Progress in tuberculosis eradication in Ireland

Private veterinarians' views of the Irish bovine TB eradication programme

There is limited understanding of Private Veterinary Practitioners' (PVPs) perceptions of, opinions about and attitudes towards the Irish Bovine Tuberculosis (bTB) eradication programme. Understanding their attitudes and behaviors towards the bTB eradication programme is both timely and crucial as their actions have a great influence on the effectiveness and sustainability of the programme itself. To date, PVPs have been consulted about how they view their role in the programme, however, less is known about the challenges they face in carrying out good quality bTB testing, and how likely they feel the programme will succeed to eradicate bTB in the future. The results from this study represent a good part of the probable sphere of perceptions, behaviors, attitudes and knowledge of the respective study population and several key critical points that are believed to have hindered the success of the bTB eradication programme in Ireland to date. This study progressed our understanding of the reasons for why farmers are demotivated by and disconnected with the Irish bTB eradication programme according to PVPs, how PVPs feel challenged in their role carrying out bTB testing, and their views on how, if possible, bTB can be eradicated in the future. Their insights will influence how the Department of Agriculture, Food and the Marine (DAFM) interacts with PVPs and farmers in the future with respect to the bTB and the eradication programme.

The Irish bTB eradication programme: combining stakeholder engagement and research-driven policy to tackle bovine tuberculosis

A new Irish bovine tuberculosis (bTB) eradication strategy was launched in 2021. The strategy was formulated following extensive discussions with stakeholders, formal reviews of several aspects of the existing bTB policy and relevant inputs from the latest scientific research projects. A stakeholder discussion body, the TB Forum, had been established in 2018 and this continues under the new strategy, supported by three working groups (scientific, financial and implementation). The strategy sets out actions to address cattle-to-cattle and badger-to-cattle bTB transmission, along with actions to improve farm biosecurity and empower farmers to make their own choices to reduce bTB risk.Large scale vaccination of badgers has been rolled out under the new strategy, with over 20,000 km2 covered by the vaccination programme and 6,586 badgers captured in vaccination areas in 2021. Vaccination efforts have been complemented by intensive communications campaigns, including a web enabled software application ("app") enabling farmers to report the location of badger setts.Cattle which test inconclusive to the tuberculin skin test have been re-tested using a gamma interferon blood test since April 2021, enabling truly infected cattle to be identified more effectively due to the higher sensitivity of this test. An enhanced oversight process has been put in place for herds experiencing extended or repeat bTB breakdowns. Whole genome sequencing is being used to investigate links between breakdowns, with the results supporting operational decision making in case management.Communications, including biosecurity advice, are co-designed with stakeholders, in order to improve their effectiveness. A programme involving veterinary practitioners providing tailored biosecurity bTB advice to their clients was established in 2021 and was rolled out nationally during 2022.A core element of the new strategy is the continual improvement of policies in response to changing bTB risks, informed by scientific research and then implemented with stakeholder consultation.

Test and vaccinate or remove: Methodology and preliminary results from a badger intervention research project

BACKGROUND

In the British Isles, it is generally accepted that the Eurasian badger (Meles meles) plays a role in the maintenance of bovine tuberculosis (bTB) in cattle. Non-selective culling is the main intervention method deployed in controlling bTB in badgers along with smaller scale Bacillus Calmette-Guérin (BCG) vaccination areas. This paper describes the use of selective badger culling combined with vaccination in a research intervention trial.

METHODS

In Northern Ireland, a 100 km² area was subjected to a test and vaccinate or remove (TVR) badger intervention over a 5-year period. Badgers were individually identified and tested on an annual basis. Physical characteristics and clinical samples were obtained from each unique badger capture event.

RESULTS

A total of 824 badgers were trapped with 1520 capture/sampling events. There were no cage-related injuries to the majority of badgers (97%). A low level of badger removal was required (4.1%-16.4% annually), while 1412 BCG vaccinations were administered. A statistically significant downward trend in the proportion of test positive badgers was observed.

CONCLUSION

This is the first project to clearly demonstrate the feasibility of cage side testing of badgers. The results provide valuable data on the logistics and resources required to undertake a TVR approach to control Mycobacterium bovis in badgers.

