Different lesion distribution in calves orally or intratracheally challenged with Mycobacterium bovis: implications for diagnosis

Prevalence of tuberculosis in bovines in Pakistan during 2000-2024: a systematic review and meta-analysis

Background

Bovine tuberculosis (bTB) primarily caused by Mycobacterium bovis (M. bovis), is a globally prevalent zoonotic infectious disease of cattle and other livestock and wildlife species. Pakistan is the fourth-largest milk-producing country in the world, with approximately 212 million animals. Livestock farming provides a livelihood for almost 8 million families. Moreover, there is currently no effective control program and national data in place. Therefore, we constructed a first meta-analysis on the prevalence of bovine tuberculosis in Pakistan. This study aimed to provide an overview of bovine tuberculosis in this country and identify the risk factors associated with its prevalence.

Methods

We searched Science Direct, Pubmed, Base, Green File-Poly U Library, Google Scholar, and additional articles were also identified manually from reference lists of articles generated in database search, systemically for papers that presented bTB prevalence data, published in English language between January 1, 2000, and April 30 2024. A total of 35 published articles were selected for inclusion in the meta-analysis.

Results

The estimated overall prevalence of bTB was found to be 6.06% [95% CI: 4.67-7.87]. Cattle were more susceptible to infection, with a higher prevalence (6.44% [95% CI: 4.04-10.26]) compared to buffalo (5.54% [95% CI: 3.13-9.81]). The prevalence determined by PCR (5.65% [95% CI: 3.33-5.98]) was much similar to that of TST (5.61% [95% CI: 4.20-7.50]) with no significant difference. Milk samples showed the highest prevalence (14.66% [95% CI: 7.38-29.11]), particularly due to the consumption of unpasteurized milk, improper handling of dairy products and suckling by calves from the infected cows. Furthermore, the analysis considered effect of various potential risk factors (age, weight, breed, body condition score, herd size, animal status) along with different geographical factors (longitude, latitude, altitude, humidity, rainfall, temperature, climate) associated with bTB prevalence, which should be considered when developing future disease surveillance and control programs.

Conclusion

In Pakistan bTB was widely distributed throughout the country, as a neglected zoonotic disease. Long-term disease prevalence monitoring should be recommended along with the need to improve diagnostic techniques, enhance farm management practices, and implement targeted surveillance to protect both animal and public health.

Vestibular syndrome in dairy heifers associated with Mycobacterium bovis: two case reports and strain characterization

Bovine tuberculosis is a chronic disease caused by Mycobacterium bovis which rarely causes a neurologic clinical presentation. Tuberculous meningitis is a common clinical finding in young calves in dairy herds where tuberculosis is endemic, associated with the early consumption of milk from infected cows. We report two simultaneous cases of vestibular syndrome, including loss of balance, circling, tilted head, and strabismus in 12- and 16-month-old Holstein heifers on a dairy farm in Tandil, Buenos Aires province, Argentina, with low tuberculosis prevalence (< 1.0%). Several widespread granulomatous lesions including large intracranial granulomas, characterized by a fibrous capsule containing pale yellow granular caseous material, with were observed during postmortem examination of both heifers. Microscopically, granulomas were characterized by the presence of a central caseous necrosis with mineralization, surrounded by an abundant macrophages, lymphocytes, and plasma cells infiltrate, with the presence of multiple Langhans-type giant cells, epithelioid macrophages, and connective tissue proliferation in the outer circumference. Mycobacterium bovis was isolated from different granulomas and associated lymph nodes and was typed by spoligotyping. This uncommon clinical presentation of bovine tuberculosis should be considered by veterinary practitioners, particularly in dairy herds where tuberculosis is endemic.

Case report: Discovery of tuberculosis caused by Mycobacterium bovis in free-ranging vervet monkeys in the Greater Kruger Conservation Area

Animal tuberculosis (TB) has been reported in several wildlife species in the Greater Kruger Conservation Area (GKCA), South Africa. This report describes the discovery of clinical tuberculosis, caused by Mycobacterium bovis (M. bovis), in free-ranging vervet monkeys (Chlorocebus pygerythrus). The "One Health" concept is especially relevant to TB since this is a multi-host disease with zoonotic potential and is endemic in GKCA. Vervet monkeys have become habituated to humans in tourist areas and may be a source of infection through close contact. Indirect transmission of M. bovis through environmental sources has also been suspected to present a risk of spread between host species. Clinically diseased monkeys present in two tourist areas in the GKCA, that died (n = 1) or were euthanized (n = 5), were submitted for diagnostic necropsies. The presence of pathological lesions, Ziehl-Neelsen-stained impression smears, Xpert® MTB/RIF Ultra (GXU) assay, mycobacterial culture and speciation by genomic regions of difference PCR, were used to confirm the diagnosis of M. bovis infection in these monkeys. The finding of multiple cases necessitates further investigation of TB in monkey troops living within the GKCA tourist areas to determine the source of infection and assess the risk of transmission to other animals and humans.

