Performance of the single intradermal comparative tuberculin test in identifying cattle with tuberculous lesions in Irish herds

Diagnostic accuracy of the Enferplex Bovine Tuberculosis antibody test in cattle sera

Bovine tuberculosis is a contagious bacterial disease of worldwide economic, zoonotic and welfare importance caused mainly by Mycobacterium bovis infection. Current regulatory diagnostic methods lack sensitivity and require improvement. We have developed a multiplex serological test for bovine tuberculosis and here we provide an estimate of the diagnostic accuracy of the test in cattle. Positive and negative reference serum samples were obtained from animals from Europe and the United States of America. The diagnostic specificity estimate was 98.4% and 99.7% using high sensitivity and high specificity settings of the test respectively. Tuberculin boosting did not affect the overall specificity estimate. The diagnostic sensitivity in samples from Mycobacterium bovis culture positive animals following tuberculin boosting was 93.9%.The relative sensitivity following boosting in tuberculin test positive, lesion positive animals and interferon gamma test positive, lesion positive animals was 97.2% and 96.9% respectively. In tuberculin test negative, lesion positive animals and in interferon gamma test negative, lesion positive animals, the relative sensitivity following tuberculin boosting was 88.2% and 83.6% respectively. The results show that the test has high diagnostic sensitivity and specificity and can detect infected animals that are missed by tuberculin and interferon gamma testing.

Revisiting the relative effectiveness of slaughterhouses in Ireland to detect tuberculosis lesions in cattle (2014-2018)

Slaughterhouse or meat factory surveillance to detect factory lesions (FL) at slaughter is an important part of the bovine tuberculosis (bTB) eradication program in Ireland. The objective of this study was to quantify the effectiveness of Irish slaughterhouses or factories in submitting FL and the proportion of those submitted FL confirmed as being due to bTB in slaughtered cattle, and to identify and quantify the association of risk factors at animal, herd, and factory level with FL submission and confirmation. The data consisted of 6,611,854 animals slaughtered in Irish factories from 2014 to 2018 obtained from the Department of Agriculture, Food and Marine (DAFM), Ireland. Selected risk factors for this study included factory, year and month of slaughter, age, sex, breed, animal movement, ever inconclusive in the standard or severe skin test, herd type, herd size, and bTB history. The association of each risk factor on the FL submission and confirmation risk were analysed with univariable followed by a multivariable logistic regression with herd as random effect. Factories were ranked and compared based on the odds ratio (OR) obtained from the univariable (crude OR) and multivariable (adjusted OR) analysis. The average submission risk of all factories was 20 per 10,000 animals slaughtered, ranging from 1 to 42 per 10,000 animals slaughtered, and the average confirmation risk over all factories was 40.72%, ranging from 0.00 to 61.84%. The odds of submitting and confirming FL as bTB positive were higher in animals over eight years old compared to animals 1–2 years old (OR = 1.91, 95 CI 95% 1.77–2.06 and OR = 4.05, 95% CI 3.17–5.18, respectively), and were higher in animals that ever had inconclusive skin result based on severe interpretation (OR = 2.83, 95% CI 2.44–3.27 and OR = 4.48, 95% CI 2.66–7.54, respectively), animals originating from sucklers herds (OR = 1.08, 95% CI 1.02–1.14 and OR = 1.31, 95% CI 1.11–1.55, respectively), or herds with bTB history in the past three years (OR = 4.46, 95% CI 4.28–4.66 and OR = 319.90, 95% CI 237.98–430.04, respectively). The odds of FL submission and confirmation decreased as the herd size increased (OR = 0.95, 95% CI 0.93–0.96 and OR = 0.82, 95% CI 0.78–0.86, respectively). An inverse relationship of FL submission and confirmation was present for variable sex and inconclusive skin result with standard interpretation, where submission odds were higher in males (OR = 1.05, 95% CI 1.00–1.10) and ever inconclusive animals (OR = 74.24, 95% CI 69.39–79.43), although the confirmation odds were lower (males OR = 0.66, 95% CI 0.56–0.76; ever inconclusive OR = 0.44, 95% CI 0.36–0.54). The crude and adjusted ranking of factories did not differ greatly for FL submission, indicating that factory-related factors may contribute significantly to the submission variation between factories. However, a substantial difference between crude and adjusted confirmation ranking was present which may indicate that animal and herd-related factors were associated to variation in confirmation risk between factories.

The History of In Vivo Tuberculin Testing in Bovines: Tuberculosis, a "One Health" Issue