A Bayesian analysis of a Test and Vaccinate or Remove study to control bovine tuberculosis in badgers (Meles meles)

A novel five year Test and Vaccinate or Remove (TVR) wildlife research intervention project in badgers (Meles meles) commenced in 2014 in a 100km2 area of Northern Ireland. It aimed to increase the evidence base around badgers and bovine TB and help create well-informed and evidence-based strategies to address the issue of cattle-to-cattle spread and spread between cattle and badgers. It involved real-time trap-side testing of captured badgers and vaccinating those that tested negative for bTB (BadgerBCG-BCG Danish 1331) and removal of those that tested bTB positive using the Dual-Path Platform VetTB test (DPP) for cervids (Chembio Diagnostic Systems, Medford, NY USA). Four diagnostic tests were utilised within the study interferon gamma release assay (IGRA), culture (clinical samples and post mortem), DPP using both whole blood and DPP using serum. BCG Sofia (SL222) was used in the final two years because of supply issues with BadgerBCG. Objectives for this study were to evaluate the performance of the DPP in field conditions and whether any trend was apparent in infection prevalence over the study period. A Bayesian latent class model of diagnostic test evaluation in the absence of a gold standard was applied to the data. Temporal variation in the sensitivity of DPP and interferon gamma release assay (IGRA) due to the impact of control measures was investigated using logistic regression and individual variability was assessed. Bayesian latent class analysis estimated DPP with serum to have a sensitivity of 0.58 (95% CrI: 0.40-0.76) and specificity of 0.97 (95% CrI: 0.95-0.98). The DPP with whole blood showed a higher sensitivity (0.69 (95% CrI: 0.48-0.88)) but similar specificity (0.98 (95% Crl: 0.96-0.99)). The change from BCG Danish to BCG Sofia significantly impacted on DPP serum test characteristics. In addition, there was weak evidence of increasing sensitivity of IGRA over time and differences in DPP test sensitivity between adults and cubs. An exponential decline model was an appropriate representation of the infection prevalence over the 5 years, with a starting prevalence of 14% (95% CrI: 0.10-0.20), and an annual reduction of 39.1% (95% CrI: 26.5-50.9). The resulting estimate of infection prevalence in year 5 of the study was 1.9% (95% CrI: 0.8-3.8). These results provide field evidence of a statistically significant reduction in badger TB prevalence supporting a TVR approach to badger intervention. They give confidence in the reliability and reproducibility in the DPP Whole Blood as a real time trap-side diagnostic test for badgers, and describe the effect of vaccination and reduced infection prevalence on test characteristics.

Liver fluke (Fasciola hepatica) co-infection with bovine tuberculosis (bTB) in cattle: A retrospective animal-level assessment of bTB risk in dairy and beef cattle

Bovine tuberculosis (bTB), caused by Mycobacterium bovis, remains a persistent problem for cattle industries in endemic countries. The frequency, quality, and performance of tests, and the presence of wildlife reservoirs, have been identified as impediments to eradication. Recently, exposure to helminth infection (Fasciola hepatica) has been associated negatively with the disclosure of bTB. Here, for the first time, we assess impact of concurrent infections of Fasciola hepatica and the disclosure of bTB at the animal-level using large surveillance datasets. We utilized a dataset of 138,566 animal records from an abattoir from Northern Ireland (2011-2013). The presence of F. hepatica infection was assessed from macroscopic tissue inspection at abattoir. Multivariable models were developed to assess co-infection associations with bTB status based on: Single Intradermal Comparative Tuberculin Test (SICTT), lesion, bacteriological confirmation, including either all animals, or only skin-test negative animals (lesions at routine slaughter; LRS; confirmed nonreactors at routine slaughter; cNRs) or positive (reactors) animals alone, respectively. The relationship between skin tuberculin reaction sizes and fluke status was also explored for a subset of animals with field recordings (n = 24,680). Controlling for known risk factors (e.g., climatic, herd, and individual level characteristics), we did not find significant associations between the SICTT (standard or severe interpretation), lesion, nor confirmation status of animals and their liver fluke status. The only exception was a negative association between liver fluke positivity, and LRS or cNRs, respectively; though effect-sizes were small (e.g., LRS Odds-Ratio: 0.87; 95% CI: 0.76-1.00). There was limited evidence of a relationship between tuberculin reaction sizes during SICTT testing and liver fluke infection status. These data do not support the contention that the detection of bTB using skin-tests or reactor postmortem follow-up may be compromised by co-infection at a population level, but the relationship with lesion formation (pathogenesis) may indicate an impact for postmortem surveillance.

