Human tuberculosis caused by Mycobacterium bovis in the United States, Latin America and the Caribbean.

Human tuberculosis (TB) caused by Mycobacterium bovis appears to be rare in most of the region of the Americas, although some localities have reported an unusually high prevalence of M. bovis among human TB cases (e.g., San Diego, CA, USA; parts of Mexico). As surveillance data are lacking in many countries, there is substantial uncertainty regarding actual incidence. M. bovis is most often not identified, as the diagnosis of TB is made by smear microscopy alone or using egg-containing culture media lacking pyruvate. Where human M. bovis cases have been studied in the region, they appear to be associated with ingestion of unpasteurized dairy products, or with airborne acquired infection in animal keepers and meat industry workers from countries where bovine TB remains a problem. Human-to-human transmission of M. bovis does occur, but appears to account for a very small proportion of cases. Efforts to eradicate M. bovis in humans in the Americas should therefore be directed at eradicating the disease in cattle, increasing pasteurization of dairy products and providing education about the dangers of consuming unpasteurized dairy products.

Tuberculosis in humans and animals: an overview.

Tuberculosis (TB) is a significant disease for both humans and animals. Susceptibility to Mycobacterium tuberculosis is relatively high in humans, other primates and guinea pigs. Cattle, rabbits and cats are susceptible to M. bovis and are quite resistant to M. tuberculosis. Wild hoofed stock is generally susceptible to M. bovis, but few reports are available on the isolation of M. tuberculosis. Swine and dogs are susceptible to both M. bovis and M. tuberculosis. M. bovis accounts for only a small percentage of the reported cases of TB in humans; however, it is a pathogen of significant economic importance in wild and domestic animals around the globe, especially in countries where little information is available on the incidence of M. bovis infection in humans. Unlike transmission of M. bovis from cattle to humans, the role of human-to-human airborne transmission in the spread of M. bovis has been somewhat controversial. Investigations are needed to elucidate the relative importance of M. bovis on TB incidence in humans, especially in developing countries. Efforts should be concentrated in countries where human immunodeficiency virus (HIV) infection is widespread, as HIV-infected individuals are more susceptible to mycobacterial disease. Eradication of M. bovis in cattle and pasteurisation of dairy products are the cornerstones of the prevention of human disease.

Lack of association between the occurrence of Crohn's disease and occupational exposure to dairy and beef cattle herds infected with Mycobacterium avium subspecies paratuberculosis.

A cross-sectional survey was conducted to identify associations between Crohn's disease (CD) and Mycobacterium avium ssp. paratuberculosis (Map) exposure. A questionnaire was used to collect information on exposure to cattle infected with Map, and personal and family history of CD in dairy and beef cattle producers with and without Map-infected herds, and in veterinarians who did or did not have contact with Map-infected herds. Cases of CD were selected from respondents and matched 1:4 with controls on occupation, age, and sex. Multivariable conditional logistic regression was used to assess associations between Map exposure and CD. There were 3 cases of CD in 702 producers and 4 cases in 774 veterinarians, yielding a prevalence of 0.47%. No association was found between exposure to JD and CD in any phase of the analysis. However, the number of cases of CD is not large and limits the power to detect important differences.

Absence of Mycobacterium bovis infection in dogs and cats residing on infected cattle farms: Michigan, 2002.

A cross-sectional field study was performed to evaluate infection in dogs and cats living on farms with Mycobacterium bovis-infected cattle. The purpose was to determine pet infection status and assess their risk to farm families and/or tuberculosis-free livestock. Data and specimens were collected from 18 cats and five dogs from nine participating farms. ELISA testing for M. bovis and M. avium was conducted. Fifty-one biological samples were cultured; all were negative for M. bovis, although other Mycobacterium species were recovered. No radiographic, serological or skin test evidence of mycobacterial infection was found. These negative results may be due to the low level of M. bovis infection in the cattle and the limited duration of exposure of pets to infected cattle residing on the same farm. No evidence was found to indicate that pets residing on M. bovis-infected Michigan cattle farms pose a risk to humans or M. bovis-free livestock; however, precautionary advice for farm owners was provided.