Tuberculosis (TB) is more than 3 million years old thriving in multiple species. Ancestral Mycobacterium tuberculosis gave rise to multiple strains including Mycobacterium bovis now distributed worldwide with zoonotic transmission happening in both directions between animals and humans. M. bovis in milk caused problems with a significant number of deaths in children under 5 years of age due largely to extrapulmonary TB. This risk was effectively mitigated with widespread milk pasteurization during the twentieth century, and fewer young children were lost to TB. Koch developed tuberculin in 1890 and recognizing the possibility of using tuberculin to detect infected animals the first tests were quickly developed. Bovine TB (bTB) control/eradication programmes followed in the late nineteenth century/early twentieth century. Many scientists collaborated and contributed to the development of tuberculin tests, to refining and optimizing the production and standardization of tuberculin and to determining test sensitivity and specificity using various methodologies and injection sites. The WHO, OIE, and EU have set legal standards for tuberculin production, potency assay performance, and intradermal tests for bovines. Now, those using tuberculin tests for bTB control/eradication programmes rarely, see TB as a disease. Notwithstanding the launch of the first-ever roadmap to combat zoonotic TB, many wonder if bTB is actually a problem? Is there a better way of dealing with bTB? Might alternative skin test sites make the test “better” and easier to perform? Are all tuberculins used for testing equally good? Why have alternative “better” tests not been developed? This review was prompted by these types of questions. This article attempts to succinctly summarize the data in the literature from the late nineteenth century to date to show why TB, and zoonotic TB specifically, was and still is important as a “One Health” concern, and that the necessity to reduce the burden of zoonotic TB, to save lives and secure livelihoods is far too important to await the possible future development of novel diagnostic assays for livestock before renewing efforts to eliminate it. Consequently, it is highly probable that the tuberculin skin test will remain the screening test of choice for farmed livestock for the considerable future.

The performance of the interferon gamma assay when used as a diagnostic or quality assurance test in Mycobacterium bovis infected herds

There are two different contexts in the Irish bTB eradication programme in which the interferon-gamma assay (IFN-γ) is applied. Firstly, the IFN-γ assay is applied routinely to high risk cohorts in herds with four or more reactors to the SICTT. The IFN-γ test is then carried out on blood samples submitted to the laboratory within 8h of collection (diagnostic testing). Secondly, the use of the IFN-γ assay has recently been extended to test SICTT reactors as part of a general quality assurance (QA) scheme to monitor the performance of the SICTT. Blood samples from reactors are tested one day after blood collection (QA testing). In this study, we analysed the relative performance of the SICTT and IFN-γ when used in parallel as an 8h diagnostic test and as a 24h QA test on SICTT reactors. A total of 17,725 IFN-γ tests were included in the analysis (11,658 diagnostic tests and 6067 QA tests). Of the samples submitted for diagnostic testing, the proportion positive to IFN-γ decreased with the severity of interpretation of the SICTT result. Of the standard reactors that were tested with IFN-γ in the QA programme, 92.2% were positive to the IFN-γ test. Among animals that were SICTT -ve/IFN-γ +ve, 18.9% were positive at post-mortem compared to 11.8% of those that were SICTT +ve (standard reactor)/IFN-γ -ve. These results highlight the risk associated with retaining SICTT -ve/IFN-γ +ve animals, and suggest that prompt removal of these animals is necessary to reduce the potential for future transmission.

Efficiency of slaughterhouse surveillance for the detection of bovine tuberculosis in cattle in Northern Ireland

Post-mortem examination continues to play an important surveillance role in the bovine tuberculosis (bTB) eradication programme in Northern Ireland. It is estimated that 18-28% of new bTB herd breakdowns are disclosed by the detection of bTB lesions in animals routinely slaughtered. The purpose of this study was to compare the performance of different slaughterhouses in Northern Ireland in detecting bTB-lesioned animals at routine slaughter (LRS) and to apply the findings to maximize the sensitivity of bTB slaughterhouse surveillance. Univariate statistical analysis on cattle slaughtered in Northern Ireland during 2011-2013 revealed that the risk of LRS disclosure varied between slaughterhouses, ranging from 0·08% to 0·54%. Furthermore, the risk of confirmation of these LRS as bTB varied between slaughterhouses, ranging from 57·9% to 72·4%. Logistic regression modelling of selected risk factors found that the risk of LRS disclosure increased with age, and was higher in purchased animals, during winter months, in animals coming from high bTB incidence areas and in animals slaughtered from herds with a bTB restriction in the last 2-3 years. Adjusting for these selected factors, the risk of LRS disclosure and bTB confirmation changed very little from the univariable analysis, suggesting that differences in disclosure risks between slaughterhouses were likely to be due to factors related to the slaughterhouses, rather than to the risk status of the animals presented. Examination of procedures within these slaughterhouses is recommended to identify ways that could increase the sensitivity of their bTB surveillance.

Quantitative genetic analysis of the bTB diagnostic single intradermal comparative cervical test (SICCT)

BACKGROUND

Bovine tuberculosis (bTB) is a disease of significant economic importance and is a persistent animal health problem with implications for public health worldwide. Control of bTB in the UK has relied on diagnosis through the single intradermal comparative cervical test (SICCT). However, limitations in the sensitivity of this test hinder successful eradication and the control of bTB remains a major challenge. Genetic selection for cattle that are more resistant to bTB infection can assist in bTB control. The aim of this study was to conduct a quantitative genetic analysis of SICCT measurements collected during bTB herd testing. Genetic selection for bTB resistance will be partially informed by SICCT-based diagnosis; therefore it is important to know whether, in addition to increasing bTB resistance, this might also alter genetically the epidemiological characteristics of SICCT.

RESULTS

Our main findings are that: (1) the SICCT test is robust at the genetic level, since its hierarchy and comparative nature provide substantial protection against random genetic changes that arise from genetic drift and from correlated responses among its components due to either natural or artificial selection; (2) the comparative nature of SICCT provides effective control for initial skin thickness and age-dependent differences; and (3) continuous variation in SICCT is only lowly heritable and has a weak correlation with SICCT positivity among healthy animals which was not significantly different from zero (P > 0.05). These emerging results demonstrate that genetic selection for bTB resistance is unlikely to change the probability of correctly identifying non-infected animals, i.e. the test's specificity, while reducing the overall number of cases.

