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Chapter 8 - Tuberculosis

Authors: Milton Friend (Modified from an earlier chapter by Thomas J. Roffe)

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Mycobacteriosis, tuberculosis, TB.

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Avian tuberculosis is usually caused by the bacterium Mycobacterium avium. At least 20 different types of M. avium have been identified, only three of which are known to cause disease in birds. Other types of Mycobacterium rarely cause tuberculosis in most avian species; however, parrots, macaws, and other large perching birds are susceptible to human and bovine types of tuberculosis bacilli. Avian tuberculosis generally is transmitted by direct contact with infected birds, ingestion of contaminated feed and water, or contact with a contaminated environment. Inhalation of the bacterium can cause respiratory tract infections. Wild bird studies in the Netherlands disclosed tuberculosis-infected puncture-type injuries in birds of prey that fight at the nest site (kestrels) or on the ground (buteo-type buzzards), but tuberculosis-infected injuries were not found in accipiters (falcons), which fight in the air and seldom inflict such wounds.

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Species Affected

All avian species are susceptible to infection by M. avium. Humans, most livestock species, and other mammals can also become infected. Recent molecular studies with a limited number of isolates from birds, humans, and other mammals clearly indicated that M. avium can be transmitted between birds and pigs, but the studies did not disclose a similar cross transmission between birds and humans for the isolates tested. It is generally accepted that pigs, rabbits, and mink are highly susceptible to M. avium; deer can also become infected. Dogs appear to be quite resistant to the avian type of tuberculosis (Fig. 8.1).

In captivity, turkeys, pheasants, quail, cranes, and certain birds of prey are more commonly infected than waterfowl. However, when avian tuberculosis becomes established, it can be a common and lethal disease in captive waterfowl flocks. Chronic infections exist in some captive nene goose flocks, making these flocks unsuitable donors to supplement the wild population of this endangered species. Pheasants are unusually susceptible to avian tuberculosis.

In free-ranging wild birds, avian tuberculosis is found most often in species that live in close association with domestic stock (sparrows and starlings) and in scavengers (crows and gulls). The prevalence of tuberculosis in free-ranging North American birds has not been determined, although generally less than 1 percent of birds examined at postmortem are affected. Sampling biases due to the limited numbers of specimens examined preclude extending findings to reflect actual prevalence (Fig. 8.2). A decade-long study of nearly 12,000 wild birds necropsied in the Netherlands disclosed that 0.7 percent of the birds had tuberculosis. The sample included waterbirds, birds of prey, songbirds, and pheasants. Studies in the United States disclosed that 0.3 percent of 3,000 waterfowl necropsied were infected with tuberculosis, and a study in British Columbia found tuberculosis in 0.6 percent of more than 600 wild birds. Tuberculosis in whooping cranes ands in marked contrast to other wild birds; approximately 39 percent of the western population’s free-ranging whooping cranes necropsied at the National Wildlife Health Center have been infected with avian tuberculosis.

Figure 8.1
Click Illustration for full-page viewRelative susceptibility of various animal groups to M.avium.


Figure 8.2
Click Illustration for full-page viewRelative occurrence of avian tuberculosis in birds.

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Avian tuberculosis is a ubiquitous and cosmopolitan disease of free-ranging, captive, and domestic birds. The disease is most commonly found in the North Temperate Zone, and, within the United States, the highest infection rates in poultry are in the North Central States. Distribution of this disease in free-ranging wild birds is inferred from birds submitted for necropsy; however, the sampling under represents both the geographic distribution and the frequency of infection for individual species. Avian tuberculosis likely exists in small numbers of free-ranging wild birds wherever there are major bird concentrations.

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Seasonal trends of tuberculosis in wild birds have not been documented. The chronic nature of this disease guarantees its presence year-round for both wild and captive birds.

Factors that may influence seasonal exposure to tuberculosis in migratory birds are changes in habitat used, food base during the year, and interspecies contacts. Contaminated sewage and wastewater environments containing tubercle bacilli are more likely to be used by waterfowl during fall and winter than during warmer months. Wastewater sites are often closed to hunting, thereby serving as refuge areas, and warm water discharges to these sites maintain open water in subfreezing temperatures, thus inviting ready use by waterfowl. Predatory and scavenger species such as raptors and crows often ingest many different food items during different periods of the year; scavengers, therefore, may be exposed to tuberculosis through contaminated food year-round. Contact between wild birds and poultry and livestock is often restricted to specific periods of the year owing to husbandry practices. Wild birds may be exposed to M. avium in manure that is spread on fields during early spring.

