RESUMO
A singular pathogen has been killing animals, contaminating food and causing an array of human diseases. Mycobacterium avium subspecies paratuberculosis (MAP) is the cause of a fatal enteric infectious disease called Johne's (Yo'-nees), a disorder mostly studied in ruminant animals. MAP is globally impacting animal health and imparting significant economic burden to animal agriculture. Confounding the management of Johne's disease is that animals are typically infected as calves and while commonly not manifesting clinical disease for years, they shed MAP in their milk and feces in the interval. This has resulted in a "don't test, don't tell" scenario for the industry resulting in greater prevalence of Johne's disease; furthermore, because MAP survives pasteurization, the contaminated food supply provides a source of exposure to humans. Indeed, greater than 90% of dairy herds in the US have MAP-infected animals within the herd. The same bacterium, MAP, is the putative cause of Crohn's disease in humans. Countries historically isolated from importing/exporting ruminant animals and free of Johne's disease subsequently acquired the disease as a consequence of opening trade with what proved to be infected animals. Crohn's disease in those populations became a lagging indicator of MAP infection. Moreover, MAP is associated with an increasingly long list of human diseases. Despite MAP scientists entreating regulatory agencies to designate MAP a "zoonotic agent," it has not been forthcoming. One Health is a global endeavor applying an integrative health initiative that includes the environment, animals and humans; One Health asserts that stressors affecting one affects all three. Recognizing the impact MAP has on animal and human health as well as on the environment, it is time for One Health, as well as other global regulatory agencies, to recognize that MAP is causing an insidious slow-motion tsunami of zoonosis and implement public health mitigation.
Assuntos
Doenças dos Bovinos , Doença de Crohn , Mycobacterium avium subsp. paratuberculosis , Saúde Única , Paratuberculose , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/microbiologia , Doença de Crohn/tratamento farmacológico , Doença de Crohn/microbiologia , Humanos , Paratuberculose/tratamento farmacológico , Paratuberculose/epidemiologia , Paratuberculose/microbiologia , Zoonoses/epidemiologiaRESUMO
Sub-phenotypes of inflammatory bowel disease (IBD)-Crohn disease, ulcerative colitis and some cases of irritable bowel syndrome-are generally considered a consequence of gastrointestinal inflammation of unknown etiology. Conventional therapy and more recently biologic agents, all with varying degrees of drawbacks, have resulted in improved control of these diseases. However, as the incidence and prevalence continue to rise, needs for prevention, permanent remission and cures remain unmet, plus there still remain needs for improved control of symptoms, such as pain and diarrhea. The case report herein describes a serendipitous, novel means for curtailing these symptoms associated with a bovine gastrointestinal disease that may have applicability for patients with diseases characterized by abdominal-visceral pain and diarrhea.