Detection of Brucella antibodies in domestic animals of southern Cameroon: Implications for the control of brucellosis

Brucellosis is one of the world's most widespread bacterial zoonoses caused by Brucella. It leads to considerable economic losses as a result of low productivity of infected animals and the long debilitating illness in humans. Despite its impact on human and animal health, little attention has been paid on Brucella infections in domestic animals. It is in this light that the prevalence of Brucella antibodies was determined in domestic animals with the overarching goal of improving our knowledge on brucellosis in southern Cameroon. During cross-sectional studies conducted from December 2016 to August 2018 in five sites of southern Cameroon, blood samples were collected in cattle, sheep, goat, pig and dog. Plasma was obtained from each blood sample and Brucella antibodies were detected using the Rose Bengal test and the enzyme-linked immunosorbent assay (ELISA). From 1873 animals that were sampled, the overall prevalence of Brucella antibodies using Indirect enzyme-linked immunosorbent assay (i-ELISA) was 6.35% (118/1873): 9.12% (78/855) in cattle; 8.04% (30/373) in sheep; 6.06% (2/33) in dog, 1.87% (3/160) in pig and 1.1% (5/452) in goat. Between animal species (p-value < .0001, x2  = 33.63) as well as sampling sites (p-value = .0001, x2  = 18.97), significant differences were observed in the prevalence of Brucella antibodies. Yoko and Noun localities have shown the highest prevalence of 8.6% (30/348) and 7.2% (78/1070), respectively. This prevalence was significantly higher (p = .03, x2  = 1.25) in female than male cattle. Between adult (16.923%) and young cattle (7.8%), significant difference (p = .04, x2  = 6.42) was observed in the prevalence of Brucella antibodies. This study shows that the prevalence of Brucella antibodies varies between animal species and localities. It also shows several domestic animals of southern Cameroon that have been in contact with Brucella. It enabled to identify villages where investigations on the transmission dynamic must be focused for the final goal of developing control measures for this neglected zoonotic disease.

Brucellosis in ruminants and pastoralists in Borena, Southern Ethiopia

Brucellosis is a bacterial zoonotic disease that has important veterinary and public health consequences as well as economic impact in sub Saharan Africa including Ethiopia. A cross-sectional study was conducted in four selected districts of Borena Pastoral setting in Southern Ethiopia from October 2017 to February 2018 to estimate the prevalence of brucellosis and assess associated risk factors in cattle, sheep, goats and occupationally associated humans. A total of 750 cattle, 882 sheep and goats and 341 human subjects were screened for evidence of brucellosis using the Rose Bengal Test (RBT) with positive results confirmed by Competitive-ELISA(c-ELISA). Structured questionnaires were used for collection of metadata from individual animals, herders and animal attendants to test the association between explanatory and outcome variables. The overall animal level prevalence was 2.4% (95% confidence interval, CI: 1.4-3.7) in cattle, 3.2% (95% CI: 2.1-4.6) in sheep and goats, and 2.6% (95% CI: 1.2-5) in humans occupationally linked to livestock production systems. Herd size, parity, and history of abortion were risk factors associated with Brucella seropositivity (P<0.05) in cattle whereas in sheep and goats the results showed that district, age group, flock size, and history of abortion were significantly associated risk factors with Brucella seropositivity (P<0.05). Assisting calving and presence of seropositive animals in a household (P<0.05) were significantly associated with Brucella seropositivity in humans. Evidence of brucellosis in various animal species and the associated human population illustrates the need for a coordinated One Health approach to controlling brucellosis so as to improve public health and livestock productivity.

Brucellosis: Evaluation of Two Hundred and Ten Cases with Different Clinical Features

INTRODUCTION

Brucellosis is an important zoonotic disease and a major cause of morbidity worldwide presenting with varying clinical manifestations. We aimed to investigate the epidemiological characteristics and complications of brucellosis at the Van Training and Research Hospital from January 2018 to December 2018.

MATERIALS AND METHODS

210 patients with brucellosis were assessed retrospectively. The clinical histories and signs, laboratory findings, therapeutic features and complications of these patients were obtained by examining their medical files.