Production of a Mycobacterium avium ssp. paratuberculosis purified protein derivative (PPD) and evaluation of potency in guinea pigs.

A Mycobacterium avium ssp. paratuberculosis purified protein derivative (PPD) was produced and the biologic activity evaluated in sensitized guinea pigs. The PPD when adjusted to a protein concentration of 1mg/ml induced a delayed-type hypersensitivity response comparable to USDA Johnin OT 133-8707.

Experimental exposure of llamas (Lama glama) to Brucella abortus: humoral antibody response.

Positive antibody reactions to brucella were observed in the sera of four llamas receiving Brucella abortus Strain 19 subcutaneously at 2-3 weeks post-exposure (PE) using five of eight conventional brucella serologic tests and an ISU-ELISA. Positive brucella antibody reactions were detected in sera of four llamas exposed by intraocular instillation (IOI) of 1.02x10(8) (high dose) B. abortus Strain 2308 at 16-35 days PE using seven of eight serologic tests or an ISU-ELISA. Brucella antibody was also detected in sera of four llamas exposed by IOI of 9x10(5) (low dose) B. abortus using each of four agglutination tests, Complement Fixation test, PCFIA, the rivanol test and the ISU-ELISA at 16-35 days PE. Positive reactions were observed using the Card test, BAPA, SPT, STT, the rivanol test, the PCFIA, and the ISU-ELISA on sera collected on days 42-70 PE, except on one llama, given the low dose; that llama was negative on the PCFIA on day 42. Positive or suspicious reactions were not detected in sera of controls, receiving saline subcutaneously, using the routine tests, with the exception of the CFT. The B. abortus Strain 2308 was isolated from tissues of seven of eight llamas exposed to virulent B. abortus Strain 2308.

Epidemiology and diagnosis of Mycobacterium tuberculosis in captive Asian elephants (Elephas maximus).

The deaths of two Asian elephants (Elephas maximus) in August 1996 led the United States Department of Agriculture to require the testing and treatment of elephants for tuberculosis. From August 1996 to September 1999. Mycobacterium tuberculosis infection was confirmed by culture in 12 of 118 elephants in six herds. Eight diagnoses were made antemortem on the basis of isolation of M. tuberculosis by culture of trunk wash samples; the remainder (including the initial two) were diagnosed postmortem. We present the case histories, epidemiologic characteristics, diagnostic test results, and therapeutic plans from these six herds. The intradermal tuberculin test, enzyme-linked immunosorbent assay serology, the blood tuberculosis test, and nucleic acid amplification and culture are compared as methods to diagnose M. tuberculosis infection in elephants.

Selective media for isolation of Brucella abortus strain RB51.

Brucella abortus strain RB51 (SRB51) is the standard vaccine used to protect cattle against brucellosis and is currently being used to vaccinate bison in the United States (US). Currently available media for culture of Brucella have not been evaluated for their ability to support growth of SRB51. In this study, five selective media for isolating brucellae, four commercially available media for gram-negative bacteria, and tryptose agar with 5% bovine serum (TSA) were compared to two SRB51 selective media developed in this study (rifampin brucellae medium (RBM), and malachite green brucellae medium (MGB)), for their ability to support growth and enhance recovery of SRB51. Four of the five media currently used for isolation of brucellae and two of the four media used for other Gram-negative bacteria did not support growth of SRB51. Modified Kuzdas and Morse (MKM), Brilliant Green, Skirrow's, RBM, and MGB supported growth of SRB51 in a manner similar to TSA. Recovery of SRB51 from tissues of SRB51-vaccinated bison was attempted on TSA, MKM, RBM, and MGB. From a total of 436 samples, SRB51 was isolated from 9.6, 4.3, 5.5, and 9.0% on TSA, MKM, RBM, or MGB media, respectively. Strain RB51 was recovered on only one medium (nine on TSA; three on RBM; and 9 on MGB) from 21 samples. Overgrowth of contaminating bacteria prevented potential detection of SRB51 from 9. 4, 5.5, 0.07, and 5.9% of samples on TSA, MKM, RBM, or MGB, respectively. These data suggest that the use of RBM and MGB, in combination with TSA, enhances the ability to recover SRB51 from tissue samples.

