Use of whole-genome sequencing and evaluation of the apparent sensitivity and specificity of antemortem tuberculosis tests in the investigation of an unusual outbreak of Mycobacterium bovis infection in a Michigan dairy herd.

OBJECTIVE To describe use of whole-genome sequencing (WGS) and evaluate the apparent sensitivity and specificity of antemortem tuberculosis tests during investigation of an unusual outbreak of Mycobacterium bovis infection in a Michigan dairy herd. DESIGN Bovine tuberculosis (bTB) outbreak investigation. ANIMALS Cattle, cats, dog, and wildlife. PROCEDURES All cattle in the index dairy herd were screened for bTB with the caudal fold test (CFT), and cattle ≥ 6 months old were also screened with a γ-interferon (γIFN) assay. The index herd was depopulated along with all barn cats and a dog that were fed unpasteurized milk from the herd. Select isolates from M bovis-infected animals from the index herd and other bTB-affected herds underwent WGS. Wildlife around all affected premises was examined for bTB. RESULTS No evidence of bTB was found in any wildlife examined. Within the index herd, 53 of 451 (11.8%) cattle and 12 of 21 (57%) cats were confirmed to be infected with M bovis. Prevalence of M bovis-infected cattle was greatest among 4- to 7-month-old calves (16/49 [33%]) followed by adult cows (36/203 [18%]). The apparent sensitivity and specificity were 86.8% and 92.7% for the CFT and 80.4% and 96.5% for the γIFN assay when results for those tests were interpreted separately and 96.1% and 91.7% when results were interpreted in parallel. Results of WGS revealed that M bovis-infected barn cats and cattle from the index herd and 6 beef operations were infected with the same strain of M bovis. Of the 6 bTB-affected beef operations identified during the investigation, 3 were linked to the index herd only by WGS results; there was no record of movement of livestock or waste milk from the index herd to those operations. CONCLUSIONS AND CLINICAL RELEVANCE Whole-genome sequencing enhanced the epidemiological investigation and should be used in all disease investigations. Performing the CFT and γIFN assay in parallel improved the antemortem ability to detect M bovis-infected animals. Contact with M bovis-infected cattle and contaminated milk were major risk factors for transmission of bTB within and between herds of this outbreak.

Herd outbreak of bovine tuberculosis illustrates that route of infection correlates with anatomic distribution of lesions in cattle and cats.

An outbreak of bovine tuberculosis (TB) in a Michigan dairy herd resulted in quarantine, depopulation, pathology, and epidemiologic investigations. This herd, compared to other TB-infected herds in Michigan, was unusual in the long-term feeding of waste milk to its replacement calves. The herd had 80 cattle with positive results on caudal fold test or gamma interferon testing, which were reclassified as suspects because the herd had never been known to be tuberculous previously. Autopsy revealed striking variation in the anatomic distribution of gross anatomic lesions, microscopic lesions, and culture-positive lymph nodes between the adult cattle, the calves, and the domestic cats present on the farm. Adult cattle had lesions and culture-positive lymph nodes predominantly within the thoracic lymph nodes, whereas cats had 50% of their lesions and culture-positive lymph nodes in their abdomens, and 50% of positive calves had culture-positive lymph nodes in their abdomens. This difference in anatomic distribution correlated with the likely routes of infection, which are believed to be by direct airborne transmission in adult cattle and indirect ingestion of contaminated milk in both calves and cats. Although TB literature over the past 100-plus years states that the route of infection may manifest itself in differences in lesion anatomic distribution, our team has been working with TB for over 20 years, and we have never encountered such striking variation between different groups of animals on the same farm.

Use of simulation modeling to estimate herd-level sensitivity, specificity, and predictive values of diagnostic tests for detection of tuberculosis in cattle.

