Rapid screening for Mycobacterium tuberculosis complex in clinical elephant trunk wash samples

SEROCONVERSION CAN PRECEDE CULTURE CONFIRMED DIAGNOSIS OF MYCOBACTERIUM TUBERCULOSIS INFECTION IN ASIAN ELEPHANTS (ELEPHAS MAXIMUS) BY DECADES

Mycobacterium tuberculosis (M. tb) infection was diagnosed in 16 human-managed Asian elephants (Elephas maximus) at four different US facilities. A retrospective review was performed to collate information on serological test results and describe the timelines from exposure to an elephant known to be positive for M. tb, detection of antimycobacterial antibodies in the exposed elephant, and M. tb isolation from the exposed elephant to confirm diagnosis. Seroconversion was defined by a positive test result using ElephantTB STAT-PAK, multiantigen print immunoassay, or DPP VetTB assay for elephants (Chembio Diagnostic Systems, Inc). Fifteen elephants were adults (age ≥24 yr) at first seroconversion and 26 yr or older when confirmed by a positive M. tb culture. Six animals were diagnosed postmortem, and 10 were diagnosed antemortem by positive trunk wash (TW) culture. The interval between last known exposure to an M. tb-positive elephant and serological conversion was 8.5 yr (median; range 0-18 yr) in the eight animals that had not already seroconverted. The median time from seroconversion to isolation of M. tb was 2.8 yr in elephants diagnosed by TW culture (antemortem) compared with those diagnosed postmortem (median 1.2 yr). Of the 10 elephants diagnosed antemortem, four were seropositive for 14 or more yr (range 0-33 yr) prior to the M. tb-positive culture. The median number of negative TW samples submitted between seroconversion and diagnosis by culture was 16 (range 0-151 samples). In contrast, a median of 48 negative TW cultures and 10 yr elapsed (range 0-41 yr) between exposure and culture diagnosis. Although this descriptive report has limitations, these findings are useful for veterinarians faced with an M. tb-seropositive elephant. This report supports the recommendation of increasing TW surveillance if an elephant has a history of exposure to an M. tb-positive elephant and has multiple seropositive results.

Molecular detection of Mycobacterium tuberculosis complex in a captive aguará popé (Procyon cancrivorus) with macroscopic tuberculosis like-lesions

Tuberculosis is a chronic and contagious infectious disease caused by multi-host species of the genus Mycobacterium grouped within the Mycobacterium tuberculosis complex. These pathogenic bacteria mainly affect mammals, including humans. The most recognized species is Mycobacterium bovis, the causative agent of bovine tuberculosis in livestock. Although livestock is the main host of M. bovis, this species is frequently isolated from wild animals. Wild native mammals from Central and South America, as the crab-eating raccoon or "aguará popé" (Procyon cancrivorus), may act as a source of tuberculosis and may represent a human health risk, especially in captive scenarios, due to closer animal-human interaction. However, the only presence of infection in wild animals is not enough to determine their epidemiological role in the disease. Here we identify tuberculosis in a captive aguará popé with clinical signs and lung macroscopic tuberculosis-like lesions during necropsy. We detected tuberculosis by polymerase chain reaction assay. DNA was extracted directly from lung tissue and the amplification target was the insertion sequence 6110. This study contributes to investigate the presence of the disease in wild native animals of Argentina and supports the knowledge that wild mammals may act as a source of TB for humans and domestic animals.

Understanding Mycobacterium tuberculosis complex in elephants through a One Health approach: a systematic review

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.