝杆菌和结核分枝杆菌分别阳性。结论结核病奶牛不仅是人类牛型结核的可能来源,也可能成为人类人型结核的潜在来源。     

Geographical association between the genotype of bovine tuberculosis in found dead badgers and in cattle herds

In a survey, 457 badgers that had been found dead in Wales were postmortem-examined, and samples were examined by histology and by extended culture (for up to 12 weeks). Mycobacterium bovis was cultured from 55 badgers (12.0 per cent), and the histology typical of M bovis infection was seen in a further six (1.3 per cent). The prevalence in badgers in each of 10 geographical areas varied between 0 and 26 per cent (P<0.001), and was associated with the incidence of confirmed M bovis infection in cattle herds in the same areas (P<0.01). In northern Wales, bTB was rare in both hosts. An infected badger was 12.3 times more likely to be within 5 km of a confirmed cattle bTB breakdown than an uninfected badger. The M bovis isolates from badgers belonged to one of four genotypes defined by spoligotype and variable number tandem repeat type. These genotypes were also found in 290 concurrent confirmed herd breakdowns, and tended to be similar to the genotypes in badgers in the same geographical areas. When badgers and cattle no more than 30 km apart were compared, the genotype diversity was greater in cattle than in badgers (P=0.016), suggesting that the movement of cattle plays a greater part in the spatial distribution of M bovis than the movement of badgers.     

细胞因子IL-17作为牛结核病诊断标志物的研究及实时荧光定量PCR检测方法的建立

试验旨在评价细胞因子IL-6和IL-17 mRNA转录水平与牛分枝杆菌感染之间的关系,及其在牛结核病诊断中的应用潜力。通过皮内变态反应试验和IFN-γ释放试验临床筛选结核病阳性牛和结核病阴性牛,采集试验动物抗凝全血,分离、收集外周血淋巴细胞,分别用牛结核菌素（PPD-B）、禽结核菌素（PPD-A）、重组蛋白CFP-10-ESAT-6（CE）、pET-32a载体标签蛋白（PET）或PBS 37℃培养6 h,用实时荧光定量PCR检测细胞因子IL-6、IL-17和IFN-γ的mRNA相对转录水平。结果显示,PET和空白对照PBS类似,不能刺激细胞因子mRNA转录水平的提高,表明CE中包含的PET对试验的影响可忽略不计;牛外周血淋巴细胞经PPD-B、PPD-A或CE刺激后,结核病阳性牛样品中IL-17和IFN-γ的mRNA转录水平均显著高于结核病阴性牛（P<0.05）,其中PPD-B刺激效果强于CE和PPD-A,而CE刺激的特异性更好;选取CE作为最佳刺激源,结果显示,IL-17和IFN-γ的mRNA转录水平之间相关性良好（spearman r=0.79）,并初步建立了基于IL-17和IFN-γ转录水平的实时荧光定量PCR检测方法;以此方法对14头结核病阳性牛进行临床检验,IL-17实时荧光定量PCR法的阳性样本检出率为85.7%,高于IFN-γ（71.4%）。本研究结果初步表明,牛分枝杆菌特异性抗原（PPD-B、CE）诱导的IL-17 mRNA转录水平与牛结核病相关,以CE为刺激源建立的IL-17实时荧光定量PCR检测方法具有用于牛结核病诊断的潜力。     

Evaluation of Spoligotyping and MIRU-VNTR for Mycobacterium bovis in Xinjiang, China

Mycobacterium bovis, the causative agent of bovine tuberculosis (bTB) in cattle, is also a pathogen for human and other mammals. In this study, 406 cows were screened for bTB by both single intradermal comparative cervical tuberculin (SICCT) test and IFN-γ assay. 135 M. bovis were isolated from 31 SICCT and IFN-γ double-positive cows in Xinjiang Uygur Autonomous Region of China. Spoligotyping and MIRU-VNTR were evaluated for genotyping, and 4 and 7 genotypes were identified, respectively. A new combination of nine MIRU-VNTR loci was most discriminative for M. bovis clones from Xinjiang. Interestingly, two new spoligotypes (SB1903 and SB1904) and special repeat numbers of three loci (ETR-D, QUB 1895 and QUB 3336) were discovered in this study. These results indicated a specific epidemic conservation in Xinjiang, China. M. bovis strains with the unique genotypes were isolated from the herds maintaining parent cows imported from the bTB-free countries, suggesting a possible transmission from the local breed of Xinjiang brown cattle.     

