A Cross-Sectional Study of Avian Influenza in One District of Guangzhou, 2013

Since Feb, 2013, more than 100 human beings had been infected with novel H7N9 avian influenza virus. As of May 2013, several H7N9 viruses had been found in retail live bird markets (LBMs) in Guangdong province of southern China where several human cases were confirmed later. However, the real avian influenza virus infection status especially H7N9 in Guangzhou remains unclear. Therefore, a cross-sectional study of avian influenza in commercial poultry farms, the wholesale LBM and retail LBMs in one district of Guangzhou was conducted from October to November, 2013. A total of 1505 cloacal and environmental samples from 52 commercial poultry farms, 1 wholesale LBM and 18 retail LBMs were collected and detected using real-time RT-PCR for type A, H7, H7N9 and H9 subtype avian influenza virus, respectively. Of all the flocks randomly sampled, 6 farms, 12 vendors of the wholesale LBM and 18 retail LBMs were type A avian influenza virus positive with 0, 3 and 11 positive for H9, respectively. The pooled prevalence and individual prevalence of type A avian influenza virus were 33.9% and 7.9% which for H9 subtype was 7.6% and 1.6%, respectively. None was H7 and H7N9 subtype virus positive. Different prevalence and prevalence ratio were found in different poultry species with partridges having the highest prevalence for both type A and H9 subtype avian influenza virus. Our results suggest that LBM may have a higher risk for sustaining and transmission of avian influenza virus than commercial poultry farms. The present study also indicates that different species may play different roles in the evolution and transmission of avian influenza virus. Therefore, risk-based surveillance and management measures should be conducted in future in this area.     

Avian flu in Altay territory

The avian flu epizootia among wild waterfowl and poultry in personal farmsteads is described. In 38.9% of tests from a sectioning material from bird's mass destruction the genetic materials of a influenza virus type A (H5N1), and in 24% of tests of serum antibodies to a influenza virus type A (H5N1) in diagnostic titers are revealed. It is carried out serological monitoring among workers of integrated poultry farms and the population. Activation of epizootic process in second half of summer and is predicted by Autumn, 2006. For the prevention of distribution of disease among birds and infection of the person carrying out of a complex of the actions directed on creation of quarantine for a wild waterfowl and restriction of contacts to a poultry, and on vaccine prevention from annual 100% immunization of workers of integrated poultry farms is necessary.     

Different genetic patterns in avian Toll-like receptor (TLR)5 genes

Toll-like receptors (TLRs) mediate immune response via recognition of pathogen-associated molecular patterns (PAMPs), thus play important roles in host defense. Polymorphisms of TLR5 may affect their recognition of bacterial flagellin, leading to varied host resistance to pathogenic infections. Here, we cloned TLR5 genes from Common Pheasant, Guinea fowl and 9 Chicken breeds and analyzed their sequences. The open reading frames of TLR5 were sequenced. Amino acid analysis indicated that TLR5 from Chicken breeds shared 99.4–99.9% homology. The amino acid homology of TLR5 ranged from 92.1 to 92.5% between Chickens and Guinea fowl, 95.7–96.1% between Chickens and Turkey, 94.3–94.7% between Chickens and Common Pheasant, and 79.9–80.1% between Chickens and Zebra-finch. Different genetic patterns were determined among Chickens, Common Pheasant, Guinea fowl, Turkey and Zebra-finch. It was found that there were 92 amino acid polymorphic sites, among which 5 sites in chicken TLR5, 63 sites in Guinea fowl TLR5 and 44 sites in Common Pheasant TLR5. Our data indicate that the positive Darwinian selection occurred in avian TLR5 genes since frequency of non-synonymous (d _N ) > frequency of synonymous (d _S ). These results also demonstrate that avian TLR5 genes are polymorphic among avian breeds, suggesting a varied resistance among breeds of avian. This information might be of help to improve the health of avian by breeding and vaccination.     