CONCLUSIONS

This study cannot exclude all theoretical risks from selection on resistance to bTB infection but the role of SICCT in disease control is unlikely to be rapidly undermined, with any adverse correlated responses expected to be weak and slow, which allow them to be monitored and managed.

Two alternative DNA extraction methods to improve the detection of Mycobacterium-tuberculosis-complex members in cattle and red deer tissue samples

Background

Bovine tuberculosis (bTB), which is caused by Mycobacterium bovis and M. caprae, is a notifiable animal disease in Germany. Diagnostic procedure is based on a prescribed protocol that is published in the framework of German bTB legislation. In this protocol small sample volumes are used for DNA extraction followed by real-time PCR analyses. As mycobacteria tend to concentrate in granuloma and the infected tissue in early stages of infection does not necessarily show any visible lesions, it is likely that DNA extraction from only small tissue samples (20–40 mg) of a randomly chosen spot from the organ and following PCR testing may result in false negative results. In this study two DNA extraction methods were developed to process larger sample volumes to increase the detection sensitivity of mycobacterial DNA in animal tissue.

The first extraction method is based on magnetic capture, in which specific capture oligonucleotides were utilized. These nucleotides are linked to magnetic particles and capture Mycobacterium-tuberculosis-complex (MTC) DNA released from 10 to 15 g of tissue material. In a second approach remaining sediments from the magnetic capture protocol were further processed with a less complex extraction protocol that can be used in daily routine diagnostics. A total number of 100 tissue samples from 34 cattle (n = 74) and 18 red deer (n = 26) were analyzed with the developed protocols and results were compared to the prescribed protocol.

Results

All three extraction methods yield reliable results by the real-time PCR analysis. The use of larger sample volume led to a sensitivity increase of DNA detection which was shown by the decrease of Ct-values. Furthermore five samples which were tested negative or questionable by the official extraction protocol were detected positive by real time PCR when the alternative extraction methods were used. By calculating the kappa index, the three extraction protocols resulted in a moderate (0.52; protocol 1 vs 3) to almost perfect agreement (1.00; red deer sample testing with all protocols).

Conclusion

Both new methods yielded increased detection rates for MTC DNA detection in large sample volumes and consequently improve the official diagnostic protocol.

Electronic supplementary material

The online version of this article (doi:10.1186/s12866-016-0816-2) contains supplementary material, which is available to authorized users.

Assessment of the sensitivity of the gamma-interferon test and the single intradermal comparative cervical test for the diagnosis of bovine tuberculosis under field conditions

In some French départements, the eradication of bovine tuberculosis is incomplete and usual skin tests [single intradermal tuberculin test (SIT) and single intradermal comparative cervical test (SICCT)] have poor specificity due to cross-reactions with non-pathogenic mycobacteria, causing economic losses. In Côte d'Or (Burgundy, France), an experimental serial testing scheme based on the combination of SICCT and gamma-interferon (IFN-γ) tests has been initiated in order to shorten the interval between suspicion and its invalidation in herds with false-positive results to skin tests. Our aim was to assess the scheme's sensitivity and to compare it to the sensitivity of the screening scheme recommended by the European Commission. Our study included 1768 animals from Côte d'Or. The sensitivities of both schemes were estimated using a Bayesian approach. The individual sensitivity of the IFN-γ test [88·1%, 95% credibility interval (CrI) 72·8-97·5] was not significantly different from individual SICCT sensitivity (80·3%, 95% CrI 61·6-98·0) and individual SIT sensitivity (84·2%, 95% CrI 59·0-98·2). The individual specificity of the IFN-γ test was 62·3% (95% CrI 60·2-64·5). No significant difference could be demonstrated between the sensitivities of the serial testing scheme used in Côte d'Or (73·1%, 95% CrI 41·1-100) and the European Union serial testing scheme (70·1%, 95% CrI 31·5-100·0).

Evaluating the tuberculosis hazard posed to cattle from wildlife across Europe

Tuberculosis (TB) caused by infection with Mycobacterium bovis (M. bovis) and other closely related members of the M. tuberculosis complex (MTC) infects many domestic and wildlife species across Europe. Transmission from wildlife species to cattle complicates the control of disease in cattle. By determining the level of TB hazard for which a given wildlife species is responsible, the potential for transmission to the cattle population can be evaluated. We undertook a quantitative review of TB hazard across Europe on a country-by-country basis for cattle and five widely-distributed wildlife species. Cattle posed the greatest current and potential TB hazard other cattle for the majority of countries in Europe. Wild boar posed the greatest hazard of all the wildlife species, indicating that wild boar have the greatest ability to transmit the disease to cattle. The most common host systems for TB hazards in Europe are the cattle-deer-wild boar ones. The cattle-roe deer-wild boar system is found in 10 countries, and the cattle-red deer-wild boar system is found in five countries. The dominance of cattle with respect to the hazards in many regions confirms that intensive surveillance of cattle for TB should play an important role in any TB control programme. The significant contribution that wildlife can make to the TB hazard to cattle is also of concern, given current population and distribution increases of some susceptible wildlife species, especially wild boar and deer, and the paucity of wildlife TB surveillance programmes.