RESULTS

Of the 210 patients;, the most common symptoms were myalgia (87.6%), arthralgia (76.2%) and fever (72.4%). The most frequent clinical signs were fever (72.4%) and arthritis (21.9%). Out of 210 patients, standard tube agglutination (STA) tests were positive in 208 (99%). Osteoarticular involvement (34.3%) was common, and a combination of rifampicin and doxycycline was the most frequently used antimicrobial regimen.

CONCLUSION

It should be kept in mind that brucellosis may occur in patients presenting with fever, sweating, arthralgia and leukopenia, especially in endemic areas where dairy livestock is prevalent. People living in these areas should be educated about proper animal care and the handling of dairy products.

Brucellosis in the Middle East: Current situation and a pathway forward

Brucellosis is a bacterial endemic zoonotic disease of global significance with detrimental impacts on public health and food animal production. It is caused by Brucella spp., an expanding group of pathogens able to infect various host species. Bovines and small ruminants, which excrete the bacteria in milk and in reproductive discharges, are major sources of infection for humans and other animals. Contact with contaminated animals and consumption of unpasteurized dairy products are the main routes for human infection. In spite of the considerable progress of knowledge gained and success achieved in brucellosis control in the developed world, this disease continues to be an important burden in the Middle East (ME). Common risk factors implicated in the difficulty and complexity of brucellosis control within the region include (1) social and political instabilities; (2) insufficient resources and infrastructure for appropriate diagnosis, reporting, and implementation of control measures; (3) variation of livestock husbandry systems and their commingling with other livestock and wildlife; and (4) traditional cultural practices, including consumption of unpasteurized dairy products. Development of core interdisciplinary competencies is required for a true One Health–based endeavor against the disease. National awareness and educational programs addressing all population sectors from consumers to decision-makers seem to be the next logical, sustainable, and economically viable approach toward improving disease status in this region. In the present review, we describe the current situation of brucellosis in the ME, focusing on the major limitations and shortcomings regarding disease control. We propose a regional approach toward public awareness of brucellosis as the first step in mitigating the disease and discuss the potential benefits, and components of such a strategy, which can further be used as a model for other endemic zoonotic diseases.

Seroprevalence and associated risk factors for chlamydiosis, coxiellosis and brucellosis in sheep and goats in Borana pastoral area, southern Ethiopia

BACKGROUND

Abortion is considered an important disease problem of small ruminants in Borana pastoral area. A cross-sectional study was conducted to estimate the prevalence and risk factors of chlamydiosis, coxiellosis (Q-fever) and brucellosis in small ruminants in selected districts of Borana zone.

RESULTS

A total of 506 sheep and goats were tested using serological tests. Fifty (9.88%; 95% CI: 7.42, 12.82), 144 (28.46%; 95% CI: 24.56, 32.61) and none (0.00%; 95% CI: 0.00, 0.59) of them were positive for chlamydiosis, coxiellosis and brucellosis, respectively. History of abortion was recorded in 136 (32.00%; CI: 27.59, 36.67) of sheep and goats in the study area. The logistic regression analysis, however, showed that statistically significant difference ccurred among districts and between the species of small ruminants. The prevalence odd of antibodies against C. abortus was significantly lower in Miyo, Dire and Teltelle districts compared to Dillo. The odd of infection with this bacterium was lower in sheep than goats. Similarly the odd of infection with C. burnettii was significantly higher in Dillo district than the rest of the districts studied, higher in goats than sheep and higher in adult animals than young ones.

CONCLUSION

High prevalence of abortion is observed in sheep and goats in the study area. High seropositivity of C. burnetii and C. abortus in both sheep and goats tested implies risks of human infection by both diseases. Thus, attention needs to be paid to further study of both diseases in animals and humans in the area.

Status of human brucellosis in district Malakand, Khyber Pakhtunkhwa, Pakistan

BACKGROUND

Brucellosis is a zoonotic disease caused by the bacteria, Brucella genus. Human is always an accidental host, infected from domesticated or wild animals.

METHODS

This study was conducted from September 2017 to April 2018. A total of 304 samples were collected in eight months duration from female of high-risk population connected with domesticated animals to investigate the sero-prevalence of Brucellosis using ELISA (Igm) in District Malakand, Khyber Pakhtunkhwa, Pakistan.

