Human-to-Human Transmission of Tuberculosis Caused by Mycobacterium bovis in Immunocompetent Patients

Abstract

Human-to-human transmission of Mycobacterium bovis in two immunocompetent patients from the same family was confirmed by spoligotyping (pattern F35, which was only observed in cattle from the same area in France). A single allelic difference between animal and human isolates was observed with mycobacterial interspersed repetitive units containing variable-number tandem repeats, suggesting a jump across the species barrier.CASE REPORTS Case 1. In April 2004, a 50-year-old man, born in France, was admitted to the Respiratory Disease Department of the Limoges Hospital for pulmonary tuberculosis. Since 1987, he had been working in a slaughterhouse and handled offal. Clinical manifestations were cough and asthenia. The chest radiograph showed a cavitation of the left upper lobe. The tuberculin skin test (TST) reaction was considered positive. Gastric aspirations were positive for acid-fast bacilli (AFB), and cultures were secondarily positive for M. bovis. M. bovis was identified by phenotyping methods, and identification was then confirmed by molecular analysis (9). The human immunodeficiency virus (HIV) antibody test was negative. Therapy consisted of an association of isoniazid (INH), rifampin (RMP), and ethambutol (EMB). Sample cultures became negative after 1 month of treatment. EMB was discontinued after 3 months; INH and RMP were continued for a total duration of 12 months. Contact tracing was performed. Only his daughter had a positive TST, but she refused any prophylactic treatment.Case 2. In May 2007, the daughter of case 1, a 20-year-old woman, born in France, was admitted to the Tours Hospital for suspicion of pulmonary tuberculosis. She had had productive cough with night sweats, thoracic pain, and asthenia for 1 month before hospitalization. The chest radiograph showed a cavitation of the left upper lobe with mediastinal adenopathy confirmed by computed tomography. Two sputum specimens and one gastric aspiration were positive for AFB. Cultures grew M. bovis. The HIV antibody test was negative. Therapy was initiated with an association of INH, RMP, and EMB and continued for 3 months. Sputum smears and culture were negative after 1 month of treatment. EMB was discontinued after 3 months of treatment, and INH and RMP were continued for a total duration of 9 months. Contact tracing was conducted and identified one contact, the patient's grandmother, whose TST reaction was positive at 20 mm. Thus, she received a regimen of INH and RMP for 3 months to treat her latent tuberculosis infection.Case 1 worked in the Limoges slaughterhouse from 1987 to 2004 and was certainly occupationally exposed during this period. On the other hand, case 2 was born after hygienic measures were applied and she had never traveled to countries where they were not applied. Moreover, she had no contact with cattle herds. Therefore, it is most likely that she was infected by her father.We compared the M. bovis strains from cases 1 and 2 using spoligotyping and mycobacterial interspersed repetitive units containing variable-number tand...

Transmission and Progression to Disease of Mycobacterium tuberculosis Phylogenetic Lineages in The Netherlands

“…Yet, all three M. bovis index cases with secondary cases in our clustering cohort also had pulmonary manifestations; two of these index cases were FB but had no indication of recent travel to a country of M. bovis endemicity. Indeed, instances of human-to-human transmission of M. bovis have been documented in other settings (21,22). Together these observations suggest that, from a public health perspective, contact investigation and treatment of pulmonary M. bovis patients should not altogether differ from those of M. tuberculosis patients.…”

Diagnóstico histopatológico e molecular de lesões sugestivas de tuberculose em búfalos abatidos nos municípios de Macapá e Santana, estado do Amapá

“…Estes números podem ser superiores, uma vez que a tuberculose relacionada ao bacilo bovino é clinicamente, radiograficamente e histopatologicamente indistinguível da enfermidade por M. tuberculosis, possivelmente incorrendo em subnotificação de tuberculose humana por M. bovis (Moda et al 1996, Pé-rez Lago et al 2014. Deve-se considerar, ainda, a possibilidade de transmissão da tuberculose zoonótica entre pessoas, inclusive entre pacientes imunocompetentes (Sunder et al 2009, Etchechoury et al 2010. Entre 1994-2005, dados retrospectivos de San Diego (EUA), mostraram que infecções por M. bovis corresponderam a 45% dos casos de tuberculose em crianças e 6% dos casos em adultos, oferecendo risco de morte ao longo do tratamento 2,55 vezes maior em comparação a M. tuberculosis (Rodwell et al 2008).…”

Zoonotic tuberculosis caused by Mycobacterium bovis, Central province, Iran

“…Although most cases of human tuberculosis are due to M. tuberculosis a proportion, called zoonotic TB, is caused by M. bovis as almost 3% of tuberculosis cases in the world are attributed to M. bovis. 1 Human to human transmission of zoonotic TB is a rarely reported event 2,3 and bovids (eg. Cattle) are the main hosts for M. bovis therefore, contact with infected animals or infectious animal products are blamed most in zoonotic TB cases.…”