Sequence analysis of hexon gene from adenovirus KR95 inducing hydropericardium syndrome in chickens

The nucleotide sequence of a part of the HindIII-D fragment (3300 b.p.) of adenovirus KR95 DNA has been determined. Analysis of the nucleotide sequence disclosed a continuous ORF for hexon gene (2814 b.p.) coding the 937 residue protein, part of ORF for the C-terminal region of pVI polypeptide, including 114 residues and the beginning of ORF coding 25 N-terminal residues for viral endoproteinase. Comparison of predicted KR95 hexon sequence and 8 mammalian and avian adenovirus hexon sequences revealed the highest homology between KR95 strain and avian adenoviruses FAV10 and FAV1 (91.1 and 80.1%, respectively). The results were used for creating a test system on the basis of the polymerase chain reaction. The system was used in analysis of fowl samples obtained from 12 poultry farms in Russia. The sequences of hexon gene amplified fragments in the isolated strains and similar fragments of other mammalian and avian adenoviruses have been compared.     

Prevalence of ornithosis and other Chlamydia-like infections in the Ukrainian SSR

The prevalence of ornithosis and other Chlamydia infections among various groups of the population, some species of birds and mammals was studied in several regions of the Ukrainian SSR. Among the town population having no occupational contact with domestic fowl and farm animals, complement-fixing antibodies to group ornithosis antigen were found in 6.5% of the examined, among the inhabitants of rural localities in 8.4% and among the workers of poultry farms in 19.9%. During the examination of the immunological state of the workers of cattle-breeding farms, antibodies were detected in 15.1%. Pigeons, hens and ducks were investigated as probable sources of infection. The number of positively reacting individuals was 53.7, 13,7 and 24.9%, respectively. This indicates that they play a role in the spread of infection. The obtained data point out a considerable spread of Chlamydia infections among farm animals. Positive results of serological examination were recorded in pigs in 25.7%, in calves in 15.1% and in 8.6% of cases examined.     

Identification of a Toll-Like Receptor 1 in Guinea Fowl (Agelastes niger)

Toll-like receptors (TLRs) recognize pathogen-associated molecular patterns, thus playing important roles in host defense. This study determined the first sequence of a TLR1 type 1 in the guinea fowl (GFTLR1). The open reading frame of GFTLR1 type 1 contains 2,115 nucleotides and encodes 705 amino acids. Amino acid analysis indicated that GFTLR1 type 1 shares 92.3?% homology with the green jungle fowl, 92.1?% with the chicken, 90.4?% with the turkey, and 84.4?% with Cooper's hawk. Genetic patterns were identified within the TLR1 type 1 of the chicken and the guinea fowl. GFTLR1 type 1 was found to have 92 polymorphic amino acid sites, of which 16 were in the leucine-rich repeat (LRR) domain, 3 in a C-terminal LRR domain, and 6 in a Toll/interleukin-1 receptor domain. The data showed that avian TLR1 type 1 genes are under purifying selection and highly conserved, because dN/dS was less than 1.     

In vitro migration of peritoneal and spleen cells and its inhibition in some avion species

Cell migration and its inhibition was tested by the capillary tube technique with peritoneal exudate cells and spleen cells of chicken, turkey, goose, guinea fowl, and Japanese quail. Peritoneal cells were produced by ip administration of proteose peptone and harvested 24 hr later. Liquid paraffin proved to be unsatisfactory for preparation of peritoneal cells in some avian species. Mononuclear cells represented no more than 50–60% of the peritoneal cell populations, the other 50% being polymorphonuclear cells in all five avian species studied. Cell migration was demonstrated with chicken, turkey, and goose peritoneal and spleen cells, but not with those of guinea fowl and Japanese quail. The composition of the cell populations in the migration areas was nearly the same as in the initial preparations of peritoneal and spleen cells. Spleen cell migration was inhibited to a greater extent than that of peritoneal cells. Migration inhibitory factor (MIF) produced by chicken and turkey lymphocytes exhibited some species specificity.     

Development of a 23S rRNA-based PCR assay for the identification of Pasteurella multocida

AIMS: The aim of this work was to develop a rapid diagnostic test for Pasteurella multocida. METHODS AND RESULTS: A polymerase chain reaction (PCR) assay using primers derived from the 23S rRNA gene sequence of Past. multocida was developed. The PCR assay correctly identified all 144 isolates of Past. multocida tested, including type strains of the three subspecies as well as the reference strains for the Heddleston and Carter typing schemes. Of 20 closely related bacteria from the family Pasteurellaceae tested, only the type strains of Past. canis biovar 2 and Past. avium biovar 2 were positive. These two bacteria, formerly known as Bisgaard Taxon 13, are the closest phylogenetic relatives of Past. multocida based on 16S ribosomal rRNA. All phylogenetically unrelated avian and porcine organisms tested were negative. CONCLUSION: This PCR enables rapid identification of Past. multocida colonies from avian or porcine origin. SIGNIFICANCE AND IMPACT OF THE STUDY: Veterinary diagnostic laboratories can use this PCR to rapidly and accurately diagnose fowl cholera and porcine pasteurellosis.     