The bovine tuberculosis cluster in north County Sligo during 2014-16

BACKGROUND

Bovine tuberculosis (bTB, caused by infection with Mycobacterium bovis) is endemic in the Irish cattle population, and the subject of a national eradication programme since the late 1950s. During 2014, a substantial area-level bTB outbreak developing in north County Sligo, necessitating the need for an enhanced response. This paper describes this outbreak, the response that was undertaken and some lessons learned.

RESULTS

In the north Sligo area between 2014 and 2016, 23 (31.9%) of restricted herds had 4 or more reactors to the single intradermal comparative tuberculin test (SICTT)/animals with bTB lesions disclosed during the restriction, and the majority (55.5%) of test-positive animals were identified as standard reactors to the SICTT. The herds restricted during 2014-16 were typically larger than other herds in the study area and introduced more animals during 2013. M. bovis was also detected in local badgers, but not deer.

CONCLUSION

This paper describes a substantial outbreak in north County Sligo over a 3-year period. A coordinated area-based approach was a key feature of the outbreak, and substantial resources were applied to bring the outbreak under control. No definitive source was identified, nor reasons why a substantial number of herds were infected over a relatively short period. A coordinated regional approach was taken, and a number of lessons were learned including the need for urgency, for a team-based approach, for a consistent message when dealing with the public, for an area-based approach, for a degree of flexibility for the breakdown manager, and for molecular tools to assist in answering key questions relating to the source and spread of M. bovis to many herds during this bTB outbreak.

A Retrospective Study on Bovine Tuberculosis in Cattle on Fiji: Study Findings and Stakeholder Responses

Bovine tuberculosis (bTB) is globally significant due to its impacts on cattle production. A Brucellosis and Tuberculosis Eradication and Control (BTEC) program commenced in Fiji during the 1980's and has since been sustained by government funding and industry cooperation. A retrospective study of bTB data obtained during the Fiji BTEC program from 1999 to 2014 was undertaken at the University of Sydney with support from the Government of Fiji. It confirmed that bTB is well-established in dairy cattle farms in Naitasiri and Tailevu provinces of Central Division on the main island of Viti Levu, and suggested that the disease is present among cattle on farms in all or most provinces across three (Central, Northern, Western) of the four divisions in the country. It was evident that despite sustained efforts, disease reduction and containment was not being achieved. Reasons contributing to this situation included the appropriateness of the protocol for conduct of the single intradermal test (SID) in cattle, absence of regular quality assurance training of BTEC field staff, lack of standard procedures for bTB data collation and evaluation, unregulated cattle movements and the presence of stray cattle. The Fiji Ministry of Agriculture responded proactively to these findings by implementing revision to the use of the SID in cattle and refresher training for staff along with the Biosecurity Authority of Fiji who implemented cattle movement restriction. A subsequent apparent outbreak of bTB in some farms due to increased detection by the new test protocol raised concerns for the local dairy industry. To clarify the status and extent of bTB infection and the challenges faced by the industry, a stakeholder forum was held in May 2017, and a new BTEC strategy was formulated and endorsed by stakeholders. bTB remains a focus for cattle disease control by the government of Fiji. This case study highlights the challenges for bTB control in Fiji and underlines the importance of technical and social considerations to achieve success in disease control.

The population and landscape genetics of the European badger (Meles meles) in Ireland

The population genetic structure of free-ranging species is expected to reflect landscape-level effects. Quantifying the role of these factors and their relative contribution often has important implications for wildlife management. The population genetics of the European badger (Meles meles) have received considerable attention, not least because the species acts as a potential wildlife reservoir for bovine tuberculosis (bTB) in Britain and Ireland. Herein, we detail the most comprehensive population and landscape genetic study of the badger in Ireland to date-comprised of 454 Irish badger samples, genotyped at 14 microsatellite loci. Bayesian and multivariate clustering methods demonstrated continuous clinal variation across the island, with potentially distinct differentiation observed in Northern Ireland. Landscape genetic analyses identified geographic distance and elevation as the primary drivers of genetic differentiation, in keeping with badgers exhibiting high levels of philopatry. Other factors hypothesized to affect gene flow, including earth worm habitat suitability, land cover type, and the River Shannon, had little to no detectable effect. By providing a more accurate picture of badger population structure and the factors effecting it, these data can guide current efforts to manage the species in Ireland and to better understand its role in bTB.

