Bovine TB Jackie Skelton, MPH, RN

Why bTB? Recent infection found in cattle on 2 farms in SW MI Farms linked by sale of cattle Cattle bought from Indiana farm Genetically linked to 2016 bTB outbreak in IN Human contacts tested on 1 farm No human cases found Still working to test contacts of 2nd farm SW MI strain NOT related to known, ongoing deer herd infection in NW lower MI 6 states have current bTB activity MI, NM,NE, SD, TX, IN

Background Organism: Mycobacterium bovis Not M.Tuberculosis but clinically indistinguishable Chronic, progressive disease Can be deadly if disease not treated Found in wild animals like deer, elk, bison Passed from wild to domestic cattle through food/water sources/close contact Can occur in the lungs, intestines, lymph nodes and other parts of the body Infected animals often appear healthy Routine testing of cattle has nearly eradicated infected cattle herds in the US Less than 2% of human cases of disease are from M. bovis in U.S. 90% of cases in Mexico are M. Bovis

Transmission Animal to Human Person to Person Consuming unpasteurized dairy products from infected animals Direct contact with bacteria Meat processing plants Hunting/field dressing game Transmission through air is thought to be rare Person to Person Same as M. Tuberculosis (airborne/droplets) Coughing Sneezing Prolonged, close contact

Signs and Sypmtoms of M. bovis Disease People Animals Very similar to M. tuberculosis May be asymptomatic Pulmonary Disease: Fever/Night sweats Weight loss Cough Depending on location of disease could also include: Abdominal pain Diarrhea Swollen Lymph Nodes May be asymptomatic Localized infection ->Lymph nodes Cough Nasal discharges Difficulty breathing Emaciation Intolerance to exercise

Testing Same tests for cattle and humans Skin test IGRA (ie. Quantiferon Gold, T-Spot) Approved for screening for M. bovis Used on cattle prior to licensing for human testing Testing usually stops after ‘mycobacterium’ identified, typing not done Due to known bTB infected deer herd in NE lower peninsula, typing is done in MI

Treatment of M. bovis in People Human cases treated the same as M. Tuberculosis cases If strain is known to be M. Bovis Disease treated with Ethambutol, Isoniazid, Rifampin M. bovis resistant to Pyrazinamide Latent infection treated with 9 months of Isoniazid *No vaccine/treatment for animals. *Herds infected with bTB are slaughtered and each animal tested

Control of M. bovis Treat latent/active disease in people Educate public about risks Federal programs started in early 1900s Test livestock on farms Monitor/test animals sent to slaughter Track animals sold/moved across state lines State level wildlife disease surveys and deer management strategies Working with hunters

Thank You! Resources: Centers for Disease Control (2011). Division of Tuberculosis Elimination. Mycobacterium bovis (Bovine Tuberculosis) in Humans. https://www.cdc.gov/tb/publications/factsheets/general/mbovis.pdf Michigan Department of Health and Human Services (2018). Michigan Emerging Disease Issues: http://www.michigan.gov/emergingdiseases