牛结核病抗体胶体金快速检测技术的建立和应用

为了建立一种快速检测牛分支杆菌抗体的新方法用于诊断牛结核病,利用胶体金免疫层析技术原理,用原核诱导表达的牛分支杆菌抗原蛋白MPB83和MPB70分别作为胶体金标记抗原和检测线上的捕获抗原,制备牛结核抗体检测试纸条.结果表明,粒径为40 nm的胶体金制备的试纸条敏感性最高,胶体金最佳标记pH为6.0,MPB83抗原最适标记量为每毫升胶体金6.5 μg,MPB70抗原的最适包被浓度为3.0 mg/mL,抗MPB83蛋白IgG的最佳包被浓度为2.5 mg/mL,交叉试验证明试纸条不与牛的其他非相关疾病的阳性血清反应,具有较高的特异性.比较试验证明其敏感性显著高于韩国进口试纸条.在上述试验条件下生产了一批胶体金试纸条进行临床样品检测,并与细菌分离培养、结核菌素皮内变态反应(TST)和韩国试纸条比较.本试纸条与牛分支杆菌分离培养的符合率为85%,与TST的符合率为79.73%,与韩国试纸条的符合率为98.75%.快速检测牛结核抗体的免疫层析试纸条具有敏感、特异、简便、快速的特点,适用于对牛结核病进行普查和检疫,也可作为TST的辅助诊断方法,在牛结核病根除计划中具有良好的应用前景.     

牛型分枝杆菌MPB70蛋白胶乳凝集方法的建立及应用

为了研究牛结核病新型诊断试剂，提高诊断的特异性和敏感性，我们用大肠杆菌工程菌表达了牛型分枝杆菌特异性抗原MPB70并提纯蛋白建立了牛结核病乳胶凝集试验（LAT）诊断方法。MPB70是一种牛型分枝杆菌特异性分泌而卡介苗BCG缺失的蛋白质，热稳定性好，用此蛋白建立的乳胶凝集方法具有良好的敏感性、特异性以及较长的保存期，检测70份临床奶牛血清，与皮内变态反应和间接血凝方法相比较分别具有71．4％和88．6％的符合率。该方法还可鉴别诊断自然感染和疫苗免疫接种。我们建立的牛型分枝杆菌MPB70蛋白乳胶凝集试验诊断方法将分子生物学手段和经典试验方法有机结合，为临床快速检测牛结核病血清特异性抗体水平提供了行之有效的方法。     

Outbreak of Mycobacterium bovis infection in a wild animal park

An outbreak of tuberculosis due to Mycobacterium bovis occurred in a wild animal park. Three pot-bellied pigs (Sus scrofa vittatus), one red deer (Cervus elaphus), one buffalo (Bison bonasus) and two European lynxes (Lynx lynx) were affected and showed clinical signs including weight loss, enlarged lymph nodes and paralysis of the hindlimbs. Postmortem examinations revealed multifocal granulomatous lesions in various organs, including the lymph nodes, lungs, intestines, kidneys and the central nervous system. Acid-fast organisms were demonstrated in various organs histologically and bacteriologically. Spoligotyping of 17 isolates from various organs of the affected animals confirmed an infection by M bovis and revealed an identical pattern indicating a common origin. The spoligotype was different from the pattern of M bovis recorded in the cattle population in Germany between 2000 and 2006. Investigations of sentinel animals such as an aged silver fox (Vulpes vulpes), a badger (Meles meles), a ferret (Mustela putorius) and rodents, and tuberculin skin tests of the animal attendants and randomly collected faecal samples from the enclosures were all negative for M bovis.     