Risk factors for bovine tuberculosis in low incidence regions related to the movements of cattle

Background

Bovine tuberculosis (bTB) remains difficult to eradicate from low incidence regions partly due to the imperfect sensitivity and specificity of routine intradermal tuberculin testing. Herds with unconfirmed reactors that are incorrectly classified as bTB-negative may be at risk of spreading disease, while those that are incorrectly classified as bTB-positive may be subject to costly disease eradication measures. This analysis used data from Scotland in the period leading to Officially Tuberculosis Free recognition (1) to investigate the risks associated with the movements of cattle from herds with different bTB risk classifications and (2) to identify herd demographic characteristics that may aid in the interpretation of tuberculin testing results.

Results

From 2002 to 2009, for every herd with confirmed bTB positive cattle identified through routine herd testing, there was an average of 2.8 herds with at least one unconfirmed positive reactor and 18.9 herds with unconfirmed inconclusive reactors. Approximately 75% of confirmed bTB positive herds were detected through cattle with no known movements outside Scotland. At the animal level, cattle that were purchased from Scottish herds with unconfirmed positive reactors and a recent history importing cattle from endemic bTB regions were significantly more likely to react positively on routine intradermal tuberculin tests, while cattle purchased from Scottish herds with unconfirmed inconclusive reactors were significantly more likely to react inconclusively. Case-case comparisons revealed few demographic differences between herds with confirmed positive, unconfirmed positive, and unconfirmed inconclusive reactors, which highlights the difficulty in determining the true disease status of herds with unconfirmed tuberculin reactors. Overall, the risk of identifying reactors through routine surveillance decreased significantly over time, which may be partly attributable to changes in movement testing regulations and the volume of cattle imported from endemic regions.

Conclusions

Although the most likely source of bTB infections in Scotland was cattle previously imported from endemic regions, we found indirect evidence of transmission within Scottish cattle farms and cannot rule out the possibility of low level transmission between farms. Further investigation is needed to determine whether targeting herds with unconfirmed reactors and a history of importing cattle from high risk regions would benefit control efforts.

Towards risk-based test protocols: estimating the contribution of intensive testing to the UK bovine tuberculosis problem

Eradicating disease from livestock populations involves the balancing act of removing sufficient numbers of diseased animals without removing too many healthy individuals in the process. As ever more tests for bovine tuberculosis (BTB) are carried out on the UK cattle herd, and each positive herd test triggers more testing, the question arises whether ‘false positive’ results contribute significantly to the measured BTB prevalence. Here, this question is explored using simple probabilistic models of test behaviour. When the screening test is applied to the average UK herd, the estimated proportion of test-associated false positive new outbreaks is highly sensitive to small fluctuations in screening test specificity. Estimations of this parameter should be updated as a priority. Once outbreaks have been confirmed in screening-test positive herds, the following rounds of intensive testing with more sensitive, albeit less specific, tests are highly likely to remove large numbers of false positive animals from herds. Despite this, it is unlikely that significantly more truly infected animals are removed. BTB test protocols should become based on quantified risk in order to prevent the needless slaughter of large numbers of healthy animals.

Estimation of the relative sensitivity of the comparative tuberculin skin test in tuberculous cattle herds subjected to depopulation

Bovine tuberculosis (bTB) is one of the most serious economic animal health problems affecting the cattle industry in Great Britain (GB), with incidence in cattle herds increasing since the mid-1980s. The single intradermal comparative cervical tuberculin (SICCT) test is the primary screening test in the bTB surveillance and control programme in GB and Ireland. The sensitivity (ability to detect infected cattle) of this test is central to the efficacy of the current testing regime, but most previous studies that have estimated test sensitivity (relative to the number of slaughtered cattle with visible lesions [VL] and/or positive culture results) lacked post-mortem data for SICCT test-negative cattle. The slaughter of entire herds ("whole herd slaughters" or "depopulations") that are infected by bTB are occasionally conducted in GB as a last-resort control measure to resolve intractable bTB herd breakdowns. These provide additional post-mortem data for SICCT test-negative cattle, allowing a rare opportunity to calculate the animal-level sensitivity of the test relative to the total number of SICCT test-positive and negative VL animals identified post-mortem (rSe). In this study, data were analysed from 16 whole herd slaughters (748 SICCT test-positive and 1031 SICCT test-negative cattle) conducted in GB between 1988 and 2010, using a bayesian hierarchical model. The overall rSe estimate of the SICCT test at the severe interpretation was 85% (95% credible interval [CI]: 78-91%), and at standard interpretation was 81% (95% CI: 70-89%). These estimates are more robust than those previously reported in GB due to inclusion of post-mortem data from SICCT test-negative cattle.

Evaluation of single reactor bovine tuberculosis breakdowns based on analysis of reactors slaughtered at an Irish export meat plant

The 'Singleton Protocol' was adopted by the Irish Department of Agriculture Fisheries and Food (DAFF) in 1996 to address the incomplete specificity of the single intra-dermal comparative tuberculin test (SICTT) used in Ireland for the detection of animals infected with bovine tuberculosis (bTB). The protocol allows the early restoration of disease-free status to herds with a single reactor breakdown, where the herd was not confirmed as infected with Mycobacterium bovis by epidemiological investigation, by postmortem examination or by further test. The current study examines the ability of the Singleton Protocol to identify false-positive reactors. It investigates the subsequent herd-reactor rate following single reactor removal and analyses the factors leading to a positive postmortem lesion outcome and a positive reactor retest result. Postmortem lesion results were obtained for 371 reactor animals from single reactor breakdowns that were killed at an export meat plant over a 19-month period. Epidemiological and test data for these animals and their herds were obtained from DAFF databases and analysed by univariate and multivariate statistical analysis. Singleton candidates had an 18.7 per cent lower lesion rate than single animal breakdowns not meeting the singleton criteria. No significant difference was found between Singletons and non singletons in the subsequent reactor retest results. Skin thickness at the SICTT is the most significant determinant of a positive lesion result. The area bTB history was shown to be a significant variable in producing a positive reactor retest result.