Further improvement in the control of bovine tuberculosis recurrence in Ireland

Ongoing objective assessment of national bovine tuberculosis (bTB) policy in Ireland is important to monitor efforts towards improved bTB control. The study objective was to investigate temporal trends in the risk of herd recurrence. The study included all herds derestricted following a bTB episode ending in 1998, 2008 or 2012. The respective ‘study periods’ were up to the end of 2001 for 1998-derestricted herds, to the end of 2011 for 2008-derestricted herds, and to the end of 2015 for 2012-derestricted herds. A multivariable Cox proportional-hazard model was developed to examine time to next restriction. The results from the model showed a continuing significant decreasing trend in herd recurrence of bTB in Ireland from 1998 until 2015: herds derestricted in 2008 were 0.75 (95 per cent CI 0.68 to 0.82) times as likely to develop a further restriction compared with 1998 herds, and herds derestricted in 2012 were 0.85 (95per cent CI 0.76 to 0.95) times as likely as 2008 herds. However, despite significant improvements, recurrence of bTB remains a concern, with 30.2 per cent (95 per cent CI 28.0 to 32.4 per cent) of herds derestricted in 2012 being re-restricted over the subsequent three years. Further work is needed to address the two key drivers of herd recurrence, namely residual infection and local reinfection.

The Herd-Level Sensitivity of Abattoir Surveillance for Bovine Tuberculosis: Simulating the Effects of Current and Potentially Modified Meat Inspection Procedures in Irish Cattle

The European Food Safety Authority (EFSA) has published a series of opinions to assess the impact of changing from the current meat inspection procedures (CMI) to visual-only inspection (VOI) procedures. Concern has been raised that changes from CMI to VOI would adversely affect the effectiveness of surveillance for bovine tuberculosis (bTB) in EU member states, both for countries with and without official status of bTB freedom (OTF and non-OTF countries, respectively). This study was conducted to estimate the impact of a change from CMI to VOI in abattoirs on herd-level detection sensitivity in Ireland, a non-OTF country. Using national Irish data, we identified all herds that sold at least one animal to slaughter during 2010-12 whilst unrestricted for bTB. For each of these herds, we calculated the number of cattle sent to slaughter whilst unrestricted, the number of factory lesion tests (FLT) that had been performed, and estimated the apparent within-herd prevalence (APwh). A FLT is a whole-herd test conducted in a herd following the confirmation of bTB in an animal at slaughter. We considered five different inspection scenarios, each based on meat inspection and bacteriology in series, including current meat inspection (CMI) and four visual-only inspection scenarios (VOI2, VOI3, VOI4, VOI5) with reducing inspection sensitivities. Separately for each inspection scenario, a simulation model was used to estimate the herd-level detection sensitivity and the number of bTB-herds (that is, herds that sent at least one animal detected with M. bovis to slaughter when unrestricted during 2010-12) that would and would not be detected. The simulated mean herd-level detection sensitivity estimates were 0.24 for CMI, and 0.16, 0.12, 0.10 and 0.08 for VOI2-5, assuming a 2-, 3-, 4- and 5-fold decrease, respectively, in the animal-level detection sensitivity of VOI relative to that of CMI. The estimated number of non-detected bTB-herds is substantial with CMI, and increases in the series of VOI scenarios with decreasing herd-level detection sensitivity. If VOI were introduced without alternative surveillance means to compensate for the decrease in animal-level inspection sensitivity, such changes might jeopardise bTB surveillance, control and eradication programmes in cattle herds of non-OTF countries, including Ireland.

