High prevalence of Mycobacterium avium subspecies paratuberculosis (‘Indian bison type’) in animal attendants suffering from gastrointestinal complaints who work with goat herds endemic for Johne's disease in India

• Published in: International journal of infectious diseases 2011-10, Vol.15 (10), p.e677-e683
• Main Authors: Singh, A.V, Singh, S.V, Singh, P.K, Sohal, J.S, Singh, M.K
• Format: Article
• Language: English
• Subjects: Animal attendants; Animals; Crohn's disease; Culture; Gastroenteritis - epidemiology; Gastroenteritis - microbiology; Genotype; Goat Diseases - epidemiology; Goat Diseases - transmission; Goats; Humans; India - epidemiology; Infectious Disease; Mycobacterium avium subsp. paratuberculosis - genetics; Mycobacterium avium subsp. paratuberculosis - isolation & purification; Mycobacterium avium subspecies paratuberculosis; Paratuberculosis - epidemiology; Paratuberculosis - transmission; Prevalence; Pulmonary/Respiratory; Zoonosis
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2011.04.013

Summary Objectives In this study we aimed to estimate the prevalence of Mycobacterium avium subspecies paratuberculosis (MAP) in animal attendants who were chronic colitis patients or who had inflammatory bowel disease and were suspected for Crohn's disease; these animal attendants worked with goat herds endemic for Johne's disease. Microscopic examination and culture tests were used. For comparison purposes a group of healthy human subjects (not suffering with colitis) was also screened. Methods Stool samples obtained from 98 human subjects (58 animal attendants suspected for Crohn's disease and 40 healthy humans) were screened for the presence of MAP by microscopic examination and culture. Of the 58 animal attendants screened, 38 had abdominal pain, 29 had suffered episodes of diarrhea, 39 had experienced weight loss, 27 had fever, and 32 had a history of raw milk consumption. Animal attendants had had contact of variable duration with goat herds endemic for Johne's disease (1–5, 6–10, 11–15, and >15 years). Forty stool samples from healthy humans with no symptoms/history of contact with animals were also screened. IS 900 PCR and IS 1311 PCR restriction endonuclease analysis were used to characterize and genotype the MAP colonies. Results MAP was recovered from 34 of the 98 human subject stool samples (34.7%). Of the 98 samples, 16.3% ( n = 16) were acid-fast. None of the 40 healthy human subjects were positive for MAP by microscopy, but five (12.5%) were positive for MAP by culture. Of the 58 animal attendants, 16 (27.6%) were positive by microscopy and 29 (50%) were positive by culture. MAP were recovered from 68.4% of animal attendants with abdominal pain, 72.4% of those with diarrhea, 71.8% of those with weight loss, 44.4% of those with fever, and 46.9% of those who had a history of raw milk consumption. Of the 29 culture-positive animal attendants, 48.3% had worked for >15 years, 27.6% for 11–15 years, 20.7% for 6–10 years, and 3.4% for 1–5 years with goat herds endemic for Johne's disease. Of the 34 culture isolates, 28 (82.4%) showed good quality DNA on agarose gel and were positive by IS 900 PCR. Of the 28 IS 900 -positive DNA samples, 23 (82.1%) were genotyped as ‘Indian bison type’ and five (17.9%) as ‘cattle type’. Conclusions The prevalence of MAP was higher in attendants suffering from gastrointestinal problems who worked with goat herds endemic for Johne's disease, than in humans with no history of contact with animals. The risk of developi