Bovine tuberculosis in cattle in the highlands of cameroon: seroprevalence estimates and rates of tuberculin skin test reactors at modified cut-offs

The aim of this study was to obtain epidemiological estimates of bovine tuberculosis (TB) prevalence in cattle in the highlands of Cameroon using two population-based tuberculin skin test (TST) surveys in the years 2009 and 2010. However, prior to the TST survey in 2010, blood was collected from already chosen cattle for serological assay. Anti-bovine TB antibodies was detected in 37.17% of tested animals and bovine TB prevalence estimates were 3.59%–7.48%, 8.92%–13.25%, 11.77%–17.26% and 13.14%–18.35% for comparative TST at ≥4 mm, ≥3 mm and ≥2 mm cut-off points and single TST, respectively. The agreement between TST and lateral flow was generally higher in TST positive than in TST negative subjects. The K coefficients were 0.119, 0.234, 0.251 and 0.254 for comparative TST at ≥4 mm, ≥3 mm and ≥2 mm cut-off points and the single TST groups, respectively. Chi square statistics revealed that strong (P < 0.05; χ² > 48) associations existed between seroprevalence rates and TST reactors. The study suggested that using lateral flow assay and TST at severe interpretations could improve the perception of bovine TB in Cameroon. The importance of defining TST at modified cut-offs and disease status by post-mortem detection and mycobacterial culture of TB lesions in local environments cannot be overemphasised.

An evaluation of the Irish Single Reactor Breakdown Protocol for 2005-2008 inclusive and its potential application as a monitor of tuberculin test performance

Under the Irish Bovine Tuberculosis (bTB) Eradication Programme all herds are subjected to at least one test per annum. The Single Intra-dermal Comparative Tuberculin Test (SICTT) is used in Ireland for the detection of cattle infected with Mycobacterium bovis. There have been concerns regarding the specificity of the SICTT, notably by farmers, and particularly in herds where the detection of a single positive animal in the absence of an obvious source of (bTB) infection could be perceived as a "false" positive. To address this issue the so-called 'Singleton Protocol' was established as part of the Irish bTB eradication programme. This protocol allows for the early restoration of free trading status to herds where a single positive animal was detected and where the herd was not confirmed as infected with M. bovis by epidemiological investigation, by post mortem, by laboratory examination, or by further test. This paper presents data from the 2005 to 2008, inclusive, bTB programmes on the number of herds that were assessed, which qualified for inclusion under the 'Singleton Protocol' and the outcome for qualifying herds up to and including having status restored early as a consequence of inclusion in that programme. The outcome of this protocol reaffirms the reliability of the SICTT at current levels of infection. Furthermore it is advocated that the 'Singleton Protocol' be continued as a monitor of herds in which a single positive animal is disclosed, and as overall infection levels of bTB fall the outcome may be used as one means to assess progress towards bTB eradication in Ireland.

Risk factors for herd breakdown with bovine tuberculosis in 148 cattle herds in the south west of England

Bovine tuberculosis (bTB) is caused by Mycobacterium bovis. The disease has a long latent period, heterogenous spread, can infect many species and can persist in the environment. In the UK, the rate of herd breakdowns (HBD) with bTB is increasing. A retrospective cohort study of 148 cattle herds was set up to investigate risk factors for HBD from October 2001 to November 2004. Herds were selected from farms located in the randomised badger culling trial (RBCT) and comprised holdings (24%) that were restocked with cattle after the foot and mouth disease (FMD) epidemic in 2001 and holdings (76%) that were continuously stocked throughout the FMD epidemic. Farmers were interviewed between June 2003 and February 2004. Questions on herd and farm management were asked for the period October 2001 to June 2003. Data on herd testing for bTB were sourced from the VetNet database and historic data from 1995 were used in the analysis. A discrete time survival analysis was used to examine factors associated with the risk of HBD. By the end of the study period, November 2004, 50% of study herds had experienced a HBD with bTB at least once. Farms that were restocked for less than 1 year after FMD had a reduced risk of HBD (P<0.01) compared with continuously stocked farms in the same year. This reduced risk did not persist after 1 year of restocking. Feeding vitamin and mineral lick supplements compared with not feeding these supplements also reduced the risk of HBD. Factors associated with an increased risk of HBD were storing manure and slurry indoors or in a closed container, spreading manure all year round, herds with dairy cattle compared with herds without dairy cattle, increasing herd size, purchase of cattle from markets, location of the farm in the proactive area of the RBCT compared with survey only and location of farms in Somerset and North Devon. The lower risk of HBD in the first year after restocking but not the second or third year suggests that removal of all cattle might have lowered the infectious load of M. bovis on these premises for a period of time but that this did not persist once cattle were reintroduced. Purchase of cattle from markets suggests that there was a risk of introduction or re-introduction of bTB from these cattle. Method of storage or lack of storage of slurry might aid persistence of M. bovis in the environment if M. bovis survives in slurry in some circumstances.

