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Rajbhandari RM, de la Fuente J, Karmacharya D, Mathema S, Maharjan B, Dixit SM, Shrestha N, Queirós J, Gortázar C, Alves PC. Understanding Mycobacterium tuberculosis complex in elephants through a One Health approach: a systematic review. BMC Vet Res 2022; 18:262. [PMID: 35794608 PMCID: PMC9258206 DOI: 10.1186/s12917-022-03356-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Mycobacterium tuberculosis complex (MTC) that causes the chronic infectious disease- tuberculosis (TB), often presents with a complicated epidemiological pattern where the transmission chain may include humans, domestic animals and wildlife, including elephants. TB has been reported globally in both captive and wild elephants. The One Health approach might be the most effective way of understanding the shared MTC infection dynamics in captive and wild animals like Asian elephants. This systematic review accumulates evidence on occurrence, transmission pathways, and preventive measures of TB in elephants from a One Health perspective. Results The prevalence of TB reported in elephant populations ranges from 0 to 23.33% and high prevalence’s are reported for elephants that are in close proximity to infected humans. The risk of elephant to human infection transmission increased significantly with exposure duration and contact with infected elephants. Some studies described the plausible TB transmission to captive elephants from other animals (wild and domestic), suggesting inter- and intra-species transmission. The results of this systematic review based on 27 relevant published works, suggest three overarching interrelated transmission pathways for M. tuberculosis infections in Asian elephants- i) humans and elephants, ii) other animals (wild or domestic) and elephants and iii) unclear sources of infection. Conclusions The progress made with new TB diagnostic tools provides multiple methods to choose from. However, lack of harmonization of TB testing in elephants and their human contacts remains a challenge to prevent TB in those animals. Routine TB screening among elephants and caretakers by setting up an occupational health program for early diagnosis of infection through combined efforts of public health, veterinary medicine, and occupational health experts is suggested. This implies the need for a One Health approach to elephant TB control. This review reveals the need for more research on Mycobacterium tuberculosis complex transmission pathways at the human-animal interface.
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Backues KA, Wiedner EB. Recommendations for the diagnosis, treatment and management of tuberculosis,
Mycobacterium tuberculosis
, in elephants in human care. ACTA ACUST UNITED AC 2019. [DOI: 10.1111/izy.12221] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. A. Backues
- Tulsa Zoo 6421 East 36th Street North Tulsa Oklahoma 74115 USA
| | - E. B. Wiedner
- Hyrax Consulting, LLC Durango Colorado 81302‐4357 USA
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Miller MA, Buss P, Roos EO, Hausler G, Dippenaar A, Mitchell E, van Schalkwyk L, Robbe-Austerman S, Waters WR, Sikar-Gang A, Lyashchenko KP, Parsons SDC, Warren R, van Helden P. Fatal Tuberculosis in a Free-Ranging African Elephant and One Health Implications of Human Pathogens in Wildlife. Front Vet Sci 2019; 6:18. [PMID: 30788347 PMCID: PMC6373532 DOI: 10.3389/fvets.2019.00018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 01/17/2019] [Indexed: 11/13/2022] Open
Abstract
Tuberculosis (TB) in humans is a global public health concern and the discovery of animal cases of Mycobacterium tuberculosis (Mtb) infection and disease, especially in multi-host settings, also has significant implications for public health, veterinary disease control, and conservation endeavors. This paper describes a fatal case of Mtb disease in a free-ranging African elephant (Loxodonta africana) in a high human TB burden region. Necropsy revealed extensive granulomatous pneumonia, from which Mtb was isolated and identified as a member of LAM3/F11 lineage; a common lineage found in humans in South Africa. These findings are contextualized within a framework of emerging Mtb disease in wildlife globally and highlights the importance of the One Health paradigm in addressing this anthroponotic threat to wildlife and the zoonotic implications.