Mycobacterium tuberculosis Complex Members Adapted to Wild and Domestic Animals

The Mycobacterium tuberculosis complex (MTBC) is composed of several highly genetically related species that can be broadly classified into those that are human-host adapted and those that possess the ability to propagate and transmit in a variety of wild and domesticated animals. Since the initial description of the bovine tubercle bacillus, now known as Mycobacterium bovis, by Theobald Smith in the late 1800's, isolates originating from a wide range of animal hosts have been identified and characterized as M. microti, M. pinnipedii, the Dassie bacillus, M. mungi, M. caprae, M. orygis and M. suricattae. This chapter outlines the events resulting in the identification of each of these animal-adapted species, their close genetic relationships, and how genome-based phylogenetic analyses of species-specific variation amongst MTBC members is beginning to unravel the events that resulted in the evolution of the MTBC and the observed host tropism between the human- and animal-adapted member species.

Development of an in vitro model of the early-stage bovine tuberculous granuloma using Mycobacterium bovis-BCG

Mycobacterium bovis causes 3.1% of human tuberculosis cases, as described by the World Health Organisation. In cattle, this organism causes bovine tuberculosis (BTB) which can have a prevalence of up to 39.5% in some developing countries. In developed countries, although the prevalence of BTB has been reduced through eradication programmes, complete eradication has in some cases proved elusive, with prevalences in cattle of 0.5% in the Republic of Ireland and of 4.3% in the UK. As the tuberculous granuloma is the fundamental lesion that reflects the pathogenesis, immune control and progression of BTB, we aimed to develop an in vitro model of the early-stage bovine tuberculous granuloma, in order to model the early stages of BTB, while also reducing the use of experimentally infected animals. In vitro models of human and ovine mycobacterial granulomas have previously been developed; however, so far, there is no model for the BTB granuloma. As the disease in cattle differs in a number of ways from that in other species, we consider this to be a significant gap in the tools available to study the pathogenesis of BTB. By combining bovine monocyte-derived macrophages infected with M. bovis-BCG and autologous lymphocytes we have developed an early-stage tuberculous bovine granuloma model. In the model, 3D cell aggregations formed a spherical-shape that grew for up to 11 days post-infection. This bovine tuberculous granuloma model can aid in the study of such lesion development, and in comparative studies of pathogenesis, such as, for example, the question of mycobacterial latency in bovine tuberculosis.

Understanding and managing bTB risk: perspectives from Ireland

There is substantial variation in herd risk for bovine tuberculosis (bTB) in Ireland, with most herds playing little to no role in the ongoing endemic. In infected areas, bTB persistence (affecting one or a group of herds) is a key feature of the infection. In this paper, we present our current understanding and management of bTB risk in Ireland, based on a detailed review of research and policy. There is close interaction between science and policy in Ireland, seeking both to understand and effectively manage bTB risk. Detailed research on bTB persistence is presented, including current understanding of the relative importance of different infection sources, which can include residual infection in cattle and/or re-infection, either from local sources or following cattle introduction. In recent years, there have been three primary drivers for policy change, including scientific advances, ongoing improvements to programme supports, and ongoing programme review. In this review, three key future programme challenges are identified. Although good progress is being made, eradication has not yet been achieved. Firstly, a key question concerns the additional effort that will be required, to move towards final eradication. Secondly, a percentage of non-infected animals are falsely positive to current testing methods. This is an ongoing challenge, given the imperfect specificity of test methods but will become more so, as the positive predictive value falls with reducing bTB prevalence. Finally, there is a need to re-engage with the farming community, so that they play a much greater role in programme ownership.

The role of badgers in the epidemiology of Mycobacterium bovis infection (tuberculosis) in cattle in the United Kingdom and the Republic of Ireland: current perspectives on control strategies

Bovine tuberculosis (TB), caused by infection with Mycobacterium bovis, is a persistent problem in cattle herds in Ireland and the United Kingdom, resulting in hardship for affected farmers and substantial ongoing national exchequer expenditure. There is irrefutable scientific evidence that badgers are a reservoir of M. bovis infection and are implicated in the transmission of infection to cattle. A range of options for the control of TB in badgers is currently available or under development including culling of badgers, vaccination of badgers and cattle, and improved biosecurity to limit contact between the two species. It is unlikely that the eradication of TB from cattle will be achieved without the reservoir of M. bovis infection in badgers being controlled. The chances of success will, however, improve with greater knowledge of the disease in both species and an understanding of the epidemiological drivers of the transmission of infection between badgers and cattle.