RESULTS

The high age wise prevalence was recorded as 32.25% in female with age group 21-30 by ELISA (P<0.05). The prevalent rate was significantly high (P<0.05) in Tehsil Batkhela (32.8%) than Dargai (22.75%). It was also recorded in the present study that the prevalence was higher from January to April. It was found 20.58%, 17.64%, 14.70%, 20.58%, 17.6%, 38.23%, 45.71% and 44.11% from September to April respectively.

CONCLUSION

The present study concluded that the prevalence of brucellosis is significantly high among the age group 20-40 and from January to April 2018. Further studies will be required to show the prevalence of the Brucellosis all over the country.

Forecasting the monthly incidence rate of brucellosis in west of Iran using time series and data mining from 2010 to 2019

Background

The identification of statistical models for the accurate forecast and timely determination of the outbreak of infectious diseases is very important for the healthcare system. Thus, this study was conducted to assess and compare the performance of four machine-learning methods in modeling and forecasting brucellosis time series data based on climatic parameters.

Methods

In this cohort study, human brucellosis cases and climatic parameters were analyzed on a monthly basis for the Qazvin province–located in northwestern Iran- over a period of 9 years (2010–2018). The data were classified into two subsets of education (80%) and testing (20%). Artificial neural network methods (radial basis function and multilayer perceptron), support vector machine and random forest were fitted to each set. Performance analysis of the models were done using the Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Mean Absolute Root Error (MARE), and R² criteria.

Results

The incidence rate of the brucellosis in Qazvin province was 27.43 per 100,000 during 2010–2019. Based on our results, the values of the RMSE (0.22), MAE (0.175), MARE (0.007) criteria were smaller for the multilayer perceptron neural network than their values in the other three models. Moreover, the R² (0.99) value was bigger in this model. Therefore, the multilayer perceptron neural network exhibited better performance in forecasting the studied data. The average wind speed and mean temperature were the most effective climatic parameters in the incidence of this disease.

Conclusions

The multilayer perceptron neural network can be used as an effective method in detecting the behavioral trend of brucellosis over time. Nevertheless, further studies focusing on the application and comparison of these methods are needed to detect the most appropriate forecast method for this disease.

Serological and molecular evidence of Brucella species in the rapidly growing pig sector in Kenya

BACKGROUND

Brucellosis is an emerging yet neglected zoonosis that has been reported in Kenya. Epidemiological data on brucellosis in ruminants is readily accessible; however, reports on brucellosis in pigs remain limited. This study sought to detect Brucella infection in pig serum by both serological and molecular techniques. Serum from 700 pigs randomly collected at a centralized abattoir in Nairobi region, Kenya were screened in parallel, using both Rose Bengal Test (RBT) and competitive Enzyme-Linked Immuno-sorbent Assay (cELISA) for antibodies against Brucella spp. All sera positive by RBT and 16 randomly selected negative samples were further tested using conventional PCR targeting bcsp31 gene and real-time PCR (RT-PCR) assays targeting IS711 and bcsp31 genes.

RESULTS

A prevalence of 0.57% (n = 4/700) was estimated using RBT; none of these samples was positive on cELISA. All RBT positive sera were also positive by both PCRs, while two sero-negative samples also tested positive on RT-PCR (n = 6/20). Brucella abortus was detected in four out of the six PCR positive samples through a real-time multiplex PCR.

CONCLUSION

The detection of antibodies against Brucella spp. and DNA in serum from slaughterhouse pigs confirm the presence of Brucella in pigs. Therefore, investigation of the epidemiology and role of pigs in the transmission of brucellosis in Kenya is needed. Further targeted studies would be useful to systematically quantify and identify the spp. of Brucella in pigs.