Survival of Brucella abortus strain RB51 lyophilized and as liquid vaccine under different storage conditions.

Brucella abortus strain RB51 (SRB51) is a new cattle vaccine that is approved for use in the U.S. for prevention of brucellosis. At the present time, other countries are implementing or considering the use of SRB51 vaccine in their brucellosis control programs. In the current study, the effect of three stabilizing media, two fill volumes (1 and 3 ml), and three storage temperatures (-25, 4 and 25 degrees C) on the viability of lyophilized SRB51 over a 52 week period was determined. The effects of three concentrations of bacteria (5 x 10(8), 1 x 10(9), or 5 x 10(9) cfu/ml) and two storage temperatures (4 or 25 degrees C) on viability of liquid SRB51 vaccine were also determined. For lyophilized strain RB51 vaccine, fill volume did not influence viability (P> 0.05) during lyophilization. Although fill volume did not influence viability during storage in World Health Organization (WHO) media or media containing both WHO and Lactose Salt (LS) media, 1 ml fill volumes of SRB51 in LS media had greater (P< 0.05) viability when compared to 3 ml fill volumes. Lyophilized SRB51 vaccine stored at 25 degrees C had a more rapid decline in viability (P< 0.05) when compared to vaccine stored at -25 or 4 degrees C. With the exception of the 3-ml fill volumes of LS media, all three stabilizing media were similar in maintaining viability of SRB51 at -25 degrees C storage temperatures. However, when compared to WHO or WHO/LS media, stabilization in LS media was associated with a more rapid decline in viability during storage at 4 or 25 degrees C (P< 0.05). Initial SRB51 concentration in liquid vaccine did not influence (P> 0.05) viability during storage at 4 or 25 degrees C. When compared to liquid SRB51 vaccine stored at 25 degrees C, storage at 4 degrees C was associated with a slower decline in viability (P< 0.05) during 12 weeks of storage. Biochemical and morphological characteristics of SRB51 were stable under the storage conditions utilized in the present study. This study suggests that viability of SRB51 can be readily maintained during storage as a lyophilized or liquid brucellosis vaccine.

Detection of Mycobacterium avium subspecies avium in formalin-fixed, paraffin-embedded tissues of captive exotic birds using polymerase chain reaction.

A presumptive diagnosis of avian tuberculosis can be made when characteristic histologic lesions and acid-fast bacilli are observed in avian tissue samples. However, a definitive diagnosis requires isolation and identification of the causative organism, a process that can take several weeks to complete. The purpose of the study was to determine whether formalin-fixed, paraffin-embedded archival avian tissues could be tested by polymerase chain reaction (PCR) to reliably and rapidly diagnose avian tuberculosis. Tissues were examined from both presumptive and definitive cases of avian tuberculosis from captive exotic birds obtained over a 14-yr period (1983-1997). The cases chosen consisted of birds that had characteristic histologic lesions with acid-fast bacilli. The primers used for PCR amplified a 180-base-pair fragment of 16S ribosomal RNA, a sequence specific for both Mycobacterium avium subsp. avium and M. avium subsp. paratuberculosis. If a sequence was detected in a sample, it was presumed that M. a. avium was the organism being detected. This M. avium fragment sequence was detected in 26 of the 97 samples (27%). Some of the negative PCR results may be explained by any of several factors that adversely affect nucleic acid integrity, particularly prolonged fixation in formalin. Of the 17 samples that were culture positive for M. avium and were known to have been fixed in formalin for < or = 4 wk, 11 tested positive by PCR (65%). The findings of this study show that PCR can be a rapid indicator of the presence of M. a. avium in formalin-fixed, paraffin-embedded tissues. However, the relatively low detection rate the test demonstrated in this sample set may limit its practical use as a diagnostic tool.

Genomic fingerprinting and development of a dendrogram for Brucella spp. isolated from seals, porpoises, and dolphins.