Future risk of bovine tuberculosis recurrence among higher risk herds in Ireland

Within the Irish national bovine tuberculosis (bTB) eradication programme, controls are tighter on higher risk herds, known as H-herds. These H-herds are defined as herds that have previously had a bTB restriction (also known as a bTB episode), with at least 2 animals positive to the single intradermal comparative tuberculin test (SICTT) or with a bTB lesion detected at slaughter. Such herds are considered at higher risk of recurrence following the end of the bTB episode. In this study, we examined if, and when, the future bTB risk of H-herds returned to a similar level comparable to herds with no history of bTB. In addition, the proportion of bTB episodes in 2012 that could be attributed to the recent introduction of an infected animal was also estimated, providing an update of earlier work. The study population consisted of all Irish herds that were not bTB restricted at the start of 2012 and with at least one whole-herd SICTT in 2012, with the herd being the unit of interest. The outcome measure was a bTB restriction, defined as any herd where at least 1 standard SICTT reactor or an animal with a bTB lesion at slaughter in 2012 was identified. A logistic regression model was used to model the probability of a herd being restricted in 2012. Herds that were previously restricted had significantly higher odds of being restricted in 2012 compared to herds that had not. Similarly, the odds of being restricted in 2012 decreased as the time since the previous restriction increased, but increased as the severity of the previous restriction increased. Odds of being restricted also increased with an increase (although not linear) in herd size, the number of animals greater than 1 year of age purchased in 2011, the county incidence rate and the proportion of cows in the herd. The recent introduction of an infected animal accounted for 7.4% (6.7-8.2) of herd restrictions. This study confirms the key role of past bTB history in determining the future risk of Irish herds, with the odds related to both the severity of and time since the previous restriction. It also illustrates the difficulty in clearly defining H-herds, noting that risk persists for extended periods following a bTB restriction, regardless of breakdown severity. There is a need for robust controls on H-herds for an extended period post de-restriction.

Risk of tuberculosis cattle herd breakdowns in Ireland: effects of badger culling effort, density and historic large-scale interventions

Bovine tuberculosis (bTB) continues to be a problem in cattle herds in Ireland and Britain. It has been suggested that failure to eradicate this disease is related to the presence of a wildlife reservoir (the badger). A large-scale project was undertaken in the Republic of Ireland during 1997-2002 to assess whether badger removal could contribute to reducing risk of cattle herd breakdowns in four areas. During the period of that "four area" study, there was a significant decrease in risk in intensively culled (removal) areas relative to reference areas. In the present study, we revisit these areas to assess if there were any residual area effects of this former intervention a decade on (2007-2012). Over the study period there was an overall declining trend in bTB breakdown risk to cattle herds. Cattle herds within former removal areas experienced significantly reduced risk of breakdown relative to herds within former reference areas or herds within non-treatment areas (OR: 0.53; P < 0.001). Increased herd breakdown risk was associated with increasing herd size (OR: 1.92-2.03; P < 0.001) and herd bTB history (OR: 2.25-2.40; P < 0.001). There was increased risk of herd breakdowns in areas with higher badger densities, but this association was only significant early in the study (PD*YEAR interaction; P < 0.001). Badgers were culled in areas with higher cattle bTB risk (targeted culling). Risk tended to decline with cumulative culling effort only in three counties, but increased in the fourth (Donegal). Culling badgers is not seen as a viable long-term strategy. However, mixed policy options with biosecurity and badger vaccination, may help in managing cattle breakdown risk.

Recurrent bovine tuberculosis in New Zealand cattle and deer herds, 2006–2010

A retrospective cohort study was conducted to identify risk factors for bovine tuberculosis (bTB) recurrence in New Zealand cattle and deer herds identified as bTB-infected from 1 June 2006 to 1 November 2010. A Cox proportional hazards model identified a positive relationship between the daily hazard of bTB recurrence and: (1) the number of prior bTB episodes for two episodes [hazard ratio (HR) 3·22, 95% confidence interval (CI) 1·21–8·60], and for five episodes (HR 89·5, 95% CI 13·8–580), (2) more than one positive bTB case animal at the index episode (HR 2·25, 95% CI 1·19–4·25) and (3) the presence of cleared test-positives at the final test of the index episode. The proportional hazards assumption was violated for the latter variable so a time-dependent covariate was introduced. Up to 2 years post-clearance, the daily hazard of bTB recurrence was greater in herds with test-positives at the final test (HR 2·59, 95% CI 1·30–5·13), but this effect was not observed more than 2 years' post-clearance (HR 1·05, 95% CI 0·28–3·91). We conclude that unresolved infection contributes to further bTB episodes in the first 2 years after herd clearance.