An Overview of a Re-Emerging Disease in Italy: Bovine Tuberculosis Outbreaks in Cattle from MTBC-Free Territories

Bovine tuberculosis (bTB) is a zoonotic disease with consequences for public health as well as the economy. In the EU, compulsory eradication programmes have been applied, and most territories in Italy have been reported as disease-free (FTs). However, outbreaks (OBs), i.e., an officially confirmed occurrence of bTB in one or more animals in an establishment, have continued to be reported. In this study we provide an overview of bTB in terms of OB numbers in cattle from Italian FTs. Legislative sources were collected to find the FTs, the relevant declaration of free status year (FSY), and regional control and surveillance plans. Then, descriptive and statistical analyses were applied to the collected OBs. A total of 12 regions and 19 provinces were declared FTs in the 20 years from 2003 to 2023. Differences in regional plans were observed with respect to the percentages of herds that were annually controlled (control frequency). Overall, 370 OBs were recorded. A non-statistically significant decrease in the OB incidence rate after the FSY was declared. However, a notable increase in OBs detected at slaughterhouses after the FSY suggests that control systems (serological tests) at the herd level are not completely effective. Differences in the herds' control frequencies among FTs seem to not have had a significant influence on the observed OB number. The Tuscany region was the most affected FT based on the OB numbers after the FSY (especially in the last year). Epidemiologically relevant primary determinants seem to be the farming system (semi-extensive and adjacent herds) and the cattle movements from positive incidence areas (trade and animal fairs). The role of wild boars in the disease maintenance cannot be excluded. The results of this study stress the need to revise bTB eradication and surveillance plans based on risk analysis.

Experimental infection of goats with Mycobacterium microti induces subclinical pulmonary tuberculosis and mild responses to tuberculin skin tests

Mycobacterium microti is a member of the Mycobacterium tuberculosis complex that seldom causes disease in livestock and humans. This study evaluated the effects on immunodiagnosis and the pathological findings in goats after experimental exposure by different routes and doses to M. microti. In a first experiment goats were challenged orally (PO, n = 7) or intranasally (IN, n = 7) with 104 CFU. In a second experiment, the endobronchial route was assessed, with a low dose of 102 CFU (EB-LD, n = 7) and a high dose of 105 CFU (EB-HD, n = 7) as well as the subcutaneous route (SC, n = 5). Temperature, body weight, clinical signs and immunological responses were monitored. Pathological evaluation was carried out and samples were processed for mycobacterial detection. RESULTS: demonstrated the induction of a subclinical pulmonary infection in all the EB-HD challenged animals. Infection was also confirmed in one animal of the SC group, but not in the EB-LD, PO or IN groups. Two animals belonging to the EB-HD and SC groups, respectively, showed positive results to the single intradermal tuberculin test, and another two animals of the EB-HD and EB-LD groups showed doubtful (inconclusive) results, indicating that M. microti can induce mild responses to tuberculin skin testing. No positive results were observed when defined antigens absent in M. microti (ESAT-6 and CPF-10) were used. Our results indicate that animals exposed to M. microti can yield positive results to the skin tests currently performed in livestock tuberculosis eradication campaigns and reinforce the need to use specific antigens in antemortem tests to avoid interference with M. bovis/M. caprae diagnosis.

Condemnation of bovine carcasses due to tuberculosis-gross lesions in Rio Grande do Sul, Brazil: Associated risk factors

Surveillance of bovine tuberculosis (bTB) lesions in animals at slaughterhouses is useful for controlling and eradicating the disease, besides providing epidemiological information. This study aimed to identify risk factors for bovine tuberculosis (bTB) condemnation in cattle at slaughterhouses in Rio Grande do Sul, Brazil. A logistic regression analysis was conducted using data on bTB-related condemnations. Variables examined included animal origin, number of slaughtered animals, season, inspection level (state or municipality), animal sex, and slaughterhouse location. A total of 297,817 Animal Transport Guides were evaluated, representing the transportation of 3497,521 animals. Among these, 6097 (2.05%) had at least one animal condemned due to bTB lesions. Risk factors for condemnation included larger batch sizes, female animals, slaughterhouses, and animal origin. The higher condemnation frequency in females and regions with dairy farms suggests links to milk production. Variation in condemnation rates by inspection level and slaughterhouse highlights the need for standardized procedures in identifying bTB lesions. Identifying these risk factors enables targeted interventions to enhance disease control and eradication efforts.