OBJECTIVE: To estimate herd-level sensitivity (HSe), specificity (HSp), and predictive values for a positive (HPVP) and negative (HPVN) test result for several testing scenarios for detection of tuberculosis in cattle by use of simulation modeling. SAMPLE POPULATION: Empirical distributions of all herds (15,468) and herds in a 10-county area (1,016) in Michigan. PROCEDURE: 5 test scenarios were simulated: scenario 1, serial interpretation of the caudal fold tuberculin (CFT) test and comparative cervical test (CCT); scenario 2, serial interpretation of the CFT test and CCT, microbial culture for mycobacteria, and polymerase chain reaction assay; scenario 3, same as scenario 2 but specificity was fixed at 1.0; and scenario 4, sensitivity was 0.9 (scenario 4a) or 0.95 (scenario 4b), and specificity was fixed at 1.0. RESULTS: Estimates for HSe were reasonably high, ranging between 0.712 and 0.840. Estimates for HSp were low when specificity was not fixed at 1.0. Estimates of HPVP were low for scenarios 1 and 2 (0.042 and 0.143, respectively) but increased to 1.0 when specificity was fixed at 1.0. The HPVN remained high for all 5 scenarios, ranging between 0.995 and 0.997. As herd size increased, HSe increased and HSp and HPVP decreased. However, fixing specificity at 1.0 had only minor effects on HSp and HPVN, but HSe was low when the herd size was small. CONCLUSIONS AND CLINICAL RELEVANCE: Tests used for detecting cattle herds infected with tuberculosis work well on a herd basis. Herds with < approximately 100 cattle should be tested more frequently or for a longer duration than larger herds to ensure that these small herds are free of tuberculosis.

Effects of positive results for Mycobacterium avium subsp paratuberculosis as determined by microbial culture of feces or antibody ELISA on results of caudal fold tuberculin test and interferon-gamma assay for tuberculosis in cattle.

OBJECTIVE: To determine whether cattle testing positive for Mycobacterium avium subsp paratuberculosis as determined by microbial culture of feces or antibody ELISA were more likely to have false-positive responses on the caudal fold tuberculin (CFT) test or interferon-gamma (IFN-gamma) assay for Mycobacterium bovis than cattle testing negative for M paratuberculosis. ANIMALS: 1043 cattle from 10 herds in Michigan. PROCEDURE: Feces and blood samples for plasma were collected from cattle > or =24 months old on the day the CFT test was read. Fecal samples were submitted for microbial culture for M paratuberculosis. Plasma samples were tested for antibody against M paratuberculosis, and IFN-gamma after stimulation with purified protein derivative tuberculin from M bovis or M avium. RESULTS: Of 1043 cattle, 180 (17.3%) had positive CFT test results (suspects) and 8 (0.8%) had positive IFN-gamma assay results after stimulation with purified protein derivative tuberculin from M bovis. Forty-five (4.3%) and 115 (11.0%) cattle tested positive for M paratuberculosis as determined by microbial culture of feces and antibody ELISA, respectively. Cattle with positive responses for M paratuberculosis appeared to have an increased likelihood of false-positive results on the CFT test, although this association was not significant. CONCLUSIONS AND CLINICAL RELEVANCE: No significant association was detected among cattle testing positive for M paratuberculosis as determined by microbial culture of feces and antibody ELISA and positive CFT test and IFN-gamma assay results for M bovis.

Bovine tuberculosis in Michigan wildlife and livestock.

Since 1994, the state of Michigan has recognized a problem with bovine tuberculosis (TB), caused by Mycobacterium bovis, in wild white-tailed deer from a 12-county area in northeastern Lower Michigan. A total of 65,000 free-ranging deer have been tested, and 340 have been found to be positive for M. bovis. The disease has been found in other wildlife species, and, in 1998, in domestic cattle, where to date 13 beef cattle and 2 dairy cattle herds have been diagnosed with bovine TB. Unfortunately, the situation is unique in that there have never been reports of self-sustaining bovine TB in a wild, free-ranging cervid population in North America. Scientists, biologists, epidemiologists, and veterinarians who have studied this situation have concluded that the most logical theory is that high deer densities and the focal concentration caused by baiting (the practice of hunting deer over feed) and feeding are the factors most likely responsible for the establishment of self-sustaining TB in free-ranging Michigan deer. Baiting and feeding have been banned since 1998 in counties where the disease has been found. In addition, the deer herd has been reduced by 50% in the endemic area with the use of unlimited antlerless permits. The measures of apparent TB prevalence have been decreased by half since 1997, providing hopeful preliminary evidence that eradication strategies are succeeding.

The sensitivity of gross necropsy, caudal fold and comparative cervical tests for the diagnosis of bovine tuberculosis.

