WHO, The Union call countries to take zoonotic TB ‘seriously’

The WHO and the International Union Against Tuberculosis and Lung Disease, The Union, now recognise the public health significance of zoonotic tuberculosis and call upon countries to take it “seriously” and improve scientific evidence to combat the infection.

The latest call came on Thursday at Liverpool in the The Union’s world conference on lung health.

 Zoonotic TB is a form of tuberculosis in people caused by Mycobacterium bovis which belongs to the Mycobacterium tuberculosis complex. Cattle are the most important animal reservoir for this bacterium.

“We know very little of it. But we need to take it seriously,” WHO’s director for global TB programme Dr Mario Raviglione said at a press briefing in presence of The Union’s Scientific Director Paula Fujiwara.

Paula said conservative estimate suggests 149,000 new human cases of zoonotic TB globally last year.

“But if we multiple this with 10 in the context of ‘end TB strategy’ adopted by WHO’s, then it’ll be 1.5 million,” she said, “but we don’t’ have good surveillance, we don’t have good diagnostic tools. Even a major drug is resistance to zoonotic TB”.

It often affects sites other than the lungs which in many cases clinically indistinguishable from TB caused by Mycobacterium tuberculosis.

The laboratory procedures most commonly used to diagnose TB do not differentiate M. tuberculosis from M. bovis. This leads to under-diagnosis of zoonotic TB.

Paula said it poses special challenges for patient treatment and recovery as zoonotic TB is naturally resistant to pyrazinamide, one of the four medications used in the standard first-line anti-TB treatment regimen.

The most common route of transmission is through food such as unpasteurized milk and untreated animal products, apart from airborne infections and direct contact with infected animals.

The WHO and The Union for the first time in decades brought the zoonotic TB to attention in April this year by hosting a consultation in Geneva.

All relevant experts of the human as well as animal health and the FAO conveyed their and formulated key actions to combat zoonotic TB in the context of the WHO’s end TB strategy.

One of the key recommendations was improving the scientific evidence base. They also asked to develop strategies to improve food safety, and strengthen inter-sectoral and collaborative approaches for combating the infection.

Paula said countries have to systematically survey, collect, analyse and report better quality data on the incidence and burden of zoonotic TB in people and improve surveillance and reporting of TB in livestock.

The action plan also called upon countries to increase awareness of zoonotic TB, and engage key public and private stakeholders in this regard.

They also stressed on prioritising zoonotic TB in the global health agenda, as the SDGs stress the importance of “multidisciplinary” approaches to improving health.

In the context of the SDGs, the WHO’s ‘end TB strategy’ calls for diagnosis and treatment for every TB case. This must include people affected by zoonotic TB, the WHO director Mario said.

“It’ll require lot of cultural, social and anthropological approaches,” he said, calling for “one health” approach in which all disciplines of both animal as well as human health and the food sector would come together to combat the disease.

The end TB strategy aims to end the global TB epidemic, with targets to reduce TB deaths by 95 percent and to cut new cases by 90 percent between 2015 and 2035, and to ensure that no family is burdened with catastrophic expenses due to TB.

It sets interim milestones for 2020, 2025, and 2030.