Challenges to quality testing for bovine tuberculosis in Ireland; perspectives from major stakeholders

Within the national bovine tuberculosis (bTB) eradication programme in Ireland, concern has been expressed about the quality of testing by veterinarians. However, there is little published evidence supporting this concern, or the challenges that undermine quality testing. Qualitative research methods were used to gather the perspectives of major stakeholders in the bTB eradication (BTE) scheme on the challenges to quality testing for bovine tuberculosis in Ireland. These stakeholders included private veterinarians, government veterinarians, senior managers and herd owners, on the quality of bTB testing and the barriers to improvement. Results are grouped into challenges that exist in the testing environment (ie, at a farm level), and challenges associated with the skills environment (ie, professional skills involved with conducting the test). Challenges in the testing environment include inadequate on-farm testing conditions; lack of clarity on responsibility to ensure adequate testing environment; and the influence of the veterinarian-client relationship. Challenges in the skills environment include deficiencies in the development and supervision of testing skills among trainees and newly qualified veterinarians; and deficiencies in testing standards at a practice level. Regular supervision of testing is necessary to ensure standards. The importance of a continued understanding of the disease (and its eradication) supported by a partnership, cooperative approach between all stakeholders, is emphasised.

Estimating the power of a Mycobacterium bovis vaccine trial in Irish badgers

The aim of this study was to estimate the power, using simulation techniques, of a group randomized vaccine field trial designed to assess the effect of vaccination on Mycobacterium bovis transmission in badgers. The effects of sample size (recapture percentage), initial prevalence, sensitivity and specificity of the diagnostic test, transmission rate between unvaccinated badgers, Vaccine Efficacy for Susceptibility (VES) and Vaccine Efficacy for Infectiousness (VEI), on study power were determined. Sample size had a small effect on power. Study power increased with increasing transmission rate between non-vaccinated badgers. Changes in VES had a higher impact on power than changes in VEI. However, the largest effect on study power was associated with changes in the specificity of the diagnostic test, within the range of input values that were used for all other modelled parameters. Specificity values below 99.4% yielded a study power below 50% even when sensitivity was 100% and, VEI and VES were both equal to 80%. The effect of changes in sensitivity on study power was much lower. The results from our study are in line with previous studies, as study power was dependent not only on sample size but on many other variables. In this study, additional variables were studied, i.e. test sensitivity and specificity. In the current vaccine trial, power was highly dependent on the specificity of the diagnostic test. Therefore, it is critical that the diagnostic test used in the badger vaccine trial is optimized to maximize test specificity.

Comparison of bovine tuberculosis recurrence in Irish herds between 1998 and 2008

During the last several decades in Ireland, there has been substantial scientific progress in our understanding and related policy changes in the bovine tuberculosis (bTB) eradication programme. A range of performance measurements are routinely available, each highlighting a steadily improving situation in Ireland. However, recent research has highlighted an on-going problem of residual infection, contributing to recurrent breakdowns. In light of this general improvement, but also cognisant of residual infection, a critical evaluation of changes in effectiveness of managing recurrence is particularly valuable. Therefore, the objective of the study was to compare the herd-level risk of recurrence of bTB in Ireland between 1998 and 2008. A retrospective cohort study was carried out, using a Cox proportional-hazards model, to compare the risk of restriction recurrence in herds derestricted during 1998 and 2008. These herds were observed for up to 3 years from the end of the 'index restriction'. At the univariable level, 46.4% and 34.8% of study herds derestricted in 1998 and 2008, respectively, had a subsequent breakdown during the study period (χ(2)=70.6, P<0.001). In the multivariable analysis, there has been a significant reduction in bTB recurrence in Ireland, with 2008-derestricted herds being 0.74 times (95% confidence interval: 0.68-0.81) as likely to be restricted during the subsequent study period compared with 1998-derestricted herds. In the final Cox model, the rate of a future breakdown increased with increasing herd size, increasing number of standard reactors in the index restriction, increasing percentage of newly restricted herds within the District Electoral Division (DED) and if the herd had a previous bTB episode in the previous 5 years. The risk varied across herd type. The results from the current study provide further reassurance of an improved national situation, both in terms of limiting the establishment of new infection (bTB incidence) and in effectively clearing infection once detected (recurrence following derestriction). Recurrence of bTB requires effective implementation of multiple control strategies, focusing on identifying and removing residually infected cattle, and limiting environmental sources of infection, which in Ireland primarily relates to badgers.