Occupational exposure to Brucella spp.: A systematic review and meta-analysis

Brucellosis is a neglected zoonotic disease of remarkable importance worldwide. The focus of this systematic review was to investigate occupational brucellosis and to identify the main infection risks for each group exposed to the pathogen. Seven databases were used to identify papers related to occupational brucellosis: CABI, Cochrane, Pubmed, Scielo, Science Direct, Scopus and Web of Science. The search resulted in 6123 studies, of which 63 were selected using the quality assessment tools guided from National Institutes of Health (NIH) and Case Report Guidelines (CARE). Five different job-related groups were considered greatly exposed to the disease: rural workers, abattoir workers, veterinarians and veterinary assistants, laboratory workers and hunters. The main risk factors and exposure sources involved in the occupational infection observed from the analysis of the articles were direct contact with animal fluids, failure to comply with the use of personal protective equipment, accidental exposure to live attenuated anti-brucellosis vaccines and non-compliance with biosafety standards. Brucella species frequently isolated from job-related infection were Brucella melitensis, Brucella abortus, Brucella suis and Brucella canis. In addition, a meta-analysis was performed using the case-control studies and demonstrated that animal breeders, laboratory workers and abattoir workers have 3.47 [95% confidence interval (CI); 1.47-8.19] times more chance to become infected with Brucella spp. than others individuals that have no contact with the possible sources of infection. This systematic review improved the understanding of the epidemiology of brucellosis as an occupational disease. Rural workers, abattoir workers, veterinarians, laboratory workers and hunters were the groups more exposed to occupational Brucella spp. infection. Moreover, it was observed that the lack of knowledge about brucellosis among frequently exposed professionals, in addition to some behaviors, such as negligence in the use of individual and collective protective measures, increases the probability of infection.

Survey of Leptospira spp. and Brucella abortus in Free-Ranging Armadillos from Pantanal, Brazil

Out of the 20 recognized species of armadillos in the world, 11 are found in Brazil, and five of them are found in Pantanal, one of the world's largest wetlands. Beef cattle (Bos taurus) farming is the main economic activity in this region, which promotes intense wildlife-livestock contact and increases the likelihood of pathogen exposure, including to agents with zoonotic and economic relevance. Previous studies demonstrated that several wildlife species in Pantanal have been exposed to Brucella abortus and Leptospira spp.; however, little is known regarding the exposure and/or prevalence of zoonotic pathogens in armadillos. We used conventional PCR, the rose Bengal test (RBT), and the microscopic agglutination test (MAT) to investigate the exposure to and infection by Brucella spp. and Leptospira spp. using blood samples from four species of armadillos: nine-banded armadillo (Dasypus novemcinctus, n=2), southern naked-tailed armadillo (Cabassous unicinctus, n=8), yellow armadillo (Euphractus sexcinctus, n=16), and giant armadillo (Priodontes maximus, n=22), captured in Nhecolândia, Pantanal, Brazil. Samples were PCR- and RBT-negative for Brucella spp. infection and exposure. However, MAT revealed a Leptospira spp. seroprevalence of 31% (5/16; 95% confidence interval [CI]=0.11-0.58) in yellow armadillo and 18% (4/22; 95% CI=0.05-0.40) in giant armadillo specimens to serogroups Autumnalis, Cynopteri, and Pomona, with titers ranging from 200 to 1,600. Our results contribute to the understanding of zoonotic pathogens in armadillos in Pantanal and reinforce the importance of wildlife health surveillance in this area.

A Serological Survey of Brucellosis in Eurasian Wild Boar (Sus scrofa) in Campania Region, Italy

Swine brucellosis is a zoonotic disease that affects both domestic pigs (Sus scrofa) and wild pigs such as wild boar (Sus scrofa). We evaluated the presence of antibodies against Brucella spp. in wild boar hunted in the Campania region, Italy, during the hunting season of 2016-17. Serum samples were collected from 434 wild boars and tested for antibodies against Brucella spp. For detection of antibodies to swine brucellosis, the rose Bengal test (RBT) and a blocking enzyme-linked immunosorbent assay (ELISA) were performed. Of 434 serum samples, 22 (5.1%) tested by RBT and 58 (13.5%) tested using the blocking ELISA were positive for brucella. The seroprevalences of Brucella spp. did not differ between the sexes or age classes, while the prevalence of infected animals was positively correlated with the Avellino province. Our data showed that wild boar in the Campania region are exposed to brucella infection, and that the prevalence of the disease has increased in recent years.