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Affiliation(s)
- Michele A Miller
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for TB Research, Stellenbosch University, Cape Town, South Africa
| | - Peter Buss
- Veterinary Wildlife Services, South African National Parks, Kruger National Park, Skukuza, South Africa
| | - Eduard O Roos
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for TB Research, Stellenbosch University, Cape Town, South Africa
| | - Guy Hausler
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for TB Research, Stellenbosch University, Cape Town, South Africa
| | - Anzaan Dippenaar
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for TB Research, Stellenbosch University, Cape Town, South Africa
| | - Emily Mitchell
- Department of Research and Scientific Services, National Zoological Gardens, South African Biodiversity Institute, Pretoria, South Africa.,Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - Louis van Schalkwyk
- Department of Agriculture, Forestry and Fisheries, Skukuza State Veterinary Office, Skukuza, South Africa
| | - Suelee Robbe-Austerman
- National Veterinary Services Laboratories, Animal Plant Health Inspection Service, United States Department of Agriculture, Ames, IA, United States
| | - W Ray Waters
- National Animal Disease Center, Agricultural Research Service, United States Department of Agriculture, Ames, IA, United States
| | | | | | - Sven D C Parsons
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for TB Research, Stellenbosch University, Cape Town, South Africa
| | - Robin Warren
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for TB Research, Stellenbosch University, Cape Town, South Africa
| | - Paul van Helden
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for TB Research, Stellenbosch University, Cape Town, South Africa
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Rapid screening for Mycobacterium tuberculosis complex in clinical elephant trunk wash samples. Res Vet Sci 2017; 112:52-58. [PMID: 28126601 DOI: 10.1016/j.rvsc.2016.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 12/06/2016] [Accepted: 12/30/2016] [Indexed: 11/23/2022]
Abstract
Mycobacterium tuberculosis can infect and be transmitted between elephants and humans. In elephants, the 'gold standard' reference test for detection of tuberculosis is culture, which takes a minimum of eight weeks for results and has limited sensitivity. A screening test that is rapid, easily implemented, and accurate is needed to aid in diagnosis of tuberculosis in elephants. Ninety-nine clinical trunk wash samples obtained from 33 elephants were utilized to validate three molecular extraction techniques followed by a polymerase chain reaction for detection of M. tuberculosis. Diagnostic sensitivity and specificity were estimated compared to culture. Kappa coefficients were determined between molecular results and various culture categories and serological test results. An internal amplification control was developed and assessed to monitor for PCR inhibition. One molecular test (the Column method) outperformed the other two, with diagnostic sensitivity and kappa agreement estimates of 100% (CI 57-100) and 0.46 (CI 0.2-0.74), respectively, compared to culture alone. The percentage of molecular-positive/culture-negative samples was 8.4% overall. The molecular extraction technique followed by PCR provides a much-needed rapid screening tool for detection of tuberculosis in elephants. Immediate procedures can be implemented to further assess PCR-positive animals and provide personnel biosecurity. While a positive result is not a definitive test for elephant tuberculosis, the molecular test results can be used to support current diagnostic procedures applied by veterinarians for treatment decisions to prevent the spread of tuberculosis in elephants.
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Zlot A, Vines J, Nystrom L, Lane L, Behm H, Denny J, Finnegan M, Hostetler T, Matthews G, Storms T, DeBess E. Diagnosis of Tuberculosis in Three Zoo Elephants and a Human Contact - Oregon, 2013. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2016; 64:1398-402. [PMID: 26741355 DOI: 10.15585/mmwr.mm6452a2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
In 2013, public health officials in Multnomah County, Oregon, started an investigation of a tuberculosis (TB) outbreak among elephants and humans at a local zoo. The investigation ultimately identified three bull elephants with active TB and 118 human contacts of the elephants. Ninety-six (81%) contacts were evaluated, and seven close contacts were found to have latent TB infection. The three bulls were isolated and treated (elephants with TB typically are not euthanized) to prevent infection of other animals and humans, and persons with latent infection were offered treatment. Improved TB screening methods for elephants are needed to prevent exposure of human contacts.