Bovine tuberculosis and milk production in infected dairy herds in Ireland

This study describes the relationship between bovine tuberculosis (TB) and milk yield in TB-infected dairy herds in Ireland. The study had two objectives: to determine whether cows detected as TB reactors (and thus subject to immediate slaughter) were likely to be the higher milk-producing cows, and to determine whether subclinical TB infection was associated with reduced milk production at or around the time of disclosure (detection). All Irish dairy herds restricted from trading between the 1(st) June 2004 and the 31(st) May 2005 as a result of two or more TB reactors by the Single Intradermal Comparative Tuberculin Test (SICTT) were considered for study. The data consisted of 419 herds. Data were collected on all TB reactors and a random sample of 5 non-reactor cows in these herds: a data set of 4340 cows (2342 TB reactors and 1998 non-reactors). Previous milk data for the cows were taken into consideration and thus all lactations on a cow were analysed together with the years of lactations. There was an inherent hierarchical structure in the data, with lactations nested within cows and cows within herds and thus a linear mixed model with two random effects was used to describe the data. The results of this study showed that for all lactations and years under investigation, milk yield was significantly lower for TB reactor cows, with differences ranging from 120kg (2003, lactation 3) to 573kg (2001, lactation 1), when compared to the non-reactor cows.

Pathology of naturally occurring bovine tuberculosis in England and Wales

The aim of this study was to obtain a contemporary data set of pathology in tuberculin reactor and in-contact cattle in England and Wales. Four hundred animals (200 reactors and 200 in-contacts) from 242 farms located in 14 counties in Western England and Wales were examined. The mean number of lymph nodes (LNs) with tuberculosis (TB)-like lesions per TB-confirmed animal was 1.7 in reactors and 1.5 in in-contact animals. Tuberculous lesions in both reactor and in-contact animals were most commonly observed in the LNs of the thorax, followed by the head and abdomen, particularly the mediastinal, retropharyngeal and tracheobronchial LNs. Twenty-five reactors had macroscopic lesions in the palatine tonsils. Among TB-confirmed cattle, 27% of reactors and 9% of in-contact animals had gross TB-like lesions in the lungs, particularly in the caudal lobes. Gross lesions that were not TB-confirmed were parasitic granulomas (45%), bacterial or mycotic club-forming pyogranulomas (27%) and bacterial abscesses (23%). Diagnostic sensitivity was maximised when bacteriology and histopathology were used concurrently. Stage IV granulomas, alone or in combination with other stages, constituted 63% of lesions, while 16% of lesions were stage I/II granulomas. Caseous necrosis and calcification were common features of the granulomas encountered in natural Mycobacterium bovis infections, even with pathology limited to a small number of sites. Granulomas often covered large areas of histological sections and typically contained only small numbers of acid fast bacilli.

Isolation of Mycobacterium spp. from Milking Buffaloes and Cattle in Nepal

In Nepal, mycobacterial isolates obtained from the milk and feces of buffaloes and cattle that were positive for the single intradermal cervical tuberculin (SICT) tests were genetically identified. A total of 36 mycobacterial strains were isolated from 39% of the buffaloes (14 of 36) and 34% of the cattle (11 of 32). Of the 36 strains, 13 were identified as M. bovis, and these strains were isolated from 17% of the buffaloes (6 of 36) and 16% of the cattle (5 of 32). M. bovis was isolated from both the milk and feces of one buffalo and one cattle, the milk alone of three buffaloes and three cattle, and the feces alone of two buffaloes and one cattle. These results suggest that milking buffaloes and cattle infected with M. bovis exist in Nepal. The remaining 23 strains were atypical mycobacteria. A program for the elimination of bovine tuberculosis should be implemented as soon as possible, and the public health education and proper hygienic practices may be required.

Ante mortem diagnosis of tuberculosis in cattle: a review of the tuberculin tests, gamma-interferon assay and other ancillary diagnostic techniques

The early, preclinical stages of bovine TB can be detected in live animals by the use of tests of cellular immunity (the skin, gamma-interferon and lymphocyte transformation tests). Tests of humoral (antibody) immunity, Mycobacterium bovis PCR probes on early tissue cultures or live cattle specimens, and tests based on "electronic nose" technology have been developed more recently. The key measure of diagnostic test accuracy is the relationship between sensitivity and specificity, which determines the false-positive and false-negative proportions. None of the tests currently available for the diagnosis of bovine TB allow a perfectly accurate determination of the M. bovis infection status of cattle. Although various factors can reduce the sensitivity and specificity of the skin tests, these remain the primary ante mortem diagnostic tools for TB in cattle, providing a cost-effective and reliable means of screening entire cattle populations. Despite the inescapable limitations of existing diagnostic tests, bovine TB has been effectively eradicated from many developed countries and regions with the implementation of sound programmes of regular tuberculin skin testing and removal of reactors, coupled with slaughterhouse surveillance for undetected infections, repeat testing and culling of infected herds, cattle movement restrictions to prevent introduction of infected animals and occasional slaughter of entire herds with intractable breakdowns. This is likely to remain the mainstay of bovine TB control programmes for the foreseeable future. Additionally, newer ancillary in vitro diagnostic assays are now available to TB control programme managers to supplement the skin tests in defined circumstances according to the specific disease situation in each country or region. The strategic deployment of ancillary in vitro tests alongside the primary skin tests has enhanced the detection of M. bovis-infected cattle and reduced the number of animals slaughtered as false positives.

