Zoonotic tuberculosis—a call for an open One Health debate

Abstract

Tuberculosis is caused by bacteria of the Mycobacterium tuberculosis complex (MTBC) and affects both human and animal populations. Animal-adapted MTBC threatens the wellbeing of humans, animals, and their livelihoods. The 2019 WHO annual tuberculosis report estimated that there were 143 000 new human cases of zoonotic tuberculosis with 12 300 deaths caused by Mycobacterium bovis globally in 2018. Prevalence estimates of zoonotic tuberculosis are inaccurate, however, because routine laboratory tests cannot differentiate between infections caused by the human-adapted and animal-adapted species of MTBC, including newer members such as Mycobacterium orygis. Thus, the true effect of zoonotic tuberculosis on the human tuberculosis epidemic remains unclear. Accurate disease differentiation is also important given that M bovis is universally resistant to pyrazinamide, a key first-line tuberculosis drug.