Persistence of Brucella abortus lineages revealed by genomic characterization and phylodynamic analysis

Brucellosis, caused by Brucella abortus, is a major disease of cattle and humans worldwide distributed. Eradication and control of the disease has been difficult in Central and South America, Central Asia, the Mediterranean and the Middle East. Epidemiological strategies combined with phylogenetic methods provide the high-resolution power needed to study relationships between surveillance data and pathogen population dynamics, using genetic diversity and spatiotemporal distributions. This information is crucial for prevention and control of disease spreading at a local and worldwide level. In Costa Rica (CR), the disease was first reported at the beginning of the 20th century and has not been controlled despite many efforts. We characterized 188 B. abortus isolates from CR recovered from cattle, humans and water buffalo, from 2003 to 2018, and whole genome sequencing (WGS) was performed in 95 of them. They were also assessed based on geographic origin, date of introduction, and phylogenetic associations in a worldwide and national context. Our results show circulation of five B. abortus lineages (I to V) in CR, phylogenetically related to isolates from the United States, United Kingdom, and South America. Lineage I was dominant and probably introduced at the end of the 19th century. Lineage II, represented by a single isolate from a water buffalo, clustered with a Colombian sample, and was likely introduced after 1845. Lineages III and IV were likely introduced during the early 2000s. Fourteen isolates from humans were found within the same lineage (lineage I) regardless of their geographic origin within the country. The main CR lineages, introduced more than 100 years ago, are widely spread throughout the country, in contrast to new introductions that seemed to be more geographically restricted. Following the brucellosis prevalence and the farming practices of several middle- and low-income countries, similar scenarios could be found in other regions worldwide.

Epidemiological Characteristics and Spatiotemporal Trend Analysis of Human Brucellosis in China, 1950-2018

The rate of brucellosis, a zoonotic disease, has rapidly increased in humans brucellosis(HB) in recent years. In 1950-2018, a total of 684,380 HB cases (median 2274/year (interquartile range (IQR) 966-8325)) were reported to the National Infectious Disease Surveillance System in mainland China. The incidence of HB peaked in 2014 (4.32/100,000), and then showed a downward trend; we predict that it will maintain a steady downward trend in 2019-2020. Since 2015, the incidence of HB has shown opposite trends in the north and south of China; rates in the north have fallen and rates in the south have increased. In 2004-2018, the most significant increases in incidence of HB were in Yunnan (IQR 0.002-0.463/100,000), Hubei (IQR 0.000-0.338/100,000), and Guangdong (IQR 0.015-0.350/100,000). The areas where HB occurs have little overlap with areas with high per capita GDP in China. The "high-high" clusters of HB are located in northeastern China (Inner Mongolia, Heilongjiang, Jilin, Liaoning, Ningxia, Shanxi, and Gansu), and the "low-low" clusters of HB are located in southern China (Yunnan, Jiangxi, Shanghai, Guangxi, Guangdong, Zhejiang, Guizhou, and Hunan). In recent years, the incidence of HB in China has been controlled to some extent, but the incidence of HB has increased in southern China, and the disease has spread geographically in China from north to south. Further research is needed to address this change and to continue to explore the relationship between the incidence of HB and relevant factors.

Genetic epidemiology of the Alpine ibex reservoir of persistent and virulent brucellosis outbreak

While it is now broadly accepted that inter-individual variation in the outcomes of host-pathogen interactions is at least partially genetically controlled, host immunogenetic characteristics are rarely investigated in wildlife epidemiological studies. Furthermore, most immunogenetic studies in the wild focused solely on the major histocompatibility complex (MHC) diversity despite it accounts for only a fraction of the genetic variation in pathogen resistance. Here, we investigated immunogenetic diversity of the Alpine ibex (Capra ibex) population of the Bargy massif, reservoir of a virulent outbreak of brucellosis. We analysed the polymorphism and associations with disease resistance of the MHC Class II Drb gene and several non-MHC genes (Toll-like receptor genes, Slc11A1) involved in the innate immune response to Brucella in domestic ungulates. We found a very low neutral genetic diversity and a unique MHC Drb haplotype in this population founded few decades ago from a small number of individuals. By contrast, other immunity-related genes have maintained polymorphism and some showed significant associations with the brucellosis infection status hence suggesting a predominant role of pathogen-mediated selection in their recent evolutionary trajectory. Our results highlight the need to monitor immunogenetic variation in wildlife epidemiological studies and to look beyond the MHC.

