Nepal Elephant TB Control and Mgt Action Plan.pdf - Elephant Care ...

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Nepal Elephant Tuberculosis Control andManagement Action Plan (2011-2015)Nepal began in 2006. Culture and experimentalserological tests were used to screen elephantsat this me. One of these tests - the ElephantTBStat-Pak® (Chembio Diagnoscs, Inc, Medford,New York, U.S.A. www.chembio.com) wassubsequently licensed by the United StatesDepartment of Agriculture (USDA) in 2007 as ascreening test for TB in elephants.Cultures collected in 2006 and evaluated atthe Naonal Tuberculosis Instute (NTI) inNepal and the Naonal Veterinary ServicesLaboratories (NVSL) in Ames, Iowa, U.S. provednon-diagnosc due to contaminaon, storage,and transport issues. The same problems wereencountered when elephant respiratory sampleswere submi ed to the Nepal An-TuberculosisAssociaon (NATA) in subsequent years. Theseand other issues, such as intermi ent shedding,limit the value of culture as a primary diagnosctechnique. In Sweden, only 7 of 189 respiratorysamples collected from 5 elephants confirmedTB-infected at postmortem were cultureposive(Moller et al. 2005). In Thailand, TB wasisolated from only 2 of 60 respiratory samplescollected from confirmed TB-infected elephants(Angkawanish et al. 2010).Culture as well as molecular diagnosctechniques such as PCR is nonetheless valuableand improving the methods to apply thesetechniques to elephants remains an importantgoal. Collaboraons have been established withthe Nepal An-tuberculosis Associaon (NATA)and the Center for Molecular Diagnoscs –Nepal (CMDN) for this purpose. In 2009-2010,these laboratories confirmed Mycobacteriumtuberculosis, the human strain of TB, as thecausave agent in three elephants in Nepal.TB can be transmi ed from humans to elephantsand from elephants to humans. In 2008, over100 elephant handlers were tested for TB, butno cases of TB were detected. TB is a longtermdisease and previous handlers, no longeremployed may have been the source of infeconfor the three M.tb-infected elephants. Theseelephants may also have acquired TB from otherinfected elephants. It is presumed that elephantsin Nepal may also harbor the bovine strain of TBhowever laboratory capacity to diagnose M. bovisis limited and this has not yet been confirmed.This is an area for further research.Tuberculosis can be caused by a number ofmycobacterial species and many of these bacteriainfect mulple hosts. The recognion of TB inelephants is smulang a shi! in thinking abouthow disease is perceived. Generally zoonoses arethe concern of the public health community butTB is an anthroponosis (an infecous disease inwhich a disease causing agent carried by humansis transferred to other animals) highlighng theneed for involvement of both animal and humanhealth professionals and agencies. A furthercomplicaon in the human community has beena rise in HIV/AIDS; a disease o!en associatedwith tuberculosis which it promotes throughimmune suppression of the human host and bywhich Nepal is increasingly suffering. Therefore,a more holisc view of tuberculosis surveillanceand control is needed. This requires a muchbroader, “One-Health” (Human - Livestock -Wildlife) approach which is gaining momentumin the global health community. This paradigmtakes into account the enre epidemiologyof the disease, examines all the suscepblespecies, carriers and likely drivers of infecon andepidemics. Part of this elephant TB strategy mustbe to integrate with the other health professionsconcerned with livestock and humans, bringingthe perspecve and knowledge gained from theelephant and wildlife experiences. A One HealthNepal iniave is in the conceptual stage and TBis considered a perfect example to provide proofof concept and be er management, diagnosis,control and prevenon of the disease amongstall animal species and most importantly, humanbeings.3
Nepal Elephant Tuberculosis ulosisControl andManagement agemenAction Plan (2011-2015)2015)Treatment for TB amongst elephants began in2008. Exposure to known cases of TB and areacve Elephant TB Stat-Pak ® result were iniallyused as the basis for treatment. The currentdecision tree includes the DPP ® VetTB test (see1.5. TB Treatment Protocol).Roune surveillance of elephants and theirhandlers together with early diagnosis andtreatment are essenal to control TB. It is hopedthat these guidelines will serve as a science-basedmodel for other Asian elephant range countries.The Nepal Elephant Tuberculosis (TB) Controland Management Acon Plan (NETCMAP) isbased on a goal of minimizing the risk of TBtransmission from capve elephants to the wildby managing TB at the capve-wild interface Thisplan outlines methods to diagnose, treat, andmanage TB in elephants in Nepal. The TB controland management program will be launched bythe Ministry of Forests and Soil Conservaon- Department of Naonal Parks and WildlifeConservaon (DNPWC) with technical supportfrom naonal and internaonal conservaonpartners including the Naonal Trust for NatureConservaon (NTNC) Nepal, the Buffer ZoneManagement Commi ees (BZMCs) Nepal,Elephant Care Internaonal (ECI) USA, WorldWildlife Fund (WWF) Nepal, and the HotelAssociaon of Nepal (HAN). The plan will beimplemented under the close supervision of aveterinarian with adequate knowledge on animalTB.1.2 TB Tesng Procedures andManagement GroupsThe TB Plan Veterinary Officer and VeterinaryTechnician will be responsible for tesng allelephants in Nepal.Procedure1. Perform the Elephant TB Stat-Pak ® test2. If Elephant TB Stat-Pak ® test is non-reacvethe elephant is considered TB-free at the meof tesng.3. If Elephant TB Stat-Pak ® test is reacveperform the DPP ® VetTB test.4. If DPP ® VetTB test is non-reacve theelephant is TB-suspect.5. If DPP ® VetTB test is reacve the elephant isconsidered TB-infected.Management groupsGroup 1. TB-free: An elephant that is nonreacveon the Elephant TB Stat-Pak ® test.Connue every other year tesng with theElephant TB Stat-Pak ® . No segregaon or workrestricons.Group 2. TB-suspect. An elephant that is reacveon the Elephant TB Stat-Pak ® test and nonreacveon the DPP ® VetTB test. There are twoopons.Opon 1 (recommended especially for elephantsthat have contact with wild elephants or rhinos):Iniate prophylacc treatment (described insecon 1.5). Elephants in this sub-group shouldbe segregated while they are adjusng totreatment and should not work unl they havecompleted 30 consecuve days of treatment (30full doses). Elephants that have had a knownexposure to a TB infected elephant or human orwhose exposure status is unknown should followOpon 1. Following compleon of treatment,elephants will be designated as Group 2 - Treated.Opon 2: Test with the DPP ® VetTB test at 6months following the first reacve Elephant TBStat-Pak ® result. If the DPP is reacve at this me,the elephant changes to Group 3. If the DPP isnon-reacve at 6 month test again at one year.If the test is non-reacve at one year, monitorannually by the DPP ® VetTB test. Elephants4
Page 1: Nepal Elephant TuberculosisControl
Page 4: Copyright © and Published By:Gover
Page 11 and 12: SummaryThe Nepal Elephant Tuberculo
Page 13: AbbreviationsAREASBCCBZBZMCCNPCVLDL
Page 16 and 17: Mul angen print immunoassay (MAPIA)
Page 18 and 19: Part ITB Management
Page 22 and 23: Nepal Elephant Tuberculosis Control
Page 34 and 35: Part IIAction Plan
Page 48 and 49: Appendices

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