The role of wild animal populations in the epidemiology of tuberculosis in domestic animals: how to assess the risk

Tuberculosis is present in wild animal populations in North America, Europe, Africa and New Zealand. Some wild animal populations are a source of infection for domestic livestock and humans. An understanding of the potential of each wild animal population as a reservoir of infection for domestic animals is reached by determining the nature of the disease in each wild animal species, the routes of infection for domestic species and the risk of domestic animals encountering an infectious dose. The mere presence of infection in a wild animal population does not of itself provide evidence of a significant wildlife reservoir. Although at times counterintuitive, wildlife populations with high disease prevalence may not necessarily have a role in the epidemiology of disease in domestic livestock. The key concepts used in deciding whether an infected wild animal population is involved in the epidemiology of tuberculosis in domestic livestock is illustrated by reference to six well-researched cases: the feral pig (Suis scrofa) and feral Asian water buffalo (Bubalus bubalis) in Australia, white tailed deer (Odocoileus virginianus) in Michigan, and the brushtail possum (Trichosurus vulpecula) and other species, such as the ferret (Mustela furo), in New Zealand. A detailed analysis of Mycobacterium bovis infection in the Eurasian badger (Meles meles) in Ireland and their role as a reservoir of infection for cattle is also presented.     

Towards harmonised procedures in wildlife epidemiological investigations: A serosurvey of infection with Mycobacterium bovis and closely related agents in wild boar (Sus scrofa) in Switzerland

Bovine tuberculosis (bTB) is a (re-)emerging disease in European countries, including Switzerland. This study assesses the seroprevalence of infection with Mycobacterium bovis and closely related agents in wild boar (Sus scrofa) in Switzerland, because wild boar are potential maintenance hosts of these pathogens. The study employs harmonised laboratory methods to facilitate comparison with the situation in other countries. Eighteen out of 743 blood samples tested seropositive (2.4%, CI: 1.5–3.9%) by ELISA, and the results for 61 animals previously assessed using culture and PCR indicated that this serological test was not 100% specific for M. bovis, cross-reacting with M. microti. Nevertheless, serology appears to be an appropriate test methodology in the harmonisation of wild boar testing throughout Europe. In accordance with previous findings, the low seroprevalence found in wild boar suggests wildlife is an unlikely source of the M. bovis infections recently detected in cattle in Switzerland. This finding contrasts with the epidemiological situation pertaining in southern Spain.     

Bovine TB and the development of new vaccines

Bovine tuberculosis (bTB) is caused by Mycobacterium bovis. The incidence of bTB is increasing in cattle herds of developed countries that have a wild life reservoir of M. bovis, such as the UK, New Zealand and the USA. The increase in the incidence of bTB is thought to be due, at least in part, to a wildlife reservoir of M. bovis. M. bovis is also capable of infecting humans and on a worldwide basis, M. bovis is thought to account for up to 10% of cases of human TB [Cosivi O, Grange JM, Daborn CJ et al. Zoonotic tuberculosis due to Mycobacterium bovis in developing countries. Emerg Infect Dis 1998;4(1):59–70]. Thus, the increased incidence of bTB, besides being a major economic problem, poses an increased risk to human health. In the UK, the incidence of bTB continues to rise despite the use of the tuberculin test and slaughter control policy, highlighting the need for improved control strategies. Vaccination of cattle, in combination with more specific and sensitive diagnostic tests, is suggested as the most effective strategy for bovine TB control. The only vaccine currently available for human and bovine TB is the live attenuated Bacille Calmette Guerin (BCG). BCG is thought to confer protection through the induction of Th1 responses against mycobacteria. However, protection against TB conferred by BCG is variable and to this date the reasons for the successes and failures of BCG are not clear. Therefore, there is a need to develop vaccines that confer greater and more consistent protection against bTB than that afforded by BCG. Given that BCG is currently the only licensed vaccine against human TB, it is likely that any new vaccine or vaccination strategy will be based around BCG. In this review we discuss immune responses elicited by mycobacteria in cattle and the novel approaches emerging for the control of bovine TB based on our increasing knowledge of protective immune responses.