Bovine tuberculosis (bTb) was diagnosed in 22 cattle herds in the northeast comer of Michigan's lower peninsula. Of these 22 herds, 494 animals in 7 herds were examined by gross necropsy, histopathologic exam, mycobacterial culture, and polymerase chain reaction (PCR) assay performed only on samples that were histologically compatible for bTb. Results of culture and PCR assay interpreted in parallel were used as the reference test for calculation of the sensitivity of 1) the caudal fold test (CFT), 2) the caudal fold and comparative cervical skin tests used in series (CFTCCTSER), and 3) gross necropsy. Mycobacterium bovis was isolated from 43 animals. Using all 7 herds, the sensitivities of the CFT, the CFTCCTSER, and gross necropsy were 93.02%, 88.37%, and 86.05%, respectively. When the data were stratified by low- and moderate-prevalence herds, the sensitivities were 83.33%, 75.0%, and 83.33% in low-prevalence herds and 96.77%, 93.55%, and 87.10% in moderate-prevalence herds. The sensitivities of the 2 skin tests were slightly higher when 2 or more gross lesions were present, and the sensitivity of gross necropsy was significantly higher (P = 0.049). The sensitivity of the CFT was found to be notably higher than most estimates in other studies; however, a direct comparison was not possible because the amount of purified protein derivative and the reference methods were different in this study compared with other published studies. Although the sensitivities are high, 2 of the 7 herds (29%) would have had 1 or more positive animals left in the herd if a test-and-removal program had been used. This suggests that when positive herds are identified, selective culling of skin test reactors is a less acceptable disease control strategy than is complete depopulation.

Epidemiologic investigation of Mycobacterium bovis in a population of cats.

OBJECTIVE: To determine whether cats exposed at a residence were infected with Mycobacterium bovis, whether the tuberculin skin test can identify cats infected with M bovis, and whether an ELISA could identify tuberculosis-infected cats. ANIMALS: 20 domestic cats exposed to a cat with laboratory-confirmed disseminated M bovis infection. PROCEDURE: Cats were administered a tuberculin skin test and monitored for 72 hours. Blood and fecal samples were collected. Cats were then euthanatized, and postmortem examinations were performed. Tissues were examined grossly and histologically for signs of mycobacteriosis. Pooled tissue samples and fecal samples were submitted for mycobacterial culture. Blood samples were examined for evidence of tuberculosis by use of a comparative ELISA. RESULTS: 4 cats had positive responses for the ELISA, and 2 cats had suspicious responses. All tuberculin skin tests yielded negative results. No gross or histologic lesions of tuberculosis were detected in any tissues, and mycobacteria were not isolated from tissues or feces obtained from the 20 cats. CONCLUSIONS AND CLINICAL RELEVANCE: All cats that had positive or suspicious responses for the ELISA were offspring of the cat with tuberculosis. Evidence of tuberculosis was not seen in other cats at the residence, the owner, or the attending veterinarian. The most likely source of tuberculosis for the infected cat was through the consumption of M bovis-infected wildlife carcasses or offal. Because M bovis is endemic in wildlife in northeastern Michigan, there is a risk of exposure to tuberculosis in companion animals, their owners, and attending veterinarians.

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.

Prevalence of Mycobacterium bovis infection in cervids on privately owned ranches.

OBJECTIVE: To determine prevalence of tuberculosis caused by infection with Mycobacterium bovis in cervids on privately owned ranches in northeastern lower Michigan. DESIGN: Epidemiologic survey. ANIMALS: Cervids on 96 privately owned ranches. PROCEDURES: A combination of slaughter and skin tuberculin testing was used to collect data. Infection with M. bovis was confirmed by use of standard necropsy and bacteriologic culture techniques. RESULTS: Cervids with tuberculosis were detected on 1 of the 96 ranches. The apparent prevalence of tuberculosis in cervids from the 96 ranches was 1.1 cases/100 cervids (21 cases/1,867 cervids tested). For the ranch with infected cervids, prevalence of infection with M. bovis was 12.1 cases/100 cervids (21 cases/174 cervids tested). No obvious gross lesions were seen in 8 of 21 white-tailed deer and 1 coyote with culture-confirmed M. bovis infection. CONCLUSIONS AND CLINICAL RELEVANCE: The lack of visible lesions in a substantial proportion of infected animals should be taken into consideration in studies involving detection and prevalence of tuberculosis.

Descriptive epidemiology of bovine tuberculosis in michigan (1975-2010): lessons learned.

Despite ongoing eradication efforts, bovine tuberculosis (BTB) remains a challenge in Michigan livestock and wildlife. The objectives of this study were to (1) review the epidemiology of BTB in Michigan cattle, privately owned cervids, and wildlife between 1975 and 2010 and (2) identify important lessons learned from the review and eradication strategies. BTB information was accessed from the Michigan BTB Eradication Project agencies. Cattle herds (49), privately owned deer herds (4), and wild white-tailed deer (668) were found infected with BTB during the review period. BTB has occurred primarily in counties located at the northern portion of the state's Lower Peninsula. Currently used BTB eradication strategies have successfully controlled BTB spread. However additional changes in BTB surveillance, prevention, and eradication strategies could improve eradication efforts.