York County Medicine Winter 2019 - 21

YO R K C O M E D S O C . O R G

FIGURE. Phylogenetic analysis of the most closely related Mycobacterium bovis isolates associated with
human tuberculosis cases* - Michigan, 2002-2017

Abbreviation: SNP = single nucleotide polymorphism.
* The most recent common ancestor is thought to have spilled over into the local deer population
from livestock at least one time during 1940-1960. All human cases are within 0-1 SNP of
sharing a common ancestor with a deer isolate. Numerals denote multiple identical isolates (for
example, identical M. bovis isolates from 5 deer and 1 other animal).

tuberculosis, exposure to M. bovis can lead to latent or active
infection, with risk for eventual reactivation of latent disease,
especially in immunocompromised hosts. To prevent exposure to
M. bovis and other diseases, hunters are encouraged to use personal
protective equipment while field-dressing deer. In addition, hunters
in Michigan who submit deer heads* that test positive for M.
bovis might be at higher risk for infection, and targeted screening
for tuberculosis could be performed. Close collaboration between
human and animal health sectors is essential for containing this
zoonotic infection.
Acknowledgment
Joshua Meyerson, MD, District Health Department No. 4, Michigan.
Corresponding author: Laura E. Power, lejohns@umich.edu,
734-647-5306.

Beaumont Health System, Dearborn, Michigan;
Department of Epidemiology, School of Public Health, University of
Michigan, Ann Arbor;
3
Department of Internal Medicine, Division of Infectious Diseases,
University of Michigan Medical School, Ann Arbor;
4
MidMichigan Health, Alpena, Michigan;
5
Michigan Department of Health and Human Services;
6
Wildlife Disease Laboratory, Michigan Department of Natural
Resources, Lansing;
7
National Veterinary Services Laboratories, Animal and Plant Health
Inspection Service, U.S. Department of Agriculture, Ames, Iowa.
1
2

All authors have completed and submitted the International
Committee of Medical Journal Editors form for disclosure of potential
conflicts of interest. No potential conflicts of interest were disclosed.
* https://www.michigan.gov/dnr/0,4570,7-35079119_79147_81438-,00.htmlexternal icon
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York County Medicine Winter 2019

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