Environmental conditions can greatly affect the susceptibility of birds to tuberculosis and the prevalence of tuberculosis in captive birds. Captive birds that are on an inadequate diet and that are maintained in crowded, wet, cold, poorly ventilated, and unhygienic aviaries have increased susceptibility to tuberculosis.

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Field Signs

No clinical signs specifically identify avian tuberculosis in birds. Advanced disease and clinical signs are seen most often in adult birds because of the chronic, insidious nature of the disease. Infected birds are often emaciated, weak, and lethargic, and they exhibit wasting of the muscles. These signs are similar to those of lead poisoning and other debilitating conditions. Other signs depend on which body system is affected and signs may include diarrhea, lameness, and unthrifty appearance. Darkening and dulling of plumage have been reported in the United Kingdom for wood pigeons infected with tuberculosis, but not for other species.

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Gross Lesions

Typical cases of avian tuberculosis in wild birds involve emaciated carcasses with solid-to-soft or crumbly, yellow-to- white or grey nodules that are less than 1 millimeter to several centimeters in size and that are deeply embedded in infected organs and tissues. The liver (Fig. 8.3A) most often contains such nodules, but the spleen (Fig. 8.3B), lung, and intestines (Fig. 8.3C) may also contain similar nodules. Aggregations of these nodules may appear as firm, fleshy, grape-like clusters. Abscesses and nodular growths (Fig. 8.4) have been reported on the skin of birds in the same locations where pox lesions are commonly seen around the eyes, at the wing joints, on the legs, side of the face, and base of the beak. Other birds have died of avian tuberculosis without any obvious clinical signs or external lesions.

Nodular tuberculosis lesions in internal organs are often grossly similar to those of aspergillosis, and laboratory diagnosis is required to differentiate the two diseases as well as others that produce similar lesions. Less typical lesions resemble those of other diseases. Sometimes the primary lesions seen at necropsy are enlarged livers and spleens that are so fragile that they easily rupture upon being handled. Most of these cases have livers and spleens with a tan-to-green translucence due to amyloid deposits. Less commonly, in situations where nodules are not formed nor is amyloid deposited, the liver and spleen can be large, pale, and firm.

The location of primary lesions is an indication of route of exposure. Intestinal lesions suggest ingestion of M. avium in contaminated feed or water. Lesions in the lungs and other areas of the respiratory tract suggest inhalation as the route of exposure.

Figure 8.3 The raised, firm nodules in these organs are typical lesions of avian tuberculosis; (A) liver; (B) spleen; and (C) intestine.
Click Photo for full-page view(A) Liver. Click Photo for full-page view(B) Spleen. Click Photo for full-page view(C) Intestine.


Figure 8.4
Click Photo for full-page viewNodular lesion, which was caused by avian tuberculosis, on the skin of a canvasback.

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Typically, tuberculosis is discovered in captive birds during routine investigation of mortality, and in wild birds during carcass examinations associated with die-offs due to other causes. The gross lesions described above (Fig. 8.3) are suggestive of tuberculosis, but a definitive diagnosis is based on bacteriological isolation and identification of the organism. Because M. avium is slow-growing and other bacteria can easily overgrow it, a noncontaminated sample is needed for examination. Whole carcasses are preferred, but when a whole carcass cannot be submitted, remove the leg at the hip joint, wrap it in clean aluminum foil, place it in a plastic bag, and freeze it for shipment to a qualified disease diagnostic laboratory. The marrow within the femur has the lowest potential for being contaminated and it provides a good sample for the bacteriologist. When carcass or tissue submissions to a laboratory are not possible within a short time, tissue preserved in 10 percent buffered formalin solution is useful for diagnostic purposes. see (Chapter 2: Specimen Collection and Preservation).

The bacterium can also be isolated from infected tissues that show gross lesions. Microscopic studies can provide a diagnosis of tuberculosis, although such studies cannot determine the species of Mycobacterium. Because this disease is transmissible to humans, extra care must be taken when handling infected carcasses.

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Tuberculosis is difficult to detect in free-ranging birds despite its broad geographic distribution. Tuberculosis rarely causes a major die-off, and there are no practical non-lethal testing procedures for mobile wild birds. Therefore, there is no focal point and, hence, no method developed for disease control in wild bird populations. By contrast, tuberculosis can cause die-offs in captive flocks, and mortality has been reported in sea ducks and other birds, including chukar partridge and pheasants. Some captive flocks of wild birds have experienced losses of nearly 30 percent or more from tuberculosis.