Genome-scale approach to study the genetic relatedness among Brucella melitensis strains

Brucellosis is an important zoonotic disease that affects both humans and animals. To date, laboratory surveillance is still essentially based on the traditional MLVA-16 methodology and the associated epidemiological information is frequently scarce. Our goal was to contribute to the improvement of Brucella spp. surveillance through the implementation of a whole genome sequencing (WGS) approach. We created a curated ready-to-use species-specific wgMLST scheme enrolling a panel of 2656 targets (http://doi.org/10.5281/zenodo.3575026) and used this schema to perform a retrospective analysis of the genetic relatedness among B. melitensis strains causing human infection in Portugal (a country where brucellosis is an endemic disease) from 2010 to 2018. The strains showed a phylogenetic clustering within genotype II (25 out of 36) and IV (4 out of 36), and shared clades with strains isolated from countries with which Portugal has intense food trading, tourism and similar eating habits, such as Spain, Italy and Greece. In addition, our results point to the identification of strong associations between B. melitensis strains, likely underlying missed "outbreaks" as 22 out of the 36 strains showed genetic linkage with others. In fact, the applied gene-by-gene approach grouped these strains into six genetic clusters each one containing putative epidemiological links. Nevertheless, more studies will be needed in order to define the appropriate range of cut-offs (probable non-static cut-offs) that best illustrate the association between genetic linkage and epidemiological information and may serve as alerts for the health authorities. The release of this freely available and scalable schema contributes to the required technological transition for laboratorial surveillance of brucellosis and will facilitate the assessment of ongoing and future outbreaks in order to prevent the transmission spread.

The seroprevalence of brucellosis and molecular characterization of Brucella species circulating in the beef cattle herds in Albania

Background

Brucellosis is a ubiquitous zoonotic disease globally. It is endemic among bovines, sheep, and goats in Albania. The national control and eradication programs for brucellosis has been applied on sheep and goat farms as well as large dairy cattle farms, i.e., those with more than ten milking cows. The current study aims at estimating the herd and average individual animal prevalence of brucellosis in the national beef cattle herds, the missing information that was essential to propose the most appropriate control measures for this sub-population. Rose Bengal Test (RBT), Fluorescence Polarization Assay (FPA), and Enzyme-Linked Immunosorbent Assay (ELISA) were used as serological tests and classical bacteriology for isolation. Results were also used to investigate the difference in sensitivity between the assays used.

Methodology

In total, 655 animals from 38 beef cattle herds from six southern districts of Albania were sampled. Sera were tested using RBT, FPA, and ELISA. Fifteen positive cows and a bull from eight high-prevalence positive herds were slaughtered, and particular tissue samples were collected for bacteriology.

Results

The overall herd seroprevalence in the tested beef cattle population was 55%, while the overall average within-herd prevalence (including only positive herds) was 38.3%, 42.7%, and 45.6% determined by the RBT, ELISA, and FPA, respectively. FPA was used for the first time in the diagnosis of bovine brucellosis in Albania, and its sensitivity was higher than RBT and ELISA. Three B. abortus strains were identified, two from the supra-mammary lymph node of two cows and one from the epididymis of a seropositive bull.

Conclusion

Brucellosis was highly prevalent in beef cattle in the southern part of Albania, and B. abortus was isolated from this subpopulation. To the best of our knowledge, this is the first statistically based survey of bovine brucellosis in beef herds in Albania. Using the FPA in parallel with other serological tests improved overall diagnostic sensitivity. Test and slaughter policy is not a rational approach for the control of brucellosis in beef cattle in Albania, and vaccination is only applicable, including strict control of the movement of animals.

Zoonotic Disease Exposure Risk and Rabies Vaccination Among Wildlife Professionals

More than 70% of zoonotic diseases are wildlife associated putting wildlife professionals at increased risk of occupational exposure. In 2008 and 2018, the Arizona Department of Health Services surveyed Arizona wildlife professionals from multiple agencies to assess the risk of disease exposure, rabies pre-exposure prophylaxis (PrEP) history, personal protective equipment (PPE) use, and zoonoses knowledge. In 2008, a 12-question survey was distributed at a state wildlife professional meeting using an anonymous email link. In 2018, a 20-question survey was distributed using an anonymous email link to wildlife agency employees. We received 164 and 81 complete responses in the 2008 and 2018 surveys, respectively. Bites from rabies reservoir or spillover species were higher in 2008 (42%) than in 2018 (16%). More respondents received PrEP in 2018 (53%) than in 2008 (45%). Among 43 respondents who performed necropsies or collected animal samples within the past 5 years (2014-2018), only 60% always wore latex or nitrile gloves, and 79% never wore a facemask. Respondents indicated lower awareness of certain zoonoses, including brucellosis (72%) and leptospirosis (60%). Results on zoonoses awareness and reasons for non-use of PPE highlighted targets for education to improve practices, including facilitation of PPE training to prevent future disease transmission.

