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Mycobacterium caprae: um agente zoonótico ignorado da tuberculose humana
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Advisor(s)
Abstract(s)
A Organização Mundial de Saúde define tuberculose zoonótica como a forma de tuberculose no Homem causada predominantemente por M. bovis, um membro do Complexo Mycobacterium tuberculosis. Contudo, outros membros daquele complexo, como M. caprae, apresentam tam- bém potencial zoonótico. Este trabalho incide sobre a tuberculose zoonótica por infeção Mycobacterium caprae na Europa e em Portugal, entre 2017 e 2023, com base em revisão preliminar da literatura. Embora a in- cidência global daquela infeção seja baixa, em certos países europeus, como Alemanha, Áustria, Espanha e França, apresenta maior relevância. Em Portugal, estão identificados casos em bovinos e caprinos. Contudo, ao contrário dos bovinos, os caprinos apenas são testados quando em coabitação com bovinos infetados, pelo que apenas nesta situação, ou após achado de lesões suspeitas na inspeção sanitária ao abate, esta in- feção naquela espécie é diagnosticada. No setor da saúde pública, após obtenção de resultado positivo para o Complexo Mycobacterium tuber- culosis, a identificação ao nível de espécie é feita apenas em situações particulares, pelo que poderá existir uma situação de subdiagnóstico. A propagação da doença ocorre na interface Homem-Animal-Ambien- te, envolvendo fatores como contaminação ambiental, circulação de M. caprae em pequenos ruminantes e espécies selvagens, e vias de trans- missão para os humanos, nomeadamente o consumo de produtos con- taminados e a exposição direta a animais infetados. Enfatiza-se assim a necessidade de uma abordagem One Health para monitorizar e pre- venir eficazmente a tuberculose zoonótica, sugerindo-se a criação de um grupo de trabalho One Health, o desenvolvimento de políticas de prevenção e vigilância intersetoriais, a análise genómica sistemática dos casos de tuberculose humana e de animais epidemiologicamen- te relacionados, e a sensibilização das populações com maior risco.
The World Health Organization defines zoonotic tuberculosis as a form of tuberculosis in humans caused predominantly by M. bovis, a member of the Mycobacterium tuberculosis Complex. However, other members of the complex, such as M. caprae, also have zoonotic potential. This work focuses on zoonotic tuberculosis caused by Mycobacterium caprae infection in Europe and Portugal, between 2017 and 2023, based on a preliminary literature review. Although a low global incidence of that infection, in certain European countries, such as Germany, Austria, Spain and France, it is more relevant. In Portugal, cases were identified in cattle and goats. However, unlike cattle, goats are only tested when in cohabitation with infected cattle, so only in this situation, or after finding suspected lesions in the health inspection at slaughter, this infection in that species is diagnosed. In the Public Health sector, after obtaining a positive result for the Mycobacterium tuberculosis Complex, the identification to the species level is done only in particular situations, meaning that there may be a situation of underdiagnosis. The spread of this zoonoses occurs at the Human-Animal-Environment in- terface, involving factors such as environmental contamination, circulation of M. caprae in small ruminants and wild species, and transmission routes to humans, including consumption of contaminated products and direct exposure to infected animals. All these factors highlight the importance of a One Health approach to effectively monitor and prevent zoonotic tuber- culosis, with the creation of a One Health working group, the development of intersectoral prevention and surveillance policies, a systematic genomic analysis of epidemiologically related human and animal tuberculosis cases, and raising awareness of occupational risk in high-risk groups.
The World Health Organization defines zoonotic tuberculosis as a form of tuberculosis in humans caused predominantly by M. bovis, a member of the Mycobacterium tuberculosis Complex. However, other members of the complex, such as M. caprae, also have zoonotic potential. This work focuses on zoonotic tuberculosis caused by Mycobacterium caprae infection in Europe and Portugal, between 2017 and 2023, based on a preliminary literature review. Although a low global incidence of that infection, in certain European countries, such as Germany, Austria, Spain and France, it is more relevant. In Portugal, cases were identified in cattle and goats. However, unlike cattle, goats are only tested when in cohabitation with infected cattle, so only in this situation, or after finding suspected lesions in the health inspection at slaughter, this infection in that species is diagnosed. In the Public Health sector, after obtaining a positive result for the Mycobacterium tuberculosis Complex, the identification to the species level is done only in particular situations, meaning that there may be a situation of underdiagnosis. The spread of this zoonoses occurs at the Human-Animal-Environment in- terface, involving factors such as environmental contamination, circulation of M. caprae in small ruminants and wild species, and transmission routes to humans, including consumption of contaminated products and direct exposure to infected animals. All these factors highlight the importance of a One Health approach to effectively monitor and prevent zoonotic tuber- culosis, with the creation of a One Health working group, the development of intersectoral prevention and surveillance policies, a systematic genomic analysis of epidemiologically related human and animal tuberculosis cases, and raising awareness of occupational risk in high-risk groups.
Description
Keywords
Mycobacterium caprae Doenças Zoonóticas Tuberculose Avaliação do Risco One Health Europa Portugal
Pedagogical Context
Citation
Boletim Epidemiológico Observações. 2023;12(Supl 15):34-37
Publisher
Instituto Nacional de Saúde Doutor Ricardo Jorge, IP