The potential Public Health Impact of Mycobacterium avium ssp. paratuberculosis: Global Opinion Survey of Topic Specialists

Abstract

Global research knowledge has accumulated over the past few decades, and there is reasonable evidence for a positive association between Mycobacterium avium spp. paratuberculosis and Crohn's disease in humans, although its role as a human pathogen has not been entirely accepted. For this reason, management of public health risk due to M. paratuberculosis remains an important policy issue in agri-food public health arenas in many countries. Responsible authorities must decide whether existing mitigation strategies are sufficient to prevent or reduce human exposure to M. paratuberculosis. A Web-based questionnaire was administered to topic specialists to elicit empirical knowledge and opinion on the overall public health impact of M. paratuberculosis, the importance of various routes of human exposure to the pathogen, existing mitigation strategies and the need for future strategies. The questionnaire had four sections and consisted of 20 closed and five open questions. Topic specialists believed that M. paratuberculosis is likely a risk to human health (44.8%) and, given the paucity of available evidence, most frequently ranked it as a moderate public health issue (40.1%). A significant correlation was detected between topic specialists' commitment to M. paratuberculosis in terms of the number of years or proportion of work dedicated to this topic, and the likelihood of an extreme answer (high or low) to the above questions. Topic specialists identified contact with ruminants and dairy products as the most likely routes of exposure for humans. There was consensus on exposure routes for ruminants and what commodities to target in mitigation efforts. Described mandatory programmes mainly focused on culling diseased animals and voluntary on-farm prevention programmes. Despite ongoing difficulties in the identification of subclinical infections in animals, the topic specialists largely agreed that further enhancement of on-farm programmes in affected commodities by the agri-food industry (68.4%) and allocation of resources by governments to monitor the issue (92%) are most appropriate given the current state of evidence.

Australian Veterinarians’ Perceptions Regarding the Zoonotic Potential of Mycobacterium avium Subspecies Paratuberculosis

“…The concern index comprised of five concern statements covering the exposure to humans via contaminated meat and milk, direct exposure via contact with animals and MAP contamination of food of animal origin that is intended for infants, old, pregnant women and immunocompromised people. This finding is not surprising in the context where there are concerns regarding the public health implications of MAP and exposure to MAP via food of animal origin, especially via dairy products, and meat and direct contact [44,45]. Similar perceptions were observed when a survey was conducted of subject matter experts working in the area of paratuberculosis [44].…”

Mycobacterium avium ssp . paratuberculosis detection in animals, food, water and other sources or vehicles of human exposure: A scoping review of the existing evidence

“…Mycobacterium paratuberculosis is the etiologic agent of Johne's disease, a severe production-limiting gastrointestinal disease that affects domestic and wild ruminants worldwide and in advanced cases is characterized by wasting and profuse diarrhea leading to death (Behr and Collins, 2010). The disease is important to ruminant industries for animal health and economic reasons (Waddell et al, 2016). However, the zoonotic potential of M. paratuberculosis is not fully understood despite 30 years of research.…”

Applying the One Health Concept to Mycobacterial Research – Overcoming Parochialism

“…The potential role of M. avium subsp. paratuberculosis , a pathogen in ruminants, in Crohn's disease is also widely debated as a public health concern with the possibility of food‐borne exposure to mycobacterial antigens (Bosshard et al., ; Aboagye and Rowe, ; Okura et al., ; Waddell et al., , ,b).…”