Will we ever eradicate animal tuberculosis?

Two characteristics of the Mycobacterium tuberculosis complex (MTC) are particularly relevant for tuberculosis (TB) epidemiology and control, namely the ability of this group of pathogens to survive in the environment and thereby facilitate indirect transmission via water or feed, and the capacity to infect multiple host species including human beings, cattle, wildlife, and domestic animals other than cattle. As a consequence, rather than keeping the focus on certain animal species regarded as maintenance hosts, we postulate that it is time to think of complex and dynamic multi-host MTC maintenance communities where several wild and domestic species and the environment contribute to pathogen maintenance. Regarding the global situation of animal TB, many industrialized countries have reached the Officially Tuberculosis Free status. However, infection of cattle with M. bovis still occurs in most countries around the world. In low- and middle-income countries, human and animal TB infection is endemic and bovine TB control programs are often not implemented because standard TB control through testing and culling, movement control and slaughterhouse inspection is too expensive or ethically unacceptable. In facing increasingly complex epidemiological scenarios, modern integrated disease control should rely on three main pillars: (1) a close involvement of farmers including collaborative decision making, (2) expanding the surveillance and control targets to all three host categories, the environment, and their interactions, and (3) setting up new control schemes or upgrading established ones switching from single tool test and cull approaches to integrated ones including farm biosafety and vaccination.

Prevalence and Molecular Characterization of Mycobacterium bovis in Slaughtered Cattle Carcasses in Burkina Faso; West Africa

This cross-sectional study was conducted at the slaughterhouses/slabs of Oudalan and Ouagadougou in Burkina Faso, between August and September 2013. It aimed at determining the prevalence of bovine tuberculosis (bTB) suggestive lesions in slaughtered cattle carcasses and to identify and characterize the mycobacteria isolated from these lesions. A thorough postmortem examination was conducted on carcasses of a total of 2165 randomly selected cattle. The overall prevalence of bTB suggestive lesions was 2.7% (58/2165; 95% CI 2.1–3.5%). Due to the low number of positive samples, data were descriptively presented. The lesions were either observed localized in one or a few organs or generalized (i.e., miliary bTB) in 96.6% (n = 57) and 3.4% (n = 2), respectively. The identified mycobacteria were M. bovis (44.4%, n = 20), M. fortuitum (8.9%, n = 4), M. elephantis (6.7%, n = 3), M. brumae (4.4%, n = 2), M. avium (2.2%, n = 1), M. asiaticum (2.2%, n = 1), M. terrae (2.2%, n = 1), and unknown non-tuberculous mycobacteria (NTM) (11.1%, n = 5). Moreover, eight mixed cultures with more than one Mycobacterium species growing were also observed, of which three were M. bovis and M. fortuitum and three were M. bovis and M. elephantis. In conclusion, M. bovis is the predominant causative agent of mycobacterial infections in the study area. Our study has identified a base to broaden the epidemiological knowledge on zoonotic transmission of mycobacteria in Burkina Faso by future studies investigating further samples from humans and animals, including wild animals employing molecular techniques.

Real-time PCR using atpE, conventional PCR targeting different regions of difference, and flow cytometry for confirmation of Mycobacterium bovis in buffaloes and cattle from the Delta area of Egypt

Background

Mycobacterium bovis notoriously causes detrimental infections in bovines and humans. In this study, 1500 buffaloes and 2200 cattle were tested by single intradermal comparative cervical tuberculin test and compared with the detection rates of M. bovis isolation, real-time and simplex PCR, and flow Cytometry.

