Mycobacterium tuberculosis, Mycobacterium bovis, and Mycobacterium avium complex can cause severe disease of the lungs and other organs in free-range and captive large apes, as well as in New and Old World primates. Infection may be caused by contact with infected human caregivers or other animals. Respiratory infections are usually transmitted by aerosol, but the oral route is also possible. Bacilli may also be shed in urine.
Old tuberculin or purified protein derivative (PPD) and avian tuberculin can be injected intradermally at separate sites on the abdomen or eyelids to conduct a comparative test. Skin tests are observed at 24, 48, and 72 hours for induration and swelling. Tuberculins prepared for use in humans might not have sufficient potency to elicit a response in nonhuman primates. Interferon-gamma and serologic assays can be used for diagnosis.
In some cases, tuberculosis in nonhuman primates has been treated with drugs that have had success in humans—eg, isoniazid, ethambutol, and rifampin. Tests should be conducted to determine the antimicrobial sensitivity of isolates. Efficacy is limited, and there are overriding arguments against treatment, based on the removal of infected animals, zoonotic risks, and the danger of developing drug resistance.