Paratuberculosis is a worldwide disease affecting both, developing as well as developed countries in Europe, North America, South America, Asia, Australia, and Africa (Behr and Collins, 2010). The distribution of MAP from its first report in Europe to dairy herds all over the world demonstrates the rapid spreading of MAP over geographical space and highlights the need for paratuberculosis eradication and control programmes (Figure 12). As over 50% of dairy cattle herds are infected with MAP, paratuberculosis is considered an endemic disease in Europe and North America (Nielsen and Toft, 2009).
Figure 12: Theoretical global epidemic curve for herd-level paratuberculosis in dairy cattle (Behr and Collins, 2010).
MAP occurs in most parts of the world with an increasing prevalence (Chiodini et al., 1984). A recent study critically reviewed published data representing prevalence of MAP in Europe and estimated the overall prevalence to be 20% (Nielsen and Toft, 2009). The true prevalence among cattle was measured in serological studies conducted in France (Petit, 2001), Germany (Donat, 2005), Italy (Robbi, 2002), and Turkey (Atala, 2001). Is has been suggested that the prevalence of MAP is at least 3-5% in several countries (Cetinkaya et al., 1996; Vicenzoni, 1999). However, a proper conclusion with regards to the prevalence of MAP infections in Europe cannot be made, due to study designs unsuitable for prevalence inference (Nielsen and Toft, 2009).
In Germany paratuberculosis is a notifiable disease according to §78a Abs. 2 of the Tierseuchengesetz. Currently 300 to 450 cases per year are reported. In 2009 and 2010, 361 and 411 MAP cases were reported respectively, whereas most cases occurred in Lower Saxony and North Rhine-Westphalia (TSN Database – Germany) (Figure 13).
Between 1997 and 2007, four prevalence studies mainly based on serological methods investigated the MAP prevalence in Germany A study in Mecklenburg-West Pomerania revealed an apparent prevalence of 12.2% by testing 59 dairy cattle for MAP specific antibodies using the SvanovirTM-ELISA (Svanova Biotech AB, Uppsala, Sweden) (Hacker et al., 2004). In Bavaria 2,748 bovine sera from 119 herds were analysed using two commercially available ELISAs (IDEXX HerdChek, Idexx Gmbh, Wörrstadt, Germany, and Pourquier ELISA, Institut Pourquier, Montpellier, France). An apparent prevalence of 1.5% and 0.9%, respectively, was defined (Bottcher and Gangl, 2004), whereas in Saxony an estimated prevalence of 4.4% was calculated by testing 3,454 animals randomly, selected from clinically suspicious herds by the HerdChek ELISA (IDEXX GmbH, Wörrstadt, Germany) (Donat, 2005). In contrast, an apparent MAP prevalence of 14.7% was determined in the rural district of Arnsberg (North Rhine-Westphalia) when 517 sera from cattle older than 18 months were investigated in an in-house ELISA (Böttcher, 1997).
Figure 13: Map of Germany ilustrating reported cases of paratuberculosis. (A) 1995-2009 and (B) 2010 (TSN: July 2011).
In Austria a study determined the prevalence of MAP in the regions Mödling, Graz, Linz and Innsbruck. They used an ELISA based on an antigen from Allied Monitor (Fayette, USA) and estimated an average prevalence of 1.99% and an apparent prevalence in Austrian herds of 6% (Gasteiner et al., 1999).
In Switzerland, studies have been carried out based on bulk tank milk PCR resulting in prevalence estimates on herd level of 22% and 20%, respectively (Corti and Stephan, 2002; Stephan et al., 2002). Among the studies based on Parachek ELISA (CSL, Parkville, Victoria, Australia), apparent prevalences of 5.1% and 0.7% were estimated, respectively (Meylan et al., 1995; Stark et al., 1997). A later study tested samples of multiple specimens (milk, feces, and tissues) from 101 animals obtained from cull-cattle that were sent to one slaughterhouse. The tests were conducted based on F57 real-time PCR and a prevalence of 20% was reported (Bosshard et al., 2006).
In Belgium, a stratified random sample of cows was obtained from 511 herds. In these herds, all cattle >24 months of age were sampled. The animals were tested by ELISA (HerdChek, IDEXX, France), and it was assumed that the prevalence on animal level was 0.9% and on herd level 18% (Boelaert et al., 2000).
One study has been published in The Netherlands based on a region stratified random sample of 15,822 cows belonging to 378 herds using the IDEXX HerdChek test (IDEXX Scandinavia AB, Österbybruk, Sweden) (Muskens et al., 2000). Of these herds, 55% (n = 207) had one or more serologically positive cows. The percentage of positive cows per herd was estimated to be 2%.