BCG vaccination reduces risk of tuberculosis infection in vaccinated badgers and unvaccinated badger cubs

Wildlife is a global source of endemic and emerging infectious diseases. The control of tuberculosis (TB) in cattle in Britain and Ireland is hindered by persistent infection in wild badgers (Meles meles). Vaccination with Bacillus Calmette-Guérin (BCG) has been shown to reduce the severity and progression of experimentally induced TB in captive badgers. Analysis of data from a four-year clinical field study, conducted at the social group level, suggested a similar, direct protective effect of BCG in a wild badger population. Here we present new evidence from the same study identifying both a direct beneficial effect of vaccination in individual badgers and an indirect protective effect in unvaccinated cubs. We show that intramuscular injection of BCG reduced by 76% (Odds ratio = 0.24, 95% confidence interval (CI) 0.11-0.52) the risk of free-living vaccinated individuals testing positive to a diagnostic test combination to detect progressive infection. A more sensitive panel of tests for the detection of infection per se identified a reduction of 54% (Odds ratio = 0.46, 95% CI 0.26-0.88) in the risk of a positive result following vaccination. In addition, we show the risk of unvaccinated badger cubs, but not adults, testing positive to an even more sensitive panel of diagnostic tests decreased significantly as the proportion of vaccinated individuals in their social group increased (Odds ratio = 0.08, 95% CI 0.01-0.76; P = 0.03). When more than a third of their social group had been vaccinated, the risk to unvaccinated cubs was reduced by 79% (Odds ratio = 0.21, 95% CI 0.05-0.81; P = 0.02).

Factors affecting European badger (Meles meles) capture numbers in one county in Ireland

Understanding factors affecting the number of badgers captured at and around badger setts (burrows) is of considerable applied importance. These factors could be used to estimate probable badger densities for bovine tuberculosis (bTB) control and also for monitoring badger populations from a conservation perspective. Furthermore, badger management and vaccination programs would benefit by increasing the probability of efficiently capturing the target badger populations. Within this context, it was investigated whether badger capture numbers can be estimated from field signs and previous capture histories. Badger capture records (initial and repeated capture numbers at a sett) from a large-scale removal program (405 km(2), 643 setts) were used. Univariable count models indicated that there were a number of significant potential predictors of badger numbers, during initial capture attempts. Using a multivariable zero-inflated Poisson (ZIP) model of initial captures we found that badger capture numbers were significantly affected by sett type, season, year, and the number of sett entrances in active use. Badger capture numbers were also affected by the total previous catch during repeated capture events and by the number of previous capture attempts. There was a significant negative trend in badger captures across events. Measures of the ability of these models to estimate badger captures suggested that the models might be useful in estimating badger numbers across a population; however the confidence intervals associated with these predictions were large.

A genome wide association scan of bovine tuberculosis susceptibility in Holstein-Friesian dairy cattle

Background

Bovine tuberculosis is a significant veterinary and financial problem in many parts of the world. Although many factors influence infection and progression of the disease, there is a host genetic component and dissection of this may enlighten on the wider biology of host response to tuberculosis. However, a binary phenotype of presence/absence of infection presents a noisy signal for genomewide association study.

Methodology/Principal Findings

We calculated a composite phenotype of genetic merit for TB susceptibility based on disease incidence in daughters of elite sires used for artificial insemination in the Irish dairy herd. This robust measure was compared with 44,426 SNP genotypes in the most informative 307 subjects in a genome wide association analysis. Three SNPs in a 65 kb genomic region on BTA 22 were associated (i.e. p<10⁻⁵, peaking at position 59588069, p = 4.02×10⁻⁶) with tuberculosis susceptibility.

Conclusions/Significance

A genomic region on BTA 22 was suggestively associated with tuberculosis susceptibility; it contains the taurine transporter gene SLC6A6, or TauT, which is known to function in the immune system but has not previously been investigated for its role in tuberculosis infection.