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TB in Four- and Two-Legged Animals

TB in Four- and Two-Legged Animals. Lorna Will RN, MA WI Division of Public Health WMLN 2013. What is the problem?. Wisconsin has a few cases of TB disease each year in humans working with four-legged animals Dairy and beef farms, zoos, pet stores…

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TB in Four- and Two-Legged Animals

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  1. TB in Four- and Two-Legged Animals Lorna Will RN, MA WI Division of Public Health WMLN 2013

  2. What is the problem? • Wisconsin has a few cases of TB disease each year in humans working with four-legged animals • Dairy and beef farms, zoos, pet stores… • WI has 1-2 cases of TB disease in humans due to M. bovis each year; cattle and other four-legged animals are very susceptible to M. bovis • Most mammals can get TB – bovis or MTB

  3. What is the problem? • A case of TB in a Mexican farmworker in 2012 crossed 5 WI counties and involved hundreds of people during the year the patient was thought to be infectious • As he was infected with M. tuberculosis, no investigation of the herds he worked with was done. • Was this correct?

  4. What is the problem? • There is no national protocol for investigating a herd (or other group of animals) which have been exposed to human TB, whether M. bovis or M. tuberculosis • Source of M. bovis TB in US is largely Hispanic workers infected by ingestion of unpasteurized dairy products from infected cows

  5. What is the problem? • M. bovis infection is NOT a problem in US herds, except in California and the lower peninsula of Michigan • Pasteurization kills TB • M. bovis is very transmissible to herds; MTB less so

  6. What is the problem? • The cost, both in terms of $ and animals, to an individual farmer and to the state, if a cow is found to be positive for TB, is enormous • California: single cow found + at necropsy; more than 400,000 cows had to be traced at a cost of almost $2 billion • Herd is quarantined and repeatedly tested; any herds that share a fence line are also quarantined and tested

  7. What is the problem? • The cost, both in terms of $ and animals, if a single cow is found to be positive for TB, is enormous • Wildlife in the quarantine area are tested by DNR • No animals may be moved until herd is clear unless the farmer chooses to depopulate the herd; then premises are decontaminated and farmer may start over • Product cannot be shipped

  8. What is the problem? • The cost, both in terms of $ and animals, if a single cow is found to be positive for TB, is enormous • If the herd is not depopulated, the herd is retested over the next five years • Milk can be sold as long as any milk from positive animals is kept out of the bulk tank • Movement is restricted

  9. The Dairy Industry in WI • The dairy industry is an annual $26.5 billion industry in Wisconsin • 86.8% of farms are family-owned • There are about 12,000 dairy farms in WI

  10. Wisconsin Dairy Industry

  11. The Plan • Advice of what to do when a farmworker tests positive for TB has varied over the years and is not consistent • Since there is no national protocol (or even any final state protocols) we decided to create our own • Major point is communication – LHD, DPH, DATCP, DNR, APHIS, USDA

  12. DPH-specific actions • Identify prevalence of TB infection • Farm worker testing: Marathon, Buffalo, Pepin Counties • Majority of farm workers there are Hispanic; many undocumented • Initial testing (both of contacts to the known case and as part of prevalence testing) results in between 3 - 4% infection rate among workers tested

  13. DPH-specific actions • Prevalence of infection is thought to vary by state in Mexico, so those data are now being collected when workers are tested. • Need to expand testing; farmers have been uneasy (as are workers) • As protocol is made final, will work with UW Extension and industry to recommend testing of workers and treatment of any with infection

  14. Draft Protocol • Priority is dairy industry; more workers with more close contact with animals • Could also apply to zoo and pet shop human cases; zoo and pet shop 4-legged cases rarer than human • Two-way notification of either positive cow or positive human • Identification of human activities around cows to try to quantify risk to herd

  15. Draft Protocol • Usually have to wait at least 12 weeks to get final genetics of human TB and know whether it is M. bovis or MTB • PCR for M. bovis available at Wadsworth lab in NY; decision to request test (and set up contract with them) will be based on actual incidence of M. bovis TB and amount of risk to herd

  16. Draft Protocol • DATCP and USDA may be aggressive in herd testing at beginning to try to establish extent of risk with carefully identified worker activities • Testing is paid for by gov’t and farmers are reimbursed for any cattle culled • DNR will be notified if human with TB had any activities with wildlife OR if a positive cow could have been in contact with wildlife

  17. Draft Protocol • Hope to complete group approval of protocol this fall • Work with industry and UW over winter and into spring • Continue to emphasize testing and treatment for the high risk population of Mexican-born farmworkers

  18. Questions?

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