Prevalence estimates from the United Kingdom have only been published in one study in South West England (Cetinkaya et al., 1996). This study was based on cull cattle that were sent to three abattoirs. Of 1,297 adult cattle tested, 3.5% were positive by an IS900 PCR used for samples of lymph nodes. PCR positive lymph nodes were also cultured, and in 34 cows (2.6% of the total sample) MAP could be isolated.
In Spain, 61,069 animals of at least 1-year of age from 2,735 randomly selected herds were bled and their samples analyzed with a commercial ELISA test (Dieguez et al., 2007). The estimated true individual-level prevalence was 3.0% in dairy cattle, 1.0% in beef cattle and 2.8% in animals from farms with both dairy and beef cattle. True herd prevalence was 10.7% for dairy herds, 0.0% for beef herds and 2.7% for mixed herds. In conclusion, these results seem to indicate that a small percentage of cows and a rather high percentage of dairy herds in this region are MAP-seropositive.
In Italy, a true prevalence of 17% was estimated in the Venetia region based on an apparent prevalence of 3.5% using an serological assay (Robbi, 2002). This result corresponded with the apparent prevalence of 6.8%, based on histopathology and culture of MAP from tissue samples of the ileocecal valve, that was measured in animals sent to slaughter houses in the Verona province of Venetia (Vicenzoni, 1999).
In the Yonne region of France a study used the ELISA test (Pourquier, Montpellier, France) and estimated a herd prevalence of 68% and an individual-level prevalence of 3.3% among a random selection of cattle (Petit, 2001).
In Turkey prevalence studies were carried out in three regions (Central Anatolia, Eastern Anatolia, and Western Anatolia combined with Eastern Thrace), based on ELISA testing (Atala, 2001), PCR in milk samples (Cetinkaya, 2000) and PCR in fecal samples (Ikiz, 2005), respectively. In the study based on ELISA an apparent herd prevalence of 38% was estimated (Atala, 2001). Individual-level prevalence was 4.6%
in ELISA (Atala, 2001), 0% in PCR in fecal samples (Ikiz, 2005) and 5% in PCR milk (Cetinkaya, 2000).
In the Republic of Ireland, 13% of the samples were found positive by bulk tank milk PCR (O'Reilly et al., 2004). In a survey of MAP in imported animals in the Republic of Ireland, the apparent prevalence on individual-level was estimated to be 3.6%
(O'Doherty et al., 2002).
However, available prevalence data need to be interpreted with caution due to a long incubation period of up to ten years (Whitlock and Buergelt, 1996). Clinical symptoms may be first seen in animals with an age of 2-5 years (Clarke, 1997). These clinical cases are merely the tip of the iceberg in terms of the total number of infected animals in a herd (Figure 14). It is assumed that for every cow with clinical signs of paratuberculosis, a minimum of 25 other animals are infected (Whitlock and Buergelt, 1996).
Figure 14: The “Iceberg concept” by Whitlock and Buergelt, 1996.
Current applied diagnostic methods detect only 15% to 25% of these infected animals (Whitlock and Buergelt, 1996). Therefore, the true prevalence of MAP might well exceed the current estimates.
Although MAP is considered to be a pathogen growing only inside of a suitable host, published data suggest that MAP survives well in the open environment, persisting for between 300 and 600 days in water and soil (Pickup et al., 2005; Whittington et al., 2005). MAP has been detected in the agricultural environment in pasture soil, manure storage areas, calving and sick pens, lakes, lagoons, and alleyways (Table 2).
Table 2: Distribution of MAP in environmental samples.
Location Country References
Pasture soil USA (Johnson-Ifearulundu and Kaneene, 1997) (Norby et al., 2007) (Ward and Perez, 2004)
Manure storage USA (Raizman et al., 2004)
(Jaravata et al., 2006)
Calving and sick pens USA (Raizman et al., 2004)
Lakes UK (Pickup et al., 2006)
River UK (Pickup et al., 2005; Pickup et al., 2006)
Sediment Australia (Whittington et al., 2005)
Lagoons USA (Berghaus et al., 2006)
Alleyways USA (Berghaus et al., 2006)
(Raizman et al., 2004)
Water USA
Ireland Australia
(Norby et al., 2007) (Raizman et al., 2004) (Whan et al., 2005) (Whittington et al., 2005)
Slurry Australia
Norway
(Gwozdz, 2006) (Jorgensen, 1977)
Sewage Australia (Gwozdz, 2006)
Recent studies have demonstrated the importance of investigating environmental sources of MAP and its effect on prevalence and persistence within affected herds (Berghaus et al., 2006; Cook and Britt, 2007; Gwozdz, 2006; Raizman et al., 2004;
Whittington et al., 2004). Some authors even suggest that environmental sampling for MAP may serve as a viable alternative to individual animal testing since it accurately predicts herd status, is lower in cost, and easier to perform (Berghaus et al., 2006;
Raizman et al., 2004).