Results

The tuberculin test is the reference test in Egypt, the positive rate was 54/3700 (1.5%) composed of 18/1500 (1.2%) buffaloes and 36/2200 (1.6%) cattle which were mandatorily slaughtered under the Egyptian legislation, after postmortem examination the non-visible-lesion proportion was 39/54 (72.2%) which surpassed the visible-lesion rate 15/54 (27.8%) with (p < 0.0001). The samples from each case were pooled into one sample representing the case, and the isolation rate of M. bovis was 25/54 (46.3%). Real-time PCR using atpE was positive for mycobacteria on the genus level in 18/18 (100%) and 5/5 (100%) of tissue samples and isolates, respectively; simplex PCR detected M. bovis in 44/54 (81.5%) and 25/25 (100%) of tissue samples and isolates, respectively. Flow Cytometry evaluation of the CD4⁺, CD8⁺, WC1⁺δγ, and CD2⁺ cell phenotypes showed increased counts in the tuberculin-positive cases compared with negative cases (p < 0.0001), and these phenotypes in the tuberculin-positive cases increased after antigen stimulation than in the negative cases (p < 0.0001). Detection rates of PCR techniques and flow Cytometry exceeded that of bacterial isolation (p < 0.0001) and exhibited a strong correlation.

Conclusions

The skin test suffers from interference from non-tuberculous mycobacteria able to cause false-positive reactions in cattle and other species. Real-time PCR using atpE, conventional PCR targeting RDs, and flow Cytometry are rapid and accurate methods that correlate with the isolation and can be promising for detection and confirmation of infected live and slaughtered cases.

Detection of Mycobacterium tuberculosis complex DNA in oronasal swabs from infected African buffaloes (Syncerus caffer)

Mycobacterium bovis (M. bovis), a member of the Mycobacterium tuberculosis complex (MTBC), is the causative agent of bovine TB (bTB) in animals. Spread occurs through inhalation or ingestion of bacilli transmitted from infected individuals. Early and accurate detection of infected African buffaloes shedding M. bovis is essential for interrupting transmission. In this pilot study, we determined if MTBC DNA could be detected in M. bovis infected buffalo oronasal secretions using a molecular transport media (PrimeStore MTM) with oronasal swabs and a rapid qPCR assay (Xpert MTB/RIF Ultra). Bovine TB test-positive buffaloes were culled, then tissue samples and oronasal swabs collected post-mortem for mycobacterial culture and Ultra testing, respectively. The Ultra detected MTBC DNA in 5/12 swabs from M. bovis culture-confirmed buffaloes. Oronasal swabs from M. bovis negative buffaloes (n = 20) were negative on Ultra, indicating the high specificity of this test. This study showed that MTM can successfully preserve MTBC DNA in oronasal swabs. The proportion of MTBC positive oronasal swabs was higher than expected and suggests that the Ultra may be an additional method for identifying infected buffaloes. Further studies are needed to confirm the utility of the Ultra assay with oronasal swabs as an assay to evaluate possible MTBC shedding in buffaloes.

An abattoir-based study on the prevalence of bovine tuberculosis from culled adult dairy cows in Wuhan, China

Abattoir surveillance is an integral component of a bovine tuberculosis (bTB) eradication programme. The objective of this study was to determine the prevalence of bTB among culled adult dairy cows in Wuhan, China and to further assess two diagnostic procedures as an adjunct to the confirmation of M. bovis in animals with TB-like lesions. The study was conducted in an abattoir located in Wuhan, China over a period of 41 days from June to July 2019. A total of 171 culled adult dairy cows were sampled and inspected, and blood samples collected from 134 of these. The viscera and lymph nodes of the carcasses were visually inspected and palpated for TB-like lesions. A total of 28.1 % (48/171) of the carcasses had gross TB-like lesions. 89.6 % (43/48) of the animals with TB-like lesions were positive to a PCR procedure for bTB. The sensitivity and specificity for post-mortem examination for TB-like lesions using a Bayesian latent class analysis model was estimated to be 60.8 % and 86.6 %, respectively. A seroprevalence of 20.9 % (28/134) was recorded for antibody response to M. bovis antigens MPB70 and MPB83 based on an ELISA procedure. There was a low-moderate agreement between the ELISA and PCR results in the detection of bTB (Kappa = 0.46, 95 % CI: 0.24-0.67). The study confirms a high prevalence of bTB among culled adult dairy cows in the abattoir and highlights the need to implement surveillance for bTB based on post-mortem examination and ELISA and PCR methods in association with backward tracing of infected dairy herds.

