Roadmap for development of disease control strategies for bTB

What are we trying to achieve and why? What is the problem we are trying to solve?

What are the fundamental pathways for host pathogen interaction and disease progression?

What are the scientific and technological challenges (knowledge gaps needing to be addressed)?

• How does the host handle pathogen exposure?
• Are there informative diagnostic biomarkers?
• What is the distribution of host responses?
• What are the stages of infection post-exposure?
• What is the natural history of infection?
• What are the correlates of protection (vaccines and diagnostics)?
• Is it possible to distinguish immune clearance from infection?
• Establishing the relationship between exposure dose and the number of exposure occurrences and risk of infection.
• Establishing the relationship between host factors (stress) and infection.
• The identity of the factors that determine disease progression rates.
• Could certain pathogen lineages be associated with worse disease outcomes – intersection between this and susceptibility could constitute a type of superspreader phenotype?

What approaches could/should be taken to address the research question?

• Omics studies to understand fundamental mechanisms of host-pathogen interaction.
• Establishing the infectious dose for various animal species/breeds.
• Establishing the differences in susceptibility of different breeds/lines and the rate of progression to active
  infection/lesion development.
• Investigation of disease progression rates in different animal species, breeds and individuals.
• Establishing the consequences of multiple exposure.
• Modelling pathogenesis and epidemiology in different infections.
• Assessing impact of pathogen lineage on disease outcomes like pathology etc through in vivo and in vitro experimentation.

What else needs to be done before we can solve this need?

Improved understanding of the role of Coinfection

Existing knowledge including successes and failures