The tuberculosis eradication programme in Ireland: a review of scientific and policy advances since 1988

A national programme to eradicate bovine tuberculosis commenced in Ireland in 1954. During the last 15-20 years, research has been conducted to address gaps in knowledge of disease epidemiology, to objectively evaluate alternative strategy options, and to critically assess the implementation of disease control strategies. This paper provides a review of scientific and policy advances in Ireland since 1988, relevant to the tuberculosis eradication programme in Ireland. There have been substantial advances in knowledge of aspects of disease epidemiology, relating to cattle-to-cattle transmission, the role of wildlife, transmission of infection from wildlife and methods to minimise wildlife-to-cattle transmission. Further, scientific advances have been made both in the detection and management of infected herds. With respect to policy, the paper describes current policy and policy advances in both the detection and management of infected herds, as well as current strategies to prevent herd breakdowns. The Irish programme is a useful example of science-informed policy in a national context.

Simple model for tuberculosis in cattle and badgers

As an aid to the study of bovine tuberculosis (TB), a simple model has been developed of an epidemic involving two species, cattle and badgers. Each species may infect the other. The proportion of animals affected is assumed relatively small so that the usual nonlinear aspects of epidemic theory are avoided. The model is used to study the long-run and transient effect on cattle of culling badgers and the effect of a period without routine testing for TB, such as occurred during the 2001 epidemic of foot-and-mouth disease in Great Britain. Finally, by examining the changes in cattle TB over the last 15 years, and with some other working assumptions, it is estimated that the net reproduction number of the epidemic is approximately 1.1. The implications for controlling the disease are discussed.

Use of rMPB70 protein and ESAT-6 peptide as antigens for comparison of the enzyme-linked immunosorbent, immunochromatographic, and latex bead agglutination assays for serodiagnosis of bovine tuberculosis

Current assays used to detect Mycobacterium bovis infection lack accuracy, especially for recently infected animals, or are impractical for rapid field diagnostic applications. To overcome these limitations with serological assays, a synthetic peptide derived from early secretory antigenic target 6 (ESAT6-p) and a recombinant major secreted immunogenic protein (rMPB70) of M. bovis were used in an enzyme-linked immunosorbent assay (EIA), an immunochromatographic assay (ICGA), and a latex bead agglutination assay (LBAA). Sera from noninfected, M. bovis-infected, or M. avium subsp. paratuberculosis-infected (by natural and experimental routes) animals were evaluated. Receiver operating characteristic analysis comparing optical density values from the EIA with results of bacterial culture or skin test, the reference test, established suitable cutoff values for assessing sensitivity and specificity. The EIA and LBAA, respectively, had sensitivities of 98.6 and 94.8%, specificities of 98.5 and 92.6%, and kappa values of 0.97 and 0.88 with ESAT6-p. The EIA, ICGA, and LBAA, respectively, had sensitivities of 96.8, 83.0, and 86.7%, specificities of 90.1, 99.4, and 97.8%, and kappa values of 0.87, 0.85, and 0.83 with rMPB70. Examination of serial samples of sera collected from experimentally M. bovis-infected cattle and deer revealed that ESAT6-p-specific responses developed early after infection whereas responses to rMPB70 developed later in the course of disease. The advantage of the LBAA and ICGA as initial tests for multiple species is a rapid reaction obtained in 2 to 3 h by LBAA or 20 min by ICGA without species-specific secondary antibodies under field conditions, thus allowing immediate segregation of suspect animals for further testing before culling.

Investigations of cattle herd breakdowns with bovine tuberculosis in four counties of England and Wales using VETNET data

Cattle herd breakdown (HBR) with bovine tuberculosis (BTB) was investigated for farms in four counties of England and Wales outside southwest England from 1986 to early 2000. Data from the national database of TB testing history (VETNET) were used. Factors that influenced HBR included calendar time, herd size, number of cattle tested, the test type, the inter-test interval and spatial grouping of farms. Herd tests other than routine herd tests had an increased risk of HBR in all four counties. In all counties, the risk of HBR increased with calendar time and in Shropshire a test interval of 3 years was associated with an increased risk of HBR compared with a 1-year test interval. In Staffordshire and Sussex, a 4-year test interval was associated with a lower risk of HBR compared with a 1-year test interval. There was no evidence of spatial clustering of HBR in West Glamorgan (equal spatial risk in a 15-30 km radius) and weak evidence of spatial clustering in Shropshire (7-15 km) and Sussex (5-10 km). In Staffordshire, there was evidence of spatial (2-4 km) and time (3-4 years) clustering of HBR. The locally increased rate of testing following a confirmed HBR increased the detection of infected herds but did not prevent local spread in two of the four counties (Shropshire and Staffordshire) since the rate of HBR increased linearly from 1988 to 2000. The main conclusion is that there were both local and distant components of spread.

Tuberculosis and badgers: new approaches to diagnosis and control

The Eurasian badger (Meles meles) is considered to be an important wildlife reservoir of Mycobacterium bovis infection for cattle in Ireland and in Great Britain. The inability to eradicate the disease from cattle is, in part, a consequence of M. bovis infection in badgers sharing the environment with cattle. Whereas national tuberculosis eradication programmes continue to be effective in maintaining the disease prevalence in cattle at a low level, strategies to control and eradicate tuberculosis in badgers remain constrained by a lack of reagents and rapid tests to diagnose tuberculosis infection in live badgers. However, the development of rational control measures for both badgers and cattle can be achieved by detailed epidemiological analysis combining immunological testing and strain typing with current developments in information technology and geographical information systems. This allows for construction of detailed profiles of tuberculosis episodes which can identify the nature of the outbreak, its likely origin and future spread. The identification of critical areas for control then permits the strategic allocation of resources based on analysis of disease patterns in cattle and badgers. Targeted vaccination of badgers is an option which could facilitate the elimination of disease in affected areas.