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Yakubu Y, Ong BL, Zakaria Z, Hassan L, Mutalib AR, Ngeow YF, Verasahib K, Razak MFAA. Evidence and potential risk factors of tuberculosis among captive Asian elephants and wildlife staff in Peninsular Malaysia. Prev Vet Med 2016; 125:147-53. [PMID: 26775804 DOI: 10.1016/j.prevetmed.2016.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 12/06/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
Abstract
Elephant tuberculosis (TB) caused by Mycobacterium tuberculosis is an important re-emerging zoonosis with considerable conservation and public health risk. We conducted prospective cohort and cross-sectional studies in elephants and wildlife staff respectively in order to identify potential risk factors associated with TB in captive Asian elephants and their handlers in Peninsular Malaysia. Sixty elephants in six different facilities were screened for TB longitudinally using the ElephantTB STAT-PAK and DPP VetTB assays from February 2012 to May 2014, and 149 wildlife staff were examined for tuberculosis infection using the QuantiFERON-TB Gold In-tube (QFT) assay from January to April, 2012. Information on potential risk factors associated with infection in both elephants and staff were collected using questionnaires and facility records. The overall seroprevalence of TB amongst the elephants was 23.3% (95% CI: 13.8-36.3) and the risk of seroconversion was significantly higher among elephants with assigned mahouts [p=0.022, OR=4.9 (95% CI: 1.3-18.2)]. The percentage of QFT responders among wildlife staff was 24.8% (95% CI: 18.3-32.7) and the risk of infection was observed to be significantly associated with being a zoo employee [p=0.018, OR=2.7 (95% CI: 1.2-6.3)] or elephant handler [p=0.035, OR=4.1 (95% CI: 1.1-15.5)]. These findings revealed a potential risk of TB infection in captive elephants and handlers in Malaysia, and emphasize the need for TB screening of newly acquired elephants, isolating sero-positive elephants and performing further diagnostic tests to determine their infection status, and screening elephant handlers for TB, pre- and post-employment.
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Affiliation(s)
- Yusuf Yakubu
- Universiti Putra Malaysia, Serdang Darul-Ehsan, Selangor 43400, Malaysia(1)(2)
| | - Bee Lee Ong
- Universiti Putra Malaysia, Serdang Darul-Ehsan, Selangor 43400, Malaysia(1)(2); Universiti Malaysia Kelantan, City Campus, 16100 Kota Bharu, Kelantan, Malaysia.
| | - Zunita Zakaria
- Universiti Putra Malaysia, Serdang Darul-Ehsan, Selangor 43400, Malaysia(1)(2)
| | - Latiffah Hassan
- Universiti Putra Malaysia, Serdang Darul-Ehsan, Selangor 43400, Malaysia(1)(2)
| | - Abdul Rahim Mutalib
- Universiti Putra Malaysia, Serdang Darul-Ehsan, Selangor 43400, Malaysia(1)(2)
| | - Yun Fong Ngeow
- Universiti Malaya Kuala Lumpur, 50603 Kuala Lumpur, Malaysia(3); Universiti Tunku Abdul Rahman, Bandar Sungai Long, 43000 Kajang, Malaysia
| | - Khebir Verasahib
- Ministry of Health, 62590 Putrajaya, Wilayah Persekutuan, Malaysia
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Prenatal passive transfer of Mycobacterium tuberculosis antibodies in Asian elephant (Elephas maximus) calves. J Zoo Wildl Med 2015; 45:955-7. [PMID: 25632691 DOI: 10.1638/2014-0026.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Asian elephant (Elephas maximus) dams and their newborn calves were tested for Mycobacterium tuberculosis antibodies in serum. Blood was drawn from dams prior to calving and from calves on their day of birth. All six calves born to tuberculosis-reactive dams were also tuberculosis reactive, suggesting prenatal passive placental transfer of tuberculosis antibodies. In contrast, all three calves born to tuberculosis-nonreactive dams lacked detectable tuberculosis antibodies in pre-suckling or day-of-birth blood samples. Of the living tuberculosis-reactive calves observed from 1 to 11 yr of age, none exhibited clinical signs of tuberculosis infection or became tuberculosis culture positive. This is the first report of prenatal passive placental transfer of tuberculosis antibodies in elephants and demonstrates that detectible tuberculosis antibodies in newborn elephant calves should not be assumed to correlate with clinical tuberculosis.
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