INTRODUCTION

Mycobacterium avium - Avian tuberclosis

 Avian tuberculosis occurs throughout the world in many avian and some mammalian
species and in domestic poultry it is generally seen in mature stock kept in conditions of poor
management.
 It usually runs a protracted course, causing reduction in condition, reduced egg production
and eventually death.
 Although loss in a flock is intermittent it is invariably in adult fowls and this, together with
the culling of unthrifty birds and the depression in egg production, can cause serious
economic loss.
 The infection is of importance also because the disease occurs in wild birds, pigs, rabbits
and mink.

Epidemiology

EPIDEMIOLOGY

Cause

 Mycobacterium avium is the name given to a complex group of

mycobacterial organisms that, according to current taxonomy, consists of
four subtypes,
 M. avium subsp. avium consists of three serotypes (1, 2 and 3)
and several genotypes: this subtype is fully virulent for birds and
small terrestrial mammals
 M avium subsp. hominissuis consists of serotypes 4-6, 8-fl and
21, and several genotypes, and is found mainly in the external
environment, dust, water, soil and invertebrates but some are
virulent for birds
 M avium subsp. paratuberculosis consists of a number of
genotypes and affects ruminants and other animals
 M. avium subsp. silvaticum is isolated rarely and can be virulent
for birds.
 These mycobacteria are acid- and alcohol-fast whcn stained by the Ziehl -
Neelsen method and the organisms often appear beaded. Of this large
number of serotypes it is types I, 2 and 3 that are most virulent and are
mainly responsible for the disease in poultry. Even among these serotypes
there is considerable variation in virulence.
 M. avium, compared with other mycobacteria, is relatively resistant to
antimicrobials and relatively resistant to a number of disinfectants but is
sensitive to ionic detergents.
 Outside the body it can survive for many years but the unprotected
organism is killed by direct sunlight and within the carcass the organism
survives for no more than a few weeks.
 It does not show tropism for any particular tissue but gross lesions of
 the liver, spleen, intestine and bone marrow are most commonly seen.

Hosts

HOSTS

 It is probable that all species of bird can be infected but susceptibility among
domestic species seems to be in the following order: chickens, ducks, geese and,
least susceptible, turkeys, in which it is relatively uncommon.
 Ike disease is observed most commonly in older poultry because of the greater
opportunity for infection with age and the generally long incubation period.
However, occasionally, heavy losses may occur in pullets on multiage sites where
the infection is endemic and the standards of hygiene poor.
 Came birds, particularly pheasants, are also susceptible. Some birds kept in
zoological gardens seem to be prone to tuberculosis, perhaps because of the
difficulty in adequately cleaning and disinfecting pens.
 Cage birds may also succumb to avian tuberculosis but tuberculosis in parrots
and canaries may also be caused by M. bovis or M.tuberculosis.
 Surveys show that many species of wild bird become naturally infected and in
some instances a predisposing factor is their close association with infection in
domestic stock.
 Among mammals Al. avium can cause progressive disease in swine, rabbits and
mink and can cause sensitivity in cattle to the skintuberculin rest.

SPREAD

 In the transmission of infection the most important source of the organism is the
infected host, including domestic poultry, game birds and per or wild birds. Next in
importance, because of the prolonged survival of Al avium outside the body of the host, are
items contaminated with the droppings and excrement of such birds. These commonly
include litter, contaminated pens and pasture, equipment and implements that come into
contact with infected hosts, and the hands, feet and clothing of attendants.
 ‘Swill’ containing offal or trimmings from ruberculous fowl or pigs can also be a source of
infection.
 Eggs would seem to be only of minor importance in the spread of avian tuberculosis.
 Tubercular lesions have occasionally been noted in the reproductive tract (ovary and
oviduct of the female and testes of the male) and tubercie bacilli have been reported, rarely, in
the eggs laid by tuberculous hens. However, there is no evidence to suggest that chicks
hatched from such eggs are likely to be infected or that disease is likely to be introduced into a
flock by this means.

INFUENCING FACTORS

 The infections are worldwide but disease varies between and within countries. In domestic
poultry lack of hygiene in management and the age of the birds influence the appearance of
the disease since the organism is highly resistant in the environment and within thehost is
generally associated with a long incubation period.
 SIGNS

 Signs may be prolonged over a period of weeks or months before death. There is
generally progressive but slow loss of condition and accompanying loss of energy and
increasing lethargy.
 Although the appetite usually remains good, there is eventually gross emaciation with
marked atrophy of the sternal muscles, with the ‘keel’ becoming prominent or even ‘knife-
edged’.
 The face and comb become pale and sometimes jaundiced and the comb is shrunken and
often there is persistent diarrhoea with soiling of the tail feathers.
 Occasionally a bird will show a hopping, jerky type of locomotion, which is usually
unilateral and is thought to be associated with tubercular lesions of the bone marrow of the
leg bones or joints. Some may adopt a sitting position.
 Occasionally, birds may die suddenly in good bodily condition and yet show
advanced lesions of tuberculosis.
 In such eases rupture of the affected liver or spleen with consequent internal
haemorrhage is often the precipitating cause of death.