Diagnosis of Mycobacterium bovis infection in calves sensitized by mycobacteria of the avium/intracellulare group

Because of the frequent exposure of cattle to mycobacteria of the avium/intracellulare group, an investigation was carried out into the possible repercussions thereof on the diagnosis of bovine tuberculosis. Three calves from a bovine tuberculosis-free herd, scored avian reactors in the gamma-interferon assay for bovine tuberculosis, were sedated and inoculated endotracheally with a virulent Mycobacterium bovis strain. Then, three other avian reactors were housed with the above donor calves. Mycobacterium bovis was isolated from the nasal swabs of the three endotracheally infected, donor calves. On these samples, TB complex-specific polymerase chain reaction (PCR) tests for IS6110 were also positive, albeit with a different time kinetics. The three contact-infected calves showed clear immunological signs of infection; however, their nasal swabs were always PCR-negative and only Mycobacterium avium was isolated. In the endotracheally infected donor calves there was a rise of the gamma-interferon responses to avian and bovine purified protein derivative (PPD) tuberculins, which reached the same stable plateau levels over the whole experiment. The above effect was also observed in the contact-infected calves, even though the response to avian PPD tuberculin always remained at a higher level. By using conventional bovine and avian PPD tuberculins, the comparative intradermal test was generally positive in endotracheally infected, as opposed to contact-infected calves; a positive intradermal test for M. bovis was obtained in two contact-infected calves by different bovine PPD tuberculins based on M. bovis bacillus Calmette-Guerin (BCG) secreted or somatic antigens. It was concluded that M. bovis infection may be concealed for some time in cattle sensitized by mycobacteria of the avium/intracellulare group and that different diagnostic procedures should be adopted for such animals.

Evaluation of the Abbott LCx Mycobacterium tuberculosis assay for direct detection of Mycobacterium bovis in bovine tissue samples

The commercial LCx amplification assay, usually employed to detect the Mycobacterium tuberculosis complex in respiratory specimens, was evaluated by comparing the results it gave with those obtained using Lowenstein-Jensen solid medium and pathological findings in 55 lymph nodes from cattle with positive and 10 lymph nodes from cattle with negative skin tests for tuberculosis. Fifty-three cultures (51 and 2, respectively) were positive for M. bovis, while the results for the LCx assay and the histological method were positive in 48 (45, 3) and 24 (20, 4) samples, respectively. None of the samples from cattle from certified tuberculosis-free herds were positive by any of the procedures. The results obtained with the LCx assay, compared with the culture procedure, regarded as the gold standard among the diagnostic techniques, gave a specificity of 91.6% and sensitivity of 90.5%. Although the sensitivity of LCx was suboptimal, DNA of M. bovis was detected in 81.8% of the skin test-positive animals. Amplification techniques could provide a rapid and reasonably reliable tool for detecting bovine tuberculosis.

Cattle-to-cattle transmission of Mycobacterium bovis

This review, illustrated with data on the characteristics of herds infected with Mycobacterium bovis (TB) in Great Britain (GB), attempts to identify the role of cattle-to-cattle transmission (CCT) of TB. CCT plays a part in the entry of infection into herds, through purchased infected animals or contiguous spread, although CCT can have a relatively small role in comparison with an established wildlife source. Experimental studies have shown that it is possible for CCT to occur within herds. In 1999, more than one reactor was found in over two-thirds of confirmed TB incidents in Great Britain. The details of transmission from an infectious animal to a susceptible animal are described: proximate, which depends on factors such as closeness of contact and ventilation, or indirect, which also depends on survival outside the host. Herd size is a risk factor for the incidence of TB, both in herds and in individual cattle. Control of TB is considered in relation to the skin test: failure of the test to remove all infected animals from incidents is possible, but probably of less significance than failure to prevent reinfection from sources external to the herd. It is concluded that CCT may have significance in determining the total number of reactors. Safeguarding herds from other sources of TB is likely to reduce CCT as a side effect.

The development of wildlife control strategies for eradication of tuberculosis in cattle in Ireland

Wildlife species, such as badgers, act as maintenance hosts for Mycobacterium bovis and contribute to the spread and persistence of tuberculosis in associated cattle populations. In areas in which there is a tuberculosis problem affecting a number of herds, the involvement of infected wildlife in the introduction of M. bovis infection into herds act as a constraint to eradication of the disease. Epidemiological evidence demonstrates a high prevalence of tuberculosis in badgers, and controlled studies involving comprehensive badger removal have shown that this strategy can serve to significantly reduce cattle reactor rates in the targeted areas. However, as the badger is a protected wildlife species, alternative strategies are required to combat the disease. Targeted vaccination of wildlife species against tuberculosis is an option which, if successfully employed, could directly facilitate the advancement of bovine tuberculosis eradication in affected areas. Any proposed vaccination programme would need to be undertaken against the background of an exhaustive investigation of the cattle and herd management-related factors, and take account of environmental issues.