Absence of Escherichia coli O157 in a survey of wildlife from Trinidad and Tobago

Fecal, cloacal, or rectal swabs of free-ranging and captive mammalian and avian wildlife in Trinidad and Tobago were cultured for non-sorbitol fermenting Escherichia coli and tested for O157:H7 strains. Ability of E. coli strains to produce hemolysin and mucoid colonies also was investigated. Of 271 free-ranging mammals tested, 158 (58%) yielded E. coli; only one (< 1%) bacterial isolate was a non-sorbitol fermenter which was not agglutinated by O157 antiserum. All isolates were negative for hemolysin production and mucoid colonial growth. Two hundred and sixty-three (90%) of 293 free-flying birds were positive for E. coli and all isolates were sorbitol fermenters and negative for production of hemolysin and mucoid growth. Of 175 captive wild animals from individual backyard farms and a government demonstration farm, 145 (83%) yielded E. coli with four (2%) non-sorbitol fermenters; all were negative for O157 strains, hemolysin production, and mucoid colonial growth. Of 373 animals in a zoo, 250 (67%) were positive for E. coli with only two (0.5%) non-sorbitol fermenters. All strains were non-hemolytic and non-mucoid farms. It appears that free-ranging and captive avian and mammalian wildlife are not important reservoirs of O157:H7 strains of E. coli in Trinidad and Tobago.     

Pathogenicity and Complete Genome Characterization of Fowl Adenoviruses Isolated from Chickens Associated with Inclusion Body Hepatitis and Hydropericardium Syndrome in China

In this study, we determined and genetically characterized three fowl adenoviruses isolated from chickens with inclusion body hepatitis (IBH) and hydropericardium syndrome (HPS) in China and assessed their pathogenicity. The full genome of HBQ12, BJH13 and JSJ13 was found to be 44,081, 43,966 and 43,756 nucleotides long, respectively. Sequence alignment and phylogenetic analysis revealed that strain HBQ12 and BJH13 were clustered together belonging to fowl adenoviruses D species and serotyped as FAdV-11, whereas strain JSJ13 was classified into fowl adenoviruses C species and serotyped as FAdV-4. To our knowledge, this is the first report of FAdV-4 strain circulating in China. The pathogenicity test showed that mortality for chickens infected with HBQ12 and JSJ13 within 21 days post infection (dpi) was 8.6% and 28.6%, respectively. Necropsy displayed mild or severe hepatitis and hydropericardium at 3 and 5 dpi as well as dead chickens. Viral DNA was detected in almost all tissues sampled from dead chickens. These results revealed that fowl adenovirus strains HBQ12 and JSJ13 are capable of causing IBH and HPS in chickens, indicating that preventive measures against FAdV infection on poultry farms should be implemented in China.     

Epithelial and neuronal calbindin in avian intestine An immunohistochemical study

Summary It is well known that calbindin immunoreactivity is highly concentrated in the duodenal absorptive cells of young birds. We have shown that in the adult intestine of three avian species, calbindin content is much more variable. In addition to absorptive cells, we have detected throughout the gut of both sexes of the domestic fowl and in the large intestine of the Japanese quail a second type of calbindin-positive epithelial cell which has the shape of a typical endocrine cell. These cells were particularly abundant in the large intestine, in contrast to the usual distribution of endocrine cells along the gut. Calbindin was also detected in the nervous system of the intestine. Calbindinpositive nerve fibres were rare in the duodenum and ileum, numerous in plexuses and nerve processes in both muscular layers and lamina propria of the large intestine in domestic fowl and Japanese quail. In the mallard, nerve fibres were rarely calbindin positive while definitively positive for VIP. Calbindin of the peripheral nervous system of the domestic fowl and Japanese quail comigrates with the duodenal calbindin (27000 dalton) in SDS gel electrophoresis.     