Genomic DNA from reference strains and biovars of the genus Brucella was analyzed using pulsed-field gel electrophoresis (PFGE). Fingerprints were compared to estimate genetic relatedness among the strains and to obtain information on evolutionary relationships. Electrophoresis of DNA digested with the restriction endonuclease XbaI produced fragment profiles for the reference type strains that distinguished these strains to the level of species. Included in this study were strains isolated from marine mammals. The PFGE profiles from these strains were compared with those obtained from the reference strains and biovars. Isolates from dolphins had similar profiles that were distinct from profiles of Brucella isolates from seals and porpoises. Distance matrix analyses were used to produce a dendrogram. Biovars of B. abortus were clustered together in the dendrogram; similar clusters were shown for biovars of B. melitensis and for biovars of B. suis. Brucella ovis, B. canis, and B. neotomae differed from each other and from B. abortus, B. melitensis, and B. suis. The relationship between B. abortus strain RB51 and other Brucella biovars was compared because this strain has replaced B. abortus strain 19 for use as a live vaccine in cattle and possibly in bison and elk. These results support the current taxonomy of Brucella species and the designation of an additional genomic group(s) of Brucella. The PFGE analysis in conjunction with distance matrix analysis was a useful tool for calculating genetic relatedness among the Brucella species.

The immunological response of llamas (Lama glama) following experimental infection with Mycobacterium bovis.

Llamas were experimentally infected with Mycobacterium bovis in order to evaluate the axillary skin test and the ELISA as diagnostic procedures for tuberculosis in llamas (Lama glama). Six llamas were given a single intratracheal challenge with 1 of 2 doses of a recent field isolate of M. bovis and 2 llamas were left as noninfected controls. This resulted in a progressive disease in some animals with 1 mortality as early as 68 d post-infection (PI). The tuberculin skin test, at the axillary site, was positive in 4 of 5 infected llamas at 80 d PI. At 143 d PI, all 3 surviving lamas were positive, including the one which had not responded at 80 d PI. The application of skin and serological tests throughout the course of this experiment adds support for the need to further evaluate the skin test and its anamnestic effect on serodiagnosis since serological responses were generally not observed in the absence of skin testing or antibiotic treatment. The wide variation in M. bovis antigens recognized by the serological response would indicate that a diagnostic panel should include multiple antigens such as MPB70 and lipoarabinomannan (LAM). While skin testing or serology alone may be of limited value to diagnose tuberculosis in llamas, together they may offer an enhanced potential for immunodiagnosis of tuberculosis.

Cytokine secretion and adhesion molecule expression by granuloma T lymphocytes in Mycobacterium avium infection.

Mice experimentally infected with Mycobacterium avium develop a chronic disease characterized by widespread noncaseating granulomas. In this report, we describe the phenotype and cytokine secretion profile of these granuloma-infiltrating effector T lymphocytes. In response to specific antigen, granuloma T cells and, to a lesser extent, spleen cells secrete interferon-gamma, but no interleukin-4 or -5. The importance of this Th1-like response to the host was demonstrated by the massively increased bacterial load and lethal disease in interferon-gamma knockout mice. One function of localized cytokine secretion is to recruit inflammatory T cells bearing surface adhesion molecules complementary to counter-receptors on vascular endothelial cells. Granuloma T cells express high levels of these pro-inflammatory adhesion molecules but have down-regulated their expression of L-selectin (CD62L). The expression of these adhesion molecules on granuloma-infiltrating T lymphocytes would alter the migration pathway of these cells and is likely to be important in facilitating the traffic of effector T cells to the granulomatous inflammatory site. In addition, T cells from Schistosoma mansoni granulomas express the same set of adhesion molecules, showing that this phenotype is not specifically dependent upon the Th1 pattern of cytokine secretion.

Determination of stability of Brucella abortus RB51 by use of genomic fingerprint, oxidative metabolism, and colonial morphology and differentiation of strain RB51 from B. abortus isolates from bison and elk.