Retrospective analysis of the control and prevention of tuberculosis among cattle in Ukraine in the period 1994–2020

Bovine tuberculosis (bTB) – is a chronic infectious disease, the causative agent of which affects many species of mammals. It is a zoonosis caused by various types of mycobacteria in the complex Mycobacterium tuberculosis family Mycobacteriaceae. The most important etiological agent of bTB in cattle is M. bovis, which has been isolated from tuberculosis infected cattle for centuries. Livestock and species of the Bovidae family are the most susceptible to this pathogen and are the main reservoir species for animals and humans. In Ukraine, the main methods of diagnosing tuberculosis in animal husbandry are lifetime (clinical examination, allergic intradermal test with tuberculin), and postmortem techniques (pathological changes, bacteriological investigation). The authors performed a retrospective analysis of the epizootic situation of tuberculosis among cattle in Ukraine for the period 1994–2020 and conducted a critical assessment of the work done to prevent and control this disease. In total, over the last 27 years, 219 088 head of cattle with tuberculosis and 933 affected locations have been identified in Ukraine. The results of this work showed that in our country the epizootic situation of bovine tuberculosis on farms of various forms of ownership is fully controlled. The most active fight against tuberculosis was carried out during 1995–2015. In 1994–1997, the largest number of affected locations was registered, from 90 to 144, respectively, and the largest number of animals with tuberculosis – 21 395–33 474. In 1994–1995, the largest number of sick animals per one affected point was registered (371.9 and 471.7 head, respectively). Currently, official statistics show that many farms, especially in Vinnytska, Cherkaska and Kyivska regions, continue to show positive allergic reactions to tuberculin (46 898 reactions for the last 12 years). Applying diagnostic methods of research in complex (bacteriological, bioassay, molecular), excludes affection of cattle by pathogenic mycobacteria. This study showed that for the last 5 years no farms with confirmed pathological diagnosis by bacteriological methods have been registered and no culture of the pathogen from animals has been detected. Besides the scurpulous work of the veterinary service, in our opinion, the catastrophic decline in the number of cattle in Ukraine also had a significant impact on improving the epizootic situation regarding tuberculosis.

High prevalence of extrapulmonary tuberculosis in dairy farms: Evidence for possible gastrointestinal transmission

Bovine tuberculosis (bTB) caused by Mycobacterium bovis (M. bovis) represents one of major zoonotic diseases among cattle, it also affects the health of human, other domestic animals and wild life populations. Inhalation of infected aerosol droplets is considered as the most frequent route of the infection. This study aims to investigate the current forms of tuberculosis in cattle and identify the possible transmission modes in dairy farms of China. 13,345 cows from eight dairy farms in three provinces were comprehensively diagnosed by a multitude of assays, including SIT, CIT, IFN-γ assay and ELISA. It has been indicated that advanced infection of bTB was found in 752 (5.64%) cattle, suggesting a high prevalence of tuberculosis in these dairy farms. In the necropsy examination of 151 positive cattle, typical bTB lesions were observed in 131 cattle (86.75%), of which, notably, 90.84% lesions appeared in liver, spleen, mesenteric lymph nodes, mammary lymph nodes and other organs, taking up a large proportion among cattle with advanced bTB infection. 71.26% extrapulmonary tuberculosis (EPTB) was related to gastrointestinal system. M. bovis nucleic acid was further found in milk and feces samples and M. bovis was even isolated from milk samples. Phylogenetic analysis based on whole genome sequencing unraveled that six isolates were closely related to M. bovis AF2122/97 originated from UK, whereas four isolates shared close relation to M. bovis 30 from China, respectively. Our data demonstrate that the increase of EPTB transmitted by digestive tract is implicated in the current high prevalence rate of bTB in China, which also provides leads for bTB control in other countries with high prevalence of bTB in the future.

Pathology of Gastrointestinal Tuberculosis in Cattle

We describe the pathology of gastrointestinal tuberculosis in three cows. Gross lesions were found in the jejunum and ileum in all cases, and were characterized by button-shaped ulcers in the mucosa overlying Peyer's patches and adjacent mucosa. One case had similar changes in the pyloric region of the abomasum. In the affected intestinal segments, marked granulomatous inflammation effaced the lymphoid follicles of Peyer's patches and often extended transmurally. Transmural granulomatous inflammation was also found in the abomasum of one cow. Acid-fast bacilli were identified by the Ziehl-Neelsen method and the lesions were immunolabelled by an anti-Mycobacterium tuberculosis complex antibody. M. tuberculosis var. bovis was isolated in one case. Disseminated tuberculosis and marked lung lesions in all cows suggested that the gastrointestinal lesions were most likely secondary to pulmonary infection.

