The epidemiology of Mycobacterium bovis infections in animals and man: a review

Tuberculosis is primarily a respiratory disease and transmission of infection within and between species is mainly by the airborne route. Mycobacterium bovis, the cause of bovine-type tuberculosis, has an exceptionally wide host range. Susceptible species include cattle, humans, non-human primates, goats, cats dogs, pigs, buffalo, badgers, possums, deer and bison. Many susceptible species, including man, are spillover hosts in which infection is not self-maintaining. In countries where there is transmission of infection from endemically infected wildlife populations to cattle or other farmed animals, eradication is not feasible and control measures must be applied indefinitely. Possible methods of limiting spread of infection from wildlife to cattle including the use of vaccines are outlined. The usefulness of DNA fingerprinting of M. bovis strains as an epidemiological tool and of BCG vaccination of humans and cattle as a control measure are reviewed. The factors determining susceptibility to infection and clinical disease, and the infectiousness of infected hosts and transmission of infection, are detailed. Reports of the epidemiology of M. bovis infections in man and a variety of animal species are reviewed. M. bovis infection was recognised as a major public health problem when this organism was transmitted to man via milk from infected cows. The introduction of pasteurization helped eliminate this problem. Those occupational groups working with M. bovis infected cattle or deer, on the farm or in the slaughter house, are more likely to develop pulmonary disease than alimentary disease. In recent years, tuberculosis in farmed cervidae has become a disease of economic as well as public health importance in several countries. Nowadays, the human immunodeficiency virus (HIV) is associated with a greatly increased risk of overt disease in humans infected with Myobacterium tuberculosis. It is believed this increased risk also occurs in the case of M. bovis infections in humans.