Prevalence of Mycobacterium tuberculosis infection among injection drug users in Toronto

BACKGROUND: Injection drug users are at increased risk of Mycobacterium tuberculosis infection and active tuberculosis (TB). The primary objective of this study was to determine the prevalence of M. tuberculosis infection among injection drug users in Toronto, as indicated by a positive tuberculin skin test result. An additional objective was to identify predictors of a positive skin test result in this population. METHODS: A cross-sectional study was carried out involving self-selected injection drug users in the city of Toronto. A total of 171 participants were recruited through a downtown Toronto needle-exchange program from June 1 to Oct. 31, 1996. RESULTS: Of 167 subjects tested, 155 (92.8%) returned for interpretation of their skin test result within the designated timeframe (48 to 72 hours). Using a 5-mm cut-off, the prevalence rate of positive tuberculin skin test results was 31.0% (95% confidence interval 23.8% to 38.9%). Birth outside of Canada and increasing age were both predictive of a positive result. INTERPRETATION: There is a high burden of M. tuberculosis infection in this population of injection drug users. The compliance observed with returning for interpretation of skin test results indicates that successful TB screening is possible among injection drug users.     

Natural foci of ornithosis in Kazakhstan]

An investigation (clinical, immunological and epidemiological) of the workers of various fowl-farms was carried out in various regions of Kazakhstan for a number for years; the sera of domestic fowl and birds was studied as well. On the basis of examination of 6264 persons the greatest percentage of ornithosis was revealed among the workers of the slaughter house and the shop for the processing of the fowl. Examination of 4749 sera of bird blood showed that the highest incidence of ornithosis was among doves and ducks (43.2 and 11.6%), and the least--in chickens (5.3%); there proved to be a direct relationship between the infection of man and birds. Thus, it was shown that domestic fowl and also doves served as the source of ornithosis infection; foci of ornithosis were revealed in a number of Kazakhstan regions as a result of these investigations.     

Tuberculin Reactions in Bulls And Boars Sensitized with Atypical Mycobacteria from Sawdust

Due to a planned export from a combined bull and boar station, more than 70 boars and 100 bulls were examined by tuberculin tests. Distinct reactions to avian tuberculin appeared in about half of the animals. Many of them also reacted to bovine tuberculin. For diagnostic purposes, many of the reactors were slaughtered, and samples from these and from the environment were examined bacteriologically. Strains of Mycobacterium avium were isolated from only 2 out of 14 reacting boars and from none of the 23 reacting bulls. No isolation of Mycobacterium bovis was made. However, atypical mycobacterial strains, classified as Runyon Group III and IV, were isolated from 3 boars, 2 bulls, 1 pigeon and from many samples of sawdust. The isolation of identical fast-growing mycobacterial strains from the sawdust used in the pens for the reacting boars and bulls, was especially remarkable. The strains differed enzymatically and biochemically from those isolated from other sources. This indicated a possible sensitization of the animals with similar mycobacterial strains. Possible cross-reactions to avian and bovine tuberculin were investigated in tuberculin assays with guniea pigs and pigs sensitized to one of the mycobacterial strains isolated. Distinct reactions to both avian and bovine tuberculin appeared in all the animals. From these results it was concluded that the tuberculin reactions in the boars and the bulls were not due to any tuberculous infection in the herd, but to a sensitization of the animals with atypical mycobacteria.     

Phylogenetic distribution of the novel avian endogenous provirus family EAV-0

A new family of related endogenous proviruses, existing at 50 to 100 copies per haploid genome and distinguishable by remarkably short long terminal repeats, has been described for domestic chickens (Gallus gallus subsp domesticus). In this communication, by using Southern blot analysis and probes derived from both internal viral sequences and locus-specific, cellular flanking sequences, we studied the genetic distribution of this family of moderately repetitive avian endogenous retroviruses within the genomes of four Gallus species. Eight inbred lines of domestic chickens, the evolutionary progenitor to the domestic chicken (red jungle fowl), and two more distantly related species (grey and green jungle fowl) were studied. All Gallus species harbored this class of elements, although the different lines of domestic chickens and different species of jungle fowl bore distinguishable complements of the proviral loci. Jungle fowl appeared to have fewer copies than domestic chickens. For three randomly isolated proviral loci, domestic chickens (G. gallus subsp. domesticus) and red jungle fowl (G. gallus subsp. gallus) showed only a proviral state, whereas the most primitive and divergent of the jungle fowl, the green jungle fowl (G. varius), consistently demonstrated only preintegration states or disparate alleles. The presence of this family in all Gallus species and of related sequences in other genera suggests that a primordial founding integration event occurred prior to the evolutionary separation of Gallus species and possibly related genera. Additionally, at least one proviral locus has been acquired subsequent to speciation, indicating that this family was actively infectious after the primary founding event. This conserved, repetitive proviral family appears to represent the vestigial remnant of an avian retrovirus class related to and evolutionarily more ancient than the Rous-associated virus-0 family of avian endogenous retroviruses.     

