Abstract
The article reviews the steadily increasing literature on tuberculosis outbreaks involving Mycobacterium bovis, a bacillus traditionally associated with cattle and dairy products but in fact syndemic in a wide range of other animals including humans. Six major categories of journals cover this story: human infectious diseases and epidemiology, general human medicine, general veterinary practice, veterinary management of zoonoses and wildlife diseases, major multiscience journals, and microbiology. The journal literature is highly concentrated: Twelve high-impact journals account for more than half the citations, while sixty-seven others account for the remainder. While the incidence of food-borne TB has declined in most of the economically developed Western world, there remains a serious potential for dairy-based flares along the U.S.–Mexican border, for venison-associated outbreaks at the U.S.–Canadian border, and for continuing infection of herds in the United Kingdom due to a stubborn residual pool of infected grazing lands. While the consumption of unpasteurized raw milk and artisanal cheeses is generally inadvisable in many parts of the world, small-scale organic dairy farmers in economically developed countries who are particularly scrupulous in maintaining the health of their herds and cleanliness of the production process pose only a limited threat to public health, although occasional small-scale outbreaks will inevitably occur without pasteurization. However, in poorer countries, and especially in Sub-Saharan Africa, the confluence of wildlife, cattle, dairy operations, and rampant TB involving HIV/AIDS-compromised farm workers and consumers has created a nightmare cycle of infection and reinfection.
Acknowledgments
Ms. Hardin and Dr. Crandall gratefully acknowledge the Arkansas Bioscience Institute, which helped support their research.