Brucellar epididymo-orchitis: a retrospective study of 25 cases

Objective: Brucellosis is a multisystemic disease which may affect all organs. Epididymo-orchitis is the most common form of genitourinary involvement. The aim of this study was to present our eight-year experience regarding the management of patients with brucellar epididymo-orchitis (BEO).Materials and method: The medical records of male brucellosis patients treated in two centers, between 2010 and 2018 were analyzed retrospectively. The diagnosis of epididymo-orchitis was made when the patients had scrotal pain, swelling, and enlarged tender testicles and/or epididymis on clinical examination. Brucellosis was diagnosed with a positive standard tube agglutination test or a positive blood culture.Results: Brucellosis was diagnosed in 996 male patients. Of these patients, 25 had a diagnosis of BEO (2.5%). All BEO patients suffered from enlarged painful testicles, however, testicular complaints were the only presentation symptoms in three of them. All patients received medical treatment alone except one patient with testicular abscess who underwent surgical drainage besides medical treatment. All patients recovered completely and no relapses have been detected during six-month follow-up.Conclusion: Patients with epididymo-orchitis should be investigated for brucellosis especially in endemic regions. To our knowledge, BEO patients may present with isolated testicular symptoms that make a diagnostic challenge.

Epidemiology of Brucellosis in Saudi Arabia

Objectives:

To provide a comprehensive summary of brucellosis incidence, prevalence, risk associated factors, and impact on the Saudi population.

Methods:

A systematic review was conducted using the PubMed database. The articles included in the review were written in English and investigated the epidemiology, etiology, distribution, impact, or burden of brucellosis in the Saudi population. Articles to be included were finalized after a mutual consensus of 2 researchers.

Results:

Seventeen (n=17) studies were included which were conducted in diverse geographical areas of Saudi Arabia. Of them, 3 studies reported the prevalence of brucellosis among pregnant women and pregnancy outcomes; 3 studies focused on risk associated factors and symptoms and signs of brucellosis among children; 2 studies highlighted the prevalence of brucellosis among workers; 9 studies reported the prevalence/incidence and risk associated factors of brucellosis. Brucellosis incidence and prevalence vary widely among regions. Contact with infected animals and consumption of raw milk and milk products were identified as the main risk associated factors of brucellosis. Abortion and intrauterine fetal deaths rates were significantly higher among pregnant women with brucellosis compared with pregnant women without brucellosis.

Conclusion:

Brucellosis poses a considerable impact on human and has a higher prevalence in developing countries as compared to developed countries. Our results revealed that brucellosis is a risk factor for adverse reproductive outcomes. PROSPERO No: CRD4201912430

Relationship of meteorological factors and human brucellosis in Hebei province, China

BACKGROUND

Brucellosis has always been one of the major public health problems in China. Investigating the influencing factors of brucellosis is conducive to its prevention and control. The incidence trend of brucellosis shows an obvious seasonality, suggesting that there may be a correlation between brucellosis and meteorological factors, but related studies were few. We aimed to use the autoregressive integrated moving average (ARIMA) model to analyze the relationship between meteorological factors and brucellosis.

METHODS

The data of monthly incidence of brucellosis and meteorological factors in Hebei province from January 2004 to December 2015 were collected from the Chinese Public Health Science Data Center and Chinese meteorological data website. An ARIMA model incorporated with covariables was conducted to estimate the effects of meteorological variables on brucellosis.

RESULTS

There was a highest peak from May to July every year and an upward trend during the study period. Atmospheric pressure, wind speed, mean temperature, and relative humidity had significant effects on brucellosis. The ARIMA(1,0,0)(1,1,0)₁₂ model with the covariates of atmospheric pressure, wind speed and mean temperature was the optimal model. The results showed that the atmospheric pressure with a 2-month lag (β = -0.004, p = 0.037), the wind speed with a 1-month lag (β = 0.030, p = 0.035), and the mean temperature with a 2-month lag (β = -0.003, p = 0.034) were significant predictors.