Prevalence of Bovine Tuberculosis in Slaughtered Cattle in Sicily, Southern Italy

Simple Summary

Mycobacterium bovis is a Gram-positive, acid-fast bacterium responsible for disease in cattle and in several other domestic and wild animal species, also representing a prominent cause of morbidity and mortality in humans. In Italy, the incidence of bovine tuberculosis (bTB) in cattle has been progressively reduced throughout the years; however, the disease still remains widespread in Southern Italy, with the highest prevalence rates recorded in Sicily. Specific eradication programs have been established, with herd testing and post-mortem inspection at the slaughterhouse used as diagnostic procedures to obtain epidemiological data on bTB prevalence. The concomitant use of these procedures is essential in epidemiological surveillance programs, and although data on disease prevalence at herd level are systematically collected and used for epidemiological surveillance in Sicily, data from post-mortem inspection are scant. Therefore, the current survey aimed to investigate the prevalence of bTB in cattle in Sicily during two different three-year periods, using data from meat inspections and histopathological methods. Results obtained show that even though bTB occurrence in cattle was well reduced over the years, the disease still remains widespread in this region, posing severe implications for public health and a prominent economic impact on the livestock industry.

Abstract

Post-mortem inspection in slaughterhouses plays a key role in the epidemiological surveillance of infectious diseases, including bTB. This study assessed the prevalence of bTB in cattle in Sicily during two different three-year periods (2010–2012; 2017–2019), using data from meat inspections and histopathological methods. Out of 100,196 cattle, 5221 (5.21%) were diagnosed with tuberculous lesions. Higher prevalence of bTB was recorded during the triennium 2010–2012 (6.74%; n = 3692) compared to the triennium 2017–2019 (3.36%; n = 1529), with a decreasing trend in annual occurrence throughout the study period and a heterogenous proportion of infected cattle among the Sicilian provinces (p < 0.01). Lower rates of infection were recorded in animals aged <12 months and >84 months (p < 0.0001). Pearson’s chi square analysis revealed a higher localization of lesions in the thoracic cavity (p < 0.0001). Gathered findings show that even though bTB occurrence in cattle was greatly reduced over the years, the disease still remains widespread in Sicily, also posing severe implications for public health.

Evaluation of the immunogenicity and efficacy of BCG and MTBVAC vaccines using a natural transmission model of tuberculosis

Effective vaccines against tuberculosis (TB) are needed in order to prevent TB transmission in human and animal populations. Evaluation of TB vaccines may be facilitated by using reliable animal models that mimic host pathophysiology and natural transmission of the disease as closely as possible. In this study, we evaluated the immunogenicity and efficacy of two attenuated vaccines, BCG and MTBVAC, after each was given to 17 goats (2 months old) and then exposed for 9 months to goats infected with M. caprae. In general, MTBVAC-vaccinated goats showed higher interferon-gamma release than BCG vaccinated goats in response to bovine protein purified derivative and ESAT-6/CFP-10 antigens and the response was significantly higher than that observed in the control group until challenge. All animals showed lesions consistent with TB at the end of the study. Goats that received either vaccine showed significantly lower scores for pulmonary lymph nodes and total lesions than unvaccinated controls. Both MTBVAC and BCG vaccines proved to be immunogenic and effective in reducing severity of TB pathology caused by M. caprae. Our model system of natural TB transmission may be useful for evaluating and optimizing vaccines.

Tuberculosis vaccination sequence effect on protection in wild boar

The Eurasian wild boar (Sus scrofa) is a reservoir for tuberculosis (TB) in which vaccination is a valuable tool for control. We evaluated the protection and immune response achieved by homologous and heterologous regimes administering BCG and heat-inactivated Mycobacterium bovis (IV). Twenty-one wild boar piglets were randomly allocated in five groups: Control, homologous BCG, homologous IV, heterologous IV-BCG, heterologous BCG-IV. Significant 67% and 66% total lesion score reductions were detected in homologous IV (IVx2) and heterologous IV-BCG groups when compared with Control group (F_4,16 = 6.393, p = 0.003; Bonferroni _{Control vs IVx2} p = 0.026, Tukey _{Control vs IV-BCG} p = 0.021). No significant differences were found for homologous BCG (although a 48% reduction in total lesion score was recorded) and BCG-IV (3% reduction). Heterologous regimes did not improve protection over homologous regimes in the wild boar model and showed variable results from no protection to similar protection as homologous regimes. Therefore, homologous regimes remain the best option to vaccinate wild boar against TB. Moreover, vaccine sequence dramatically influenced the outcome underlining the relevance of studying the effects of prior sensitization in the outcome of vaccination.