Estimating the true prevalence of Mycobacterium bovis in free-ranging elk in Michigan.

Although relatively small, Michigan's elk (Cervus elaphus nelsoni) herd is highly valued by both hunters and the general public. Elk and red deer (Cervus elaphus elaphus) are highly susceptible to infection with Mycobacterium bovis, the causative agent of bovine tuberculosis (TB), and outbreaks have been documented worldwide. The Michigan elk range lies entirely within counties where TB is known to be enzootic in white-tailed deer (Odocoileus virginianus). Consequently, a project was undertaken to estimate the true prevalence of TB in Michigan's free-ranging elk herd. All elk harvested by licensed hunters during 2002-2004, and all nonharvest elk mortalities examined by the Michigan Department of Natural Resources Wildlife Disease Laboratory from November 2002-May 2005, were screened for gross lesions of TB with samples of cranial lymph nodes and palatine tonsils collected for histopathology and mycobacterial culture. In all, 334 elk were included in the study. Twenty-three elk with gross lesions were considered TB suspects; all were culture-negative for M. bovis. However, M. bovis was cultured from two elk without gross lesions. The sensitivity, specificity, and negative predictive value of the current TB surveillance protocol were 0%, 100%, and 99.4%, respectively, while the apparent prevalence and true prevalence calculated directly from the sample were 0% and 0.6%, respectively. The positive predictive value and the estimated true prevalence of the population were undefined. The poor sensitivity of current surveillance was likely an artifact of its application to a relatively small sample, in order to detect a disease present at very low prevalence. The low prevalence of TB in Michigan elk, and the early stage of pathogenesis of the few infected animals, does not suggest elk are maintenance hosts at the present time.

Estimating the true prevalence of Mycobacterium bovis in hunter-harvested white-tailed deer in Michigan.

Apparent prevalence, although useful as a consistent index, may underestimate the true prevalence of disease. In Michigan, the ability to estimate the true prevalence of bovine tuberculosis (TB; caused by Mycobacterium bovis) in free-ranging white-tailed deer (Odocoileus virginianus) will become increasingly important to accurately assess progress towards eradication. Our objectives were threefold: to estimate the true prevalence of M. bovis in free-ranging deer in Michigan, to evaluate the effectiveness of existing TB surveillance methods, and to indirectly assess whether TB epidemiologic data from captive cervid herds can be meaningfully extrapolated to free-ranging populations. The study population consisted of all free-ranging deer submitted for TB testing in 2001 from six townships in northeastern Lower Michigan. Tissue samples of tonsil and cranial lymph nodes were collected bilaterally from all deer eligible for the study that did not have gross lesions suggestive of TB (n = 701). Samples were subjected to histopathologic, acid-fast (AF) staining, mycobacterial culture, and polymerase chain reaction (PCR) testing. Seven deer cultured positive for M. bovis that would not have been detected by current surveillance, yielding apparent and true prevalence estimates (95% confidence limits) of 2.7% (1.6, 3.8) and 3.6% (2.3, 4.9), respectively. The sensitivity, specificity, and positive and negative predictive values of the current surveillance protocol were 75, 100, 100, and 99%, respectively. Histologic lesions were present only in tonsils, and ranged from simple necrosis to caseation, suppuration, and granuloma formation. Acid-fast staining and PCR detected M. bovis in only one of the seven culture-positive deer. Our study provides the first estimate of the true prevalence of M. bovis in Michigan's free-ranging deer population and suggests modest underestimation of that prevalence by current surveillance. This study also suggests that caution is warranted when extrapolating epidemiologic data on TB in captive cervids to free-ranging populations and confirms the pivotal role of the tonsil in early infections.

Epidemiology of Mycobacterium bovis in free-ranging white-tailed deer, Michigan, USA, 1995-2000.

An endemic area of bovine tuberculosis (TB) (Mycobacterium bovis) currently affecting wild white-tailed deer (Odocoileus virginianus) in northern lower Michigan, USA, constitutes the first self-sustaining outbreak of the infection in free-ranging North American cervids. Given this precedent, epidemiologic insights gained from the outbreak afford the opportunity to guide not only current surveillance and intervention but also control efforts for future outbreaks involving wildlife reservoirs. Our specific objectives were to evaluate retrospective data from field surveillance conducted from 1995 to 2000 to determine apparent prevalence, trends in apparent prevalence, and the effects of various factors on the odds of being M. bovis positive. Data were gathered from post-mortem examinations of 62,560 wild deer collected from all 83 Michigan counties. Records of survey method, sex, age, geographic area and infection status as determined by mycobacterial culture were subjected to trend analysis and multivariable logistic regression. Apparent prevalence for the period was 0.54% (336/62,560) statewide. Prevalence varied widely with geographic area, but significantly decreased since 1995 in the core area of the outbreak-which coincided with implementation of control strategies. Significant risk factors were geographic area, sex, age, and the sex-by-age interaction. The survey method by which deer were obtained for testing was not a predictor of infection. Our results to date suggest an outbreak characterized by broad areas of very low prevalence surrounding focal areas where prevalence is sometimes orders-of-magnitude higher (e.g., deer originating from the core area were up to 147 times more likely to be TB positive than deer from other areas). Our results also identify older male deer as most likely to be M. bovis positive (OR=11.3, 95% CI 3.2, 40.3 for bucks > or =5 years vs. does < or =1.5 years)-an observation consistent with the biology and behavior of the species. Synthesizing these results with those of other ongoing investigations, we hypothesize a two-stage model of disease transmission where TB is maintained at very low prevalence in matriarchal groups, with primary dissemination of the disease attributable to the dispersal and movements of bucks (as well as to the large aggregations of animals created by human activities).