LESIONS

 Gross lesions, in the chicken, are most commonly seen in the intestines, liver, spleen and
bone marrow but may be found in any organ or tissue.
 Irrespective of the organ involved, the lesions are typical tubercular granulomata. They are
irregular, grey-white nodules, varying in size from pinpoint to large masses of coalescing
tubercular material.
 ‘When cut through, the nodules are firm and caseous and the centres may be a pale yellow
colour, particularly those from the bone marrow. Those in the liver and intestine may show
bile staining. llae liver and spleen are often grossly enlarged and occasionally rupture,
resulting in blood in the body cavity and sudden death.
 The smaller tubercles in these organs can be readily enucleated from the surrounding
tissue, particularly when they protrude from the surface. Such protrusion of tubercles from
the surface of the spleen gives rhe organ an irregular, ‘knobbly’ appearance.
 The wall of the intestine is invariably studded with similar lesions, varying in size from a
millimetre to several centimetres in diameter. They usually involve the whole thickness of the
intestinal wall and eventually ulcerate into the lumen of the intestine, with consequent
discharge of bacilli and probably constituting the major source of infection within the
droppings.
 The bone marrow of the long bones of the legs frequently contains tubercular nodules,
which can best be seen macroscopically if the bones are split longitudinally, particularly in the
region of the femoro-ribiotarsal and tibiotarsal—tarsometatarsal joints. They are pale yellow
in colour and vary in size and number. This is one of the distinctive features of tuberculosis in
the chicken.
 The lungs are less frequently affected in the domestic chicken but more commonly in
waterfowl. Tubercle bacilli have been isolated from some eases of arthritis affecting the
phalangeal joints (‘bumble foot’) in the fowl.

DIAGNOSIS

 The clinical signs and gross lesions are strongly indicative of avian tuberculosis and the
demonstration of acid/alcohol-fast tubercle bacilli in lesions or sections is supportive of this.
There is seldom any difficulty in demonstrating the organisms, which are often present in very
large numbers, particularly in young lesions and those from the bone marrow.
 Cultural examination, or even chick inoculation of suspect material, may be necessary
when organisms are few or for isolation and identification of the causal agent. The agent can
also be identified by DNA techniques.
 Immunological tests are also of value in the recognition of infected birds during life. They
include the tuberculin test, an agglutination test and ELISA.
 The tuberculin test in the fowl consists of injection of 0.05-0.1 mL of avian tuberculin into
one wattle using a needle about 1 cm long and of 25 gauge.
 The other wattle remains uninjected as the control. When testing a flock it is usual to inject
the tuberculin into the wattle on the same side for each bird.
 The needle is introduced at the lower edge of the wattle and is directed upwards into the
centre.
 The test is read 48 h after the injection of tuberculin, although some positive reactions may
be observed sooner than this.
 The test is read by palpating the two wattles simultaneously between the first finger and
thumb of each hand.
 A positive reaction is recognized by a hot, soft, edematous swelling of the injected wattle,
which maybe twice the size of the uninjected one or even larger.
 Most uninfected birds will show no reaction in the injected wattle and occasional small,
firm, pea-like swellings can usually be ignored.
 The accuracy of the test, relative to gross lesions seen at necropsy, in detecting infected
birds is about 80%. However, birds in an advanced stage of infection may give no reaction. It
is possible, however, that such birds would be thin or emaciated on handling during the
testing of a flock and thus arouse suspicion of tuberculosis.
 Various modifications of the site of inoculation of tuberculin have been suggested for
turkeys, ducks and other birds but this test has not yet proved to be reliable for these species.
For these the whole-blood, stained antigen agglutination rest may be preferable.
 In this test a drop of antigen (a suspension of avian tubercle bacilli) is mixed with a drop of
blood from the bird under test. A positive reaction is indicated by agglutination within 1 mm.
The distinct advantage of this test is that birds have only to be handled once; however, its lack
of specificity must be considered.

DIFFERENTIAL DIAGNOSIS

 In differential diagnosis, at necropsy, most difficulty might be in differentiation from

neoplasia but the simple enucleation of tubercular lesions from the surrounding tissues and
the demonstration of typical acid fast organisms should be adequate.