The Avian XPR1 Gammaretrovirus Receptor Is under Positive Selection and Is Disabled in Bird Species in Contact with Virus-Infected Wild Mice

Xenotropic mouse leukemia viruses (X-MLVs) are broadly infectious for mammals except most of the classical strains of laboratory mice. These gammaretroviruses rely on the XPR1 receptor for entry, and the unique resistance of laboratory mice is due to two mutations in different putative XPR1 extracellular loops. Cells from avian species differ in susceptibility to X-MLVs, and 2 replacement mutations in the virus-resistant chicken XPR1 (K496Q and Q579E) distinguish it from the more permissive duck and quail receptors. These substitutions align with the two mutations that disable the laboratory mouse XPR1. Mutagenesis of the chicken and duck genes confirms that residues at both sites are critical for virus entry. Among 32 avian species, the 2 disabling XPR1 mutations are found together only in the chicken, an omnivorous, ground-dwelling fowl that was domesticated in India and/or Southeast Asia, which is also where X-MLV-infected house mice evolved. The receptor-disabling mutations are also present separately in 5 additional fowl and raptor species, all of which are native to areas of Asia populated by the virus-infected subspecies Mus musculus castaneus. Phylogenetic analysis showed that the avian XPR1 gene is under positive selection at sites implicated in receptor function, suggesting a defensive role for XPR1 in the avian lineage. Contact between bird species and virus-infected mice may thus have favored selection of mouse virus-resistant receptor orthologs in the birds, and our data suggest that similar receptor-disabling mutations were fixed in mammalian and avian species exposed to similar virus challenges.     

禽流感H5、H7、H9亚型多重实时荧光RT-PCR检测方法的建立

为了对致病性强、危害性大的H5、H7、H9亚型禽流感病毒进行同时集成化快速检测,通过对GenBank已报道的禽流感病毒的HA基因进行序列分析比较,设计了H5、H7、H9 3个亚型的特异性引物和分别用3个荧光基团标记的Taqman MGB核酸探针。将各个亚型引物与探针优化组合,筛选出能够同时检测禽流感病毒H5、H7、H9 3个亚型、且对Ct值和扩增效率影响不大的3组引物和探针,建立了三重实时荧光RT-PCR方法。该方法特异性好,在我们检测的样品中,没有发现假阳性和假阴性现象。同时敏感性高,检测禽流感病毒H5、H7、H9亚型的敏感性分别达到1 0001、000、500个模板拷贝数;此外抗干扰能力强,对禽流感H5、H7、H9 3个亚型的不同模板浓度进行组合,仍可有效地同时检测3个病毒亚型。所建立的方法对保存的89个禽流感病毒样品进行检测,结果与经典检测方法(病毒分离鉴定、HA、HI)的符合率达100%。用上述建立的方法与鸡胚分离法同时对新鲜采集的4 000多份临床样品进行检测,两种方法的检测结果符合率为100%。     

Prevalence of Helicobacter pullorum in conventional, organic, and free-range broilers and typing of isolates

Helicobacter pullorum represents a potential food-borne pathogen, and avian species appear to be a relevant reservoir of this organism. In this study, the prevalence of H. pullorum was investigated at 30 conventional farms where 169 ceca from 34 flocks were tested, at eight organic farms where 39 ceca from eight flocks were tested, and at seven free-range farms where 40 ceca from eight flocks were tested. All of the ceca were obtained from healthy broiler chickens. Moreover, amplified fragment length polymorphism, pulsed-field gel electrophoresis, and automated ribotyping were employed to estimate the levels of genetic variability of H. pullorum broiler isolates within and between flocks. Overall, Gram-negative, slender, curved rods, identified as H. pullorum by PCR, were isolated at 93.3% of the farms tested. The percentage of positive free-range farms (54.2%) was significantly lower than that of conventional (100%) or organic (100%) farms (P < 0.001). The level of within-flock genetic variability, calculated as the number of flocks colonized by isolates genetically different by all of the typing methods, was 34.9%. Isolates showing identical profiles by each typing method were observed in 11.6% of the flocks, but they were never detected between flocks. However, groups of isolates clustered together with an overall similarity level of ≥85%. Our results suggest that even though a high level of genetic variability is attributable to H. pullorum broiler isolates, their hierarchical genotyping produces data useful for epidemiological investigations.     

