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To better document the burden and generate accurate, representative data that differentiate disease due to M. bovis from that due to M. tuberculosis, countries should strive to incorporate zoonotic TB into their routine surveillance activities. Better detection of cases requires greater awareness and expertise of healthcare providers, strengthened laboratory capacity, and improved access to accurate, rapid diagnostic tools.

Not all M.bovis infections progress to TB disease, there might be no symptoms at all. The symptoms of TB disease caused by M.bovis are similar to the symptoms of TB caused by M.tuberculosis, which includes fever, weight loss, anorexia, night sweats, etc. Since, the symptoms of Bovine TB are similar to MTB, the clinical picture of sick animal can help in confirmation of diagnosis. 

Clinical Presentations in animals:

People are most commonly infected with M. bovis by eating or drinking contaminated, unpasteurized dairy products. Infection can also occur from direct contact with a wound, such as what might occur during slaughter or hunting, or by inhaling the bacteria in air exhaled by animals infected with M. bovis. Direct transmission from animals to humans through the air is thought to be rare, but M. bovis can be spread directly from person to person when people with the disease in their lungs cough or sneeze.

Zoonotic Tuberculosis (zTB) is not a new disease but has long been neglected. Majority of tuberculosis (TB) cases in humans are caused by Mycobacterium tuberculosis (M. tuberculosis). A number of other organisms from the  M. tuberculosis complex (MTBC), present in animals and the environment, can cause zoonotic TB (zTB), these include M. canetti, M. bovis, M. caprae, M. microti, M. pinnipedii, M. mungi, and M. orygis. 

In various DR-TB regimens under the National TB Elimination Programme (NTEP); Rifampicin, Isoniazid, Pyrazinamide, PAS, Ethionamide and Bedaquiline are potentially hepatotoxic drugs.​

The use of appropriate Personal Protective Equipment (PPE) in a TB laboratory is determined by risk assessment (according to the procedure and suspected pathogen).

Designated Microscopy Centres (DMCs) are low-risk TB laboratories, hence PPE should be used as follows:

Counselling before initiating treatment for a patient. is an important component of the National TB Elimination Programme (NTEP). The patient is counselled along with his family by the health staff.

Counselling is done on the following points:

When the referring health facility receives the test results from the DMC, the results are communicated to the patient through NTEP supervisors/health facility staff/Medical Officer.

Both Positive and negative results need to be communicated to the patient. For negative results, counselling for further evaluation and testing need to be done for the symptoms.

Communication as a tool embodies attitudes, behavior, body language, style, method of presentation, quality of listening and perceptions and interpretations.

The Medical Officer (MO) of the referring health facility initiates TB treatment on receipt of the diagnostic test results. All efforts are made to initiate the treatment at the earliest.

The treatment regimen is decided based on the type of patient and TB (based on drug sensitivity pattern, i.e., drug-sensitive TB or H-mono/ poly resistance, history of adverse drug reaction to anti-TB drugs).

All efforts must be made to have decentralised local arrangements for transporting the specimens to the TB detection centre (TDC). If a proper transport mechanism for collected specimen is in place, it spares the patients from travelling to the laboratory.

The sputum sample is packaged in triple layers in such a manner that it arrives at the destination in good condition and presents no hazard to the transporter.

Transporter/ personnel transporting the sample should be sensitized by the National TB Elimination Programme (NTEP) staff prior to engagement.