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Was there a link between human TB cases in Madinah and the bovine TB outbreak among cows in 2007-2008?


In February 2007, a number of cases of bovine tuberculosis (TB) were reported among cows in Madinah City, Western Region of Saudi Arabia. Since that time, several measures have been taken to control the outbreak. This study aims to investigate any epidemiological link between this bovine TB outbreak among cows and the registered human TB cases in Madinah.


A cross-sectional study was conducted among the registered human TB cases in a TB Hospital in Madinah (2007 and 2008). It covered a total of 129 patients. An interview-based questionnaire was designed to collect information through telephone and direct interviews. Data were statistically analyzed using Epi Info software.


The study covered a total of 66 males (51.2%) and 63 females (48.8%). The majority (97 patients; 75.2%) had pulmonary TB, compared to 32 patients (24.8%) had extra-pulmonary TB. Regarding past history of contact with any type of cattle before illness, 18 patients (14.0%) gave a positive history, compared to 111 (86.0%) with a negative history. Detailed history data of those 18 patients with positive history of cattle contact revealed that half of them (9 patients; 50.0%) were in contact for a long duration of 20 years, while 3 (16.7%) for 30 years, and 2 (11.1%) for 5-years-duration. With regard to history of abnormal symptoms on cattle, 4 patients (22.2%) reported weight loss in their cattle, compared to 3 (16.7%) reported chronic cough, and 1 (5.6%) reported sudden death of one or more of his/her cattle. Among those 122 patients with a positive history of consuming milk, 47 patients (38.5%) consumed raw milk, while 75 (61.5%) consumed packed pasteurized milk.


Bovine TB outbreak among cows in Madinah seems to be under good control, since all the possible channels of its transmission to humans were almost blocked. Drinking raw milk was discovered among more than 30% of human TB cases. In addition, a long past history of contact with cattle was found among 14% of them. These might indicate a link between disease in animals and humans. However, further investigation (DNA Fingerprinting test) of animal and human samples is needed in order to specify the mycobacterial strains and, accordingly, to confirm such a possible link. TB surveillance among humans and all types of cattle in Madinah during the coming years is important to follow the disease trend and evaluate the control measures.