1. Bovine Tuberculosis: Public Health Considerations
Jen Brown, DVM, MPH, DACVPM
State Public Health Veterinarian
Updated in March 2017

2. Mycobacterium bovis (Mb)
Gram positive, acid-fast bacterium in Mtb complex
Host species: cattle, deer, bison, elk
Many developed countries are Mb free
Widespread in Africa, Asia, and the Middle East
White-tailed deer. Photo: John White.
Elk. Gerald and Buff Corsi,
© California Academy of Sciences.

3. Zoonotic Mb transmission
Consumption of unpasteurized milk/cheese
Consumption of infected meat
Introduction of body fluids into a wound
Inhalation of respiratory aerosols
Person-to-person transmission possible
CDC/Minnesota Department of Health, 1929.

4. Zoonotic Mb infection Clinically similar to Mtb
Extrapulmonary infection more likely
Asymptomatic (LTBI)
Constitutional symptoms
Pulmonary symptoms
GI symptoms
Resistant to pyrazinamide
Constitutional symptoms: fever, weight loss, night sweats
Radiograph shows bilateral advanced TB with pulmonary infiltrates and cavitation
Photo: CDC.

5. Zoonotic Mb epidemiology (US)
Rare: 1.4% of TB disease cases
Higher prevalence in US-Mexico border areas
Risk factors:
Foreign born
Hispanic or Latino ethnicity
Less than 15 years of age
HIV infection
Exposure to cattle, bison, or cervids
Consumption of unpasteurized dairy products, especially Mexican origin
Why is zoonotic M. bovis rare in the US? 1) M. bovis eradication programs in animals; 2) Pasteurization of milk.

7. Prevention of zoonotic Mb infection
Do not consume unpasteurized dairy products
Prevent infected meat/milk from entering the food supply
Take precautions against contact with body fluids or tissue from wild bison or cervids
People at risk of exposure should promptly seek medical attention for compatible illness

8. CDC/Minnesota Department of Health, 1925.

9. PPE for responders Testing: boots, coveralls, disposable gloves
Necropsy:
Disposable gloves
Cut-resistant glove on non-dominant hand
Goggles, safety glasses, or face shield
Disposable apron
Forearm protectors
Cloth or Tyvek® coveralls
Rubber boots
Hairnet
Fit-tested N95 respirator

10. Testing for responders
Responders to bovine TB outbreaks are generally considered low-risk for Mb infection
Higher-risk exposures: handling or necropsy of confirmed positive animals
Recommendations:
Baseline TB test at the time of hire
Testing 8-10 weeks after high-risk exposure

11. Recommendations for hunters
Wear disposable gloves when field-dressing deer
Know the appearance of Mb pathology
Do not eat meat from animals with TB lesions
Contact DNR for testing of suspect animals

12. JEN BROWN, DVM, MPH, DACVPM State Public Health Veterinarian
      
JEN BROWN, DVM, MPH, DACVPM
State Public Health Veterinarian
Zoonotic and Vector-Borne Epidemiology
Indiana State Department of Health
office
mobile
fax
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