Close monitoring of the health of bird populations — free-ranging or captive — is an essential first step toward detecting tuberculosis so that control efforts can be developed and initiated when feasible. Monitoring can best be accomplished by the timely submission of carcasses to disease diagnostic laboratories. Tuberculosis testing of birds maintained in captivity and laboratory analyses of fecal samples from captive and wild flocks also can be used to identify the presence of this disease. These tests do not detect all infected birds, but the tests are useful for identifying infected flocks.

Fecal contamination of the environment is the major means of tuberculosis dissemination; ingestion of the bacterium in contaminated feed and water is the most common means of disease transmission. Because this bacterium can survive outside of the vertebrate host for long time periods in an organic substrate (Fig. 8.5), a few infected animals can contaminate an area that has prolonged bird-use patterns. The long-term environmental survival of M. avium that is shed by disease carriers when combined with repeated site use and, possibly, a high degree of susceptibility to avian tuberculosis may be the factors contributing to the high prevalence of this disease observed in whooping cranes. A site can also be contaminated by wastewater discharges containing M. avium and by the application of contaminated manure for fertilizer. Tuberculosis outbreaks in birds have been associated with sewage effluents and discharges from slaughter houses, meat processing plants, and dairies. In one instance, an outbreak occurred in a captive waterfowl flock when contaminated water was sprayed into the enclosure. These events illustrate the importance of disease prevention for addressing tuberculosis in free-ranging and captive wild birds.

The use of wastewater for maintaining captive waterfowl and other wild birds is questionable without adequate testing or treatment or both to assure that the wastewater does not contain tubercle bacilli. Also, the use of wetlands for wastewater discharges and the use of wastewater to create wetlands for migratory bird habitat should be carefully considered because of the possible presence of M. avium in the wastewater. Other actions that should be considered include preventing land use that could place tuberculosis-infected swine in close proximity to major wild bird concentrations and not using unexamined chicken and pigeon carcasses as food for raptors being reared in captivity for release into the wild.

Infected flocks of captive birds should be destroyed because treatment is ineffective and because not all infected birds will be detected by current testing procedures. Because of the long-term environmental persistence of the tubercle bacilli, additional bird use of the site should be avoided for approximately 2 years. Vegetation removal and turning of the soil several times during this period will facilitate sunlight- induced environmental decay of the bacilli. Eradication of free-ranging migratory flocks is rarely feasible. However, when a major outbreak of tuberculosis occurs in wild birds, the circumstances should be assessed, and limited population reduction should be considered if the remaining population-at-risk is well defined, limited in immediate distribution, and involves species that can withstand this action. Habitat manipulation, such as drainage, and scaring devices, such as propane exploders, can sometimes be used to deny birds use of areas where tuberculosis outbreaks occur.

The insidious nature of avian tuberculosis combined with the long environmental persistence of the causative bacterium strongly indicate a need to prevent the establishment of this disease in wild bird populations. When the disease becomes established in free-ranging populations, interspecies transmission and the mobility of free-ranging birds could serve to spread it widely. The continued persistence of avian tuberculosis as a major cause of avian mortality in zoological collections attests to the difficulty of disease control.

Figure 8.5
Click Illustration for full-page viewExamples of environmental persistence of M. avium.

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Human Health Considerations

There are many authenticated cases of M. avium infection in people, although humans are considered highly resistant to this organism. Avian tuberculosis is generally considered noncontagious from an infected person to an uninfected person. Infection is more likely to occur in persons with pre-existent diseases, especially those involving the lungs, and in persons whose immune systems are impaired by an illness, such as AIDS or steroid therapy.

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Supplementary Reading

  • Karlson, A.G., 1978, Avian tuberculosis, in Montali, R.J., ed.,
    Mycobacterial infections of zoo animals: Washington, D.C.,
    Smithsonian Institution Press, p. 21–24.
  • Smit, T., Eger, A., Haagsma, J., and Bakhuizen, T., 1987, Avian
    tuberculosis in wild birds in the Netherlands: Journal of
    Wildlife Diseases 23, p. 485–487.
  • Thoen, C.O., 1997, Tuberculosis, in Calnek, B.W., and others,
    eds., Diseases of poultry (10th ed.): Ames, Iowa, Iowa State
    University Press, p. 167–178.
  • Wobeser, G.A., 1997, Tuberculosis, in Diseases of wild waterfowl
    (2nd ed): New York, N.Y., Plenum Press, p. 71–75.

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