Advances in paratuberculosis research and control: a comprehensive expert review.

This review summarizes the 2025 update of the DISCONTOOLS gap analysis for Paratuberculosis, which was based on scientific literature review combined with expert knowledge. It summarizes recent advances across key areas including diagnostics, epidemiology, pathogenesis, vaccination, genetic resistance and alternative therapies. Progress in understanding host-pathogen interactions and immune responses is highlighted alongside developments in diagnostic tools such as molecular assays and phage-based detection. Vaccination strategies continue to evolve with efforts to improve efficacy and reduce interference with bovine Tuberculosis testing. Genetic studies reveal certain heritability of resistance traits, supporting breeding programs as complementary control measures. Alternative therapies including antibodies, mycobacteriophages, and probiotics show promise for early-life infection management. This review also addresses potential public health implications mostly related to the association with Crohn's disease. Despite advances, significant knowledge gaps persist, emphasizing the need for advanced control strategies or therapies to effectively manage Paratuberculosis in ruminants.