Brucella abortus RB51 and isolates from cattle, bison, and elk were characterized by pulsed-field gel electrophoresis and standard techniques for biotyping Brucella species, which included biochemical, morphological, and antigenic techniques, phage susceptibility, and antibiotic resistance. The objectives were to ascertain the stability of RB51 and to differentiate RB51 from other brucellae. Genomic restriction endonuclease patterns produced by pulsed-field gel electrophoresis demonstrated a unique fingerprint for RB51 relative to other brucellae. Comparisons of the oxidative metabolic profiles of RB51 after time in vivo (14 weeks) and in vitro (75 passages) showed no change in characteristic patterns of oxygen uptake on selected amino acid and carbohydrate substrates. Strain RB51 was biotyped as a typical rough B. abortus biovar 1 (not strain 19) after animal passage or a high number of passages in vitro and remained resistant to rifampin or penicillin and susceptible to tetracycline. No reactions with A or M antiserum or with a monoclonal antibody to the O antigen of Brucella lipopolysaccharides were detected; however, RB51 agglutinated with R antiserum. The results indicate that the genomic fingerprint and rough colonial morphology of RB51 are stable characteristics and can be used to differentiate this vaccine strain from Brucella isolates from cattle, bison, and elk.

Evaluation of a potassium chloride extract of Brucella abortus in an ELISA for detecting Brucella antibodies in bulk tank milk samples from cows.

An enzyme-linked immunosorbent assay (ELISA) was developed using as antigen a potassium chloride extract of Brucella abortus strain 1119-3 for detecting Brucella antibodies in bulk tank samples of cow's milk. Three-hundred-thirty-four Milk Ring Test (MRT) suspicions milk samples originating from cattle herds in 13 states and 106 BRT negative milk samples were analyzed. Fifty-four of 334 MRT suspicious milk samples were positive on ELISA; bacteriologic examinations revealed B. abortus field strain was isolated from cows in 15 herds, B. abortus strain 19 was isolated from cows in 16 herds and serologic suspects were reported in 6 of the other 23 herds. Two-hundred-fifty-eight (85.6%) of the 301 MRT suspicious samples were negative on ELISA; field investigations and/or serologic tests on cattle failed to disclose Brucella infection in these herds. Suspicious ELISA reactions were detected in 22 MRT suspicious bulk tank milk samples; serologic suspects were reported in 8 of the 22 herds. No false positive ELISA reactions were detected in the 106 MRT negative bulk tank milk samples collected from dairy herds in 7 states.

Evaluation of tuberculin testing and measles prophylaxis procedures used in rhesus macaque quarantine/conditioning protocols.

Twenty-three of 103 adult rhesus macaques (Macaca mulatta) entering NIH holding facilities with no history of measles vaccination or infection, no titer to rubeola virus, a minimum of four negative results of intrapalpebral tuberculosis tests, and negative for Herpesvirus simiae and type D retroviruses were selected to evaluate the adequacy of commonly used quarantine/conditioning protocol procedures. One month after sensitization by subcutaneous inoculation with 100 mg of killed Mycobacterium tuberculosis in oil, an intrapalpebral tuberculosis test was administered in the right eyelid. All animals had reactions that ranged from grade II to grade V. The animals were then randomly allotted to three groups. Ten animals were inoculated with a rubeola-containing veterinary vaccine (VET), 10 were inoculated with a human measles vaccine routinely used in macaque quarantine procedures (HUM), and 3 were used as unvaccinated controls. Intradermal tuberculosis tests were administered in the left eyelid and the skin of the abdomen at vaccination (day 0), and subsequent abdominal skin tests were performed on days 5, 14, and 28. In addition, intrapalpebral tests were conducted on day 28. A higher response in the rubeola antibody enzyme-linked immunosorbent assay (ELISA) optical density (OD) results was observed in the VET-inoculated group at 14 days after inoculation. More significantly, two members of the HUM-vaccinated group had negative ELISA results after a single dose of vaccine. Three other members of the HUM-inoculated group had ELISA results that were near the OD cutoff value (0.15) and were retested by the measles indirect fluorescent antibody (IFA) test.(ABSTRACT TRUNCATED AT 250 WORDS)