Background: There are nearly a thousand captive Asian elephants and not less than 3,000 mahouts in southern India. In the hands-on and open systems of captive elephant management, diseased mahouts and captive elephants could present the risk of cross-species tuberculosis transmission. With the help of evidence based results, we intend to formulate specific policy guidelines, which can suggest locally relevant preventive and control measures to help mitigate the risk of cross-species infection.
Methods & Materials: Over a period of three years, one time screening of nearly 800 elephants and their mahouts was achieved. Tuberculosis screening of mahouts was done by clinical examination, chest X-ray evaluation, sputum culture and tuberculin skin testing, as required. Screening of elephants was done using the USDA licensed serological test, DPP Vet Assay® (Chembio Diagnostics Inc., Medford, New York) and trunk wash culture, as required. Detailed contact investigation of traceable human and animal contacts of the identified diseased mahouts and elephants were done. We examined three different contexts of tuberculosis transmission among captive elephants and mahouts. First scenario is the risk of infection from an infected mahout to an elephant. Second is the risk of infection from an infected elephant to a mahout and third is the risk of infection from an infected elephant to another elephant.
Results: There is evidence to suggest cross-species tuberculosis transmission. However, under the tropical climatic conditions in southern India, the risk of infection to a captive elephant from a diseased mahout seems to far outweigh the risks of infection to a mahout or another elephant, from a diseased elephant. There are political as well as ethical consequences to the outcomes in each of the three scenarios and they are both varied and complex.
Conclusion: Mahouts and captive elephants in southern India are highly migrant and locating the subjects for contact tracing and follow-up testing is difficult. Hence, systematic and regular tuberculosis screening of mahouts and captive elephants is a challenge. Formulating as well as implementing policy guidelines for prevention and control of cross-species tuberculosis transmission, in the existing cultural and religious contexts of captive elephant managements in southern India, appears to be an even bigger challenge.
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