A Serological Survey of Antibodies to H5, H7 and H9 Avian Influenza Viruses amongst the Duck-Related Workers in Beijing,China

The continued spread of highly pathogenic avian influenza (HPAI) viruses of H5 and H7 subtypes and low pathogenic avian influenza (LPAI) viruses of H5, H7 and H9 subtypes in birds and the subsequent infections in humans pose an ongoing pandemic threat. It has been proposed that poultry workers are at higher risk of exposure to HPAI or LPAI viruses and subsequently infection due to their repeated exposure to chickens or domestic waterfowl. The aim of this study was to examine the seroprevalence of antibodies against H5, H7 and H9 viruses amongst duck-related workers in Beijing, China and the risk factors associated with seropositivity. In March, 2011, 1741 participants were recruited from (1) commercial duck-breeding farms; (2) private duck-breeding farms; and (3) duck-slaughtering farms. Local villagers who bred ducks in their backyards were also recruited. A survey was administered by face-to-face interview, and blood samples were collected from subjects for antibody testing against H5, H7 and H9 viruses. We found that none of the subjects were seropositive for either H5 or H7 viruses, and only 0.7% (12/1741) had antibody against H9. A statistically significant difference in H9 antibody seroprevalence existed between the various categories of workers (P = 0.005), with the highest figures recorded amongst the villagers (1.7%). Independent risk factors associated with seropositivity toinfection with H9 virus included less frequent disinfection of worksite (OR, 5.13 [95% CI, 1.07–24.58]; P = 0.041; ≤ twice monthly versus>twice monthly) and handling ducks with wounds on hands (OR, 4.13 [95% CI, 1.26–13.57]; P = 0.019). Whilst the risk of infection with H5, H7 and H9 viruses appears to be low among duck-related workers in Beijing, China, ongoing monitoring of infection with the H9 virus is still warranted, especially amongst villagers who breed backyard ducks to monitor for any changes.     

Allergenicity of Mycobacterial Ribosomal and Ribonucleic Acid Preparations in Mice and Guinea Pigs

Guinea pigs were injected subcutaneously with mycobacterial ribosomal fraction incorporated in Freund's incomplete adjuvant and tested 6 and 12 weeks later by the intradermal injection of 0.5 μg (25 TU) of Purified Protein Derivative. No evidence of delayed-type hypersensitivity could be detected in these animals, although large necrotic reactions were obtained in guinea pigs sensitized with living, attenuated mycobacterial cells. Mice also were vaccinated by the intraperitoneal injection of mycobacterial ribosomal fraction or ribonucleic acid (RNA) and tested for sensitivity to tuberculin at various subsequent times. No evidence of true tuberculin hypersensitivity could be detected at any time, although what appeared to be small Arthus type reactions were seen in mice given the largest vaccinating doses. Attempts to recall tuberculin sensitivity in vaccinated mice by the intravenous injection, 4 weeks after vaccination of living cells, of either the virulent or attenuated mycobacterial strains were unsuccessful. Instead, when the virulent cells were injected, a suppression of footpad reactivity was noted in animals made sensitive to tuberculin by the previous intraperitoneal injection of viable attenuated mycobacterial cells. Both guinea pigs and mice, vaccinated as described above, were also skin tested or footpad tested, respectively, with 2 μg of the ribosomal fraction or RNA used for vaccination. No evidence of true tuberculin hypersensitivity could be obtained; instead, in guinea pig skin very small dermonecrotic areas were noted, and in mice swelling and redness of the footpad occurred to an equal extent in both vaccinated and nonvaccinated mice. The possible role of tuberculin hypersensitivity in acquired immunity to tuberculosis is discussed, and the conclusion is reached that its part, if any, is minor.