A newly acquired 31-year-old female Asian elephant (“Calle”), came under suspicion of being infected with Mycobacterium tuberculosis when a former pen mate at another institution was diagnosed with tuberculosis on postmortem examination.
Using guidelines for evaluating tuberculosis suspect elephants provided by the Elephant Tuberculosis Advisory Committee and the National Tuberculosis Working Group for Zoo and Wildlife Species, we evaluated Calle and one other resident Asian elephant female who was considered a contact animal. On 20 June 1997, a trunk wash culture taken from Calle came back positive for M. tuberculosis. With this positive culture came the many challenges associated with managing and treating a M. tuberculosis positive elephant, a culture negative contact animal, personnel working with those animals and the general public.
These challenges were met by becoming familiar with the disease caused by M. tuberculosis, educating the entire zoo staff and addressing their concerns, and educating the public relations department so they could address the concerns of visitors.
Quarantine procedures were established for the elephant barn and a program was established to screen and protect zoo personnel exposed to Calle. Treatment protocols were developed for Calle and the contact elephant. Because Calle refused to take oral medication (isoniazid and rifampin) a rectal suppository dosing regimen was developed. Oral prophylactic treatment was initiated on the contact animal but is becoming increasingly difficult to administer. The animal is undergoing conditioning so that a suppository can be used on it as well.
Both oral and suppository treatment have presented many challenges. At this time, we have achieved acceptable blood drug levels only with isoniazid and work continues with rifampin to achieve a multiple drug treatment protocol. Since starting the current treatment protocol, Calle has been trunk wash culture negative and the other animal has remained negative.
The management of these two elephants has been accomplished by developing a communication network including members of the Elephant Tuberculosis Advisory Committee and Working Group, members of the San Francisco Public Health Department, compounding pharmacists, and other zoos and elephant owners with tuberculosis positive elephants. There has been a significant financial commitment by the San Francisco Zoo and time commitments by zoo personnel involved in the care and treatment of these animals. A successful, proactive public relations campaign has resulted in an informed public, which has been overwhelmingly supportive of the zoo’s efforts.