Note: Detailed guidelines for the treatment of tuberculosis in elephants have been developed in the U.S.A. by the National Tuberculosis Working Group for Zoo and Wildlife Species. The drugs and dosages recommended are based on human treatment protocols and information obtained from pharmacokinetic studies in elephants (unpublished data). The reader is advised to consult the current Guidelines available at the following websites:
http://www.elephantcare.org\protodoc_files\new03\Guidelines For The Control Of Tuberculosis In Elephants 2003.pdf [AVAILABLE
IN FULL IN Wildpro: D303]
a) Rifampin 10 mg/kg orally only. Therapeutic levels have not been achieved with rectal administration (Natl. TB Working Group, 2003).
b) Adverse effects: In one elephant under treatment for tuberculosis, isoniazid (INH) administered orally together with rifampin (8 mg/kg), pyrazinamide (35mg/kg) and vitamin B6 caused partial anorexia. Rifampin was discontinued after the first 6 months of treatment due to failure to achieve therapeutic levels. Four elephants receiving daily direct oral administration of isoniazid (7.5 mg/kg) and rifampin (9.9 mg/kg) developed inappetance, lethargy, and pica. Symptoms resolved when the INH dose was reduced to 5.6 mg/kg and the rifampin dose was reduced to 7.5 mg/kg. One elephant also showed a decreased white blood cell count (from 13,000/Ál to 1,900/Ál) which resolved when INH was discontinued. (Mikota, et.al. 2001)
a) The National Tuberculosis Working Group for Zoo and Wildlife Species. 2003.
Guidelines for the Control of Tuberculosis in Elephants. Internet links above.
b) Mikota,S.K., Peddie,L., Peddie,J., Isaza,R., Dunker,F., West,G., Lindsay,W., Larsen,R.S., Salman,M.D., Chatterjee,D., Payeur,J., Whipple,D., Thoen,C., Davis,D.S., Sedgwick,C., Montali,R.J., Ziccardi,M., and Maslow,J. 2001.
Epidemiology and diagnosis of Mycobacterium tuberculosis in captive Asian elephants
(Elephas maximus). Journal of Zoo and Wildlife Medicine 32:(1):1-16 Abstract: The deaths of two Asian elephants
(Elephas maximus) in August 1996 led the United States Department of Agriculture to require the testing and treatment of elephants for tuberculosis. From August 1996 to September 1999,
Mycobacterium tuberculosis infection was confirmed by culture in 12 of 118 elephants in six herds. Eight diagnoses were made antemortem on the basis of isolation of M. tuberculosis by culture of trunk wash samples; the remainder (including the initial two) were diagnosed postmortem. We present the case histories, epidemiologic characteristics, diagnostic test results and therapeutic plans from these six herds. The intradermal tuberculin test, enzyme-linked immunosorbent assay serology, the blood tuberculosis test and nucleic acid amplification and culture are compared as methods to diagnose M. tuberculosis infection in elephants.
Mikota,S.K., Larsen,R.S., and Montali,R.J. 2000. Tuberculosis in Elephants in North
America. Zoo Biology 19:393-403 Abstract: Within the past 4 years, TB has emerged as a disease of concern in elephants. The population of elephants in North America is declining (Weise,1997), and transmissible diseases such as TB may exacerbate this trend. Guidelines for all elephants for TB, were instituted in 1997 (USDA, 1997, 2000). Between August 1996 and May 2000,
Mycobacterium tuberculosis was isolated form 18 of 539 elephants in North America, indicating an estimated prevalence of 3.3%. Isolation of the TB organism by culture is the currently recommended test to establish a diagnosis of TB; however, culture requires 8 weeks. Further research is essential to validate other diagnostic tests and treatment protocols.
Dunker,F. and Rudovsky,M. 1998. Management and treatment of a Mycobacterium tuberculosis positive elephant at the San Francisco Zoo. Proceedings AAZV and AAWV Joint Conference. Pages: 122-123