Fasciola hepatica is associated with the failure to detect bovine tuberculosis in dairy cattle

Bovine tuberculosis (BTB) is a significant and intractable disease of cattle caused by Mycobacterium bovis. In the United Kingdom, despite an aggressive eradication programme, the prevalence of BTB is increasing with an unexplained, exponential rise in cases year on year. Here we show in a study involving 3,026 dairy herds in England and Wales that there is a significant negative association between exposure to the common, ubiquitous helminth parasite, Fasciola hepatica and diagnosis of BTB. The magnitude of the single intradermal comparative cervical tuberculin test used to diagnose BTB is reduced in cattle experimentally co-infected with M. bovis and F. hepatica. We estimate an under-ascertainment rate of about one-third (95% confidence interval 27–38%) among our study farms, in the hypothetical situation of no exposure to F. hepatica. This finding may in part explain the continuing spread of BTB and the failure of the current eradication programme in the United Kingdom. The incidence of bovine tuberculosis in the UK is increasing despite efforts to eradicate the disease. The authors of this paper show that infection of cattle with the parasiteFasciola hepaticaimpedes the diagnosis of tuberculosis, which may in part explain why the current eradication campaign is failing.