CONCLUSION

Our study suggests that atmospheric pressure, wind speed, mean temperature, and relative humidity have a significant impact on brucellosis. Further understanding of its mechanism would help facilitate the monitoring and early warning of brucellosis.

The prevalence of Brucella spp. in dairy products in the Middle East region: A systematic review and meta-analysis

Brucellosis, known as Malta fever or Mediterranean fever, is one of the most common bacterial zoonotic diseases caused by Brucella spp. which can result in serious health issues. The objective of the present study was to systematically review and summarize the studies regarding the prevalence of Brucella spp. in milk and milk products in the Middle East region. Some international databases (PubMed, Web of Science, Scopus, Science Direct, and Google Scholar) were searched to retrieve relevant reports published between 1 January 2008 and 30th October 2018. After assessing for eligibility, 30 articles containing 9281 samples, were included in the current study. The highest number of publications were found in Iran and Turkey (n = 12 and 7, respectively), while Saudi Arabia, Kuwait, and Syria had the lowest number of publications (n = 1). Besides, the highest and lowest prevalence was observed in Kuwait (62%) and Egypt (15%), respectively. The highest and lowest overall prevalence of Brucella spp. in milk was found in raw cow milk 36% (95%CI: 28-54%) and raw buffalo milk 13% (95%CI: -22-48%), respectively. The overall prevalence in cheese estimated to be 9% (95%CI: -16-35%). The overall prevalence of Brucella spp. in dairy products in the Middle East was estimated to be 29% (95%CI: 23-35%). The results indicate that more risk management plans are needed to reduce the incidence of Brucella spp. in dairy products in the Middle East, especially in cow milk.

Epidemiological features of human brucellosis in Tongliao City, Inner Mongolia province, China: a cross-sectional study over an 11-year period (2007-2017)

OBJECTIVES

To describe the epidemiology of human brucellosis in the past decade and provide evidence of disease control in Tongliao city, which is one of the highest-risk areas of human brucellosis in Inner Mongolia province, China.

DESIGN

Cross-sectional study.

PARTICIPANTS

Clinically and bacteriologically confirmed human brucellosis cases.

PRIMARY AND SECONDARY OUTCOME MEASURES

An analysis of the reported cases of human brucellosis during 2007-2017 was carried out to describe the age, sex and occupational distributions of the cases. The time series analysis model and the geographical information system were explored to describe the seasonality and spatiotemporal distribution, respectively, at the county level.

RESULTS

A total of 13 938 cases of human brucellosis was collected in Tongliao from 2007 to 2017; the majority was aged 25 years to 59 years (85.4%) and the male-to-female ratio was 2.64:1; most of them were agriculturalists (81.9%) and pastoralists (12.4%). The incidence rates increased dramatically from 9.22/100 000 in 2007 to 69.16/100 000 in 2011 with an annual increase of 14.99%. They decreased during 2012-2016 (annual decrease of 8.37%) and rose again in 2017 (44.32/100 000). The disease peaked during March-July, with a clear periodicity and trend of monthly anterior displacement since 2012. Jarud Banner, the region located in the north-west of Tongliao, had the highest accumulated incidence rate (130.1/100 000) compared with other counties. The high-risk regions were spread from the north-west to the south and east of Tongliao during the past decade.

CONCLUSIONS

The prevalence of human brucellosis in Tongliao was aggravated during the past decade and peaked during March-July. High-risk areas were mainly concentrated in the counties with extensive prairies and livestock.

Zoonotic Pathogen Seroprevalence in Cattle in a Wildlife-Livestock Interface, Kenya

A cross-sectional study was conducted to determine the seroprevalence of Brucella spp. and Leptospira spp. and risk factors of exposure in cattle in three zones with varying land use types and wildlife-livestock interactions. Five villages were selected purposively; two in areas with intensive livestock-wildlife interactions (zone 1), another two in areas with moderate livestock-wildlife interactions (zone 2) and one in areas where wildlife-livestock interactions are rarer (zone 3). Sera samples were collected from 1170 cattle belonging to 390 herds in all the zones and tested for antibodies against Brucella abortus and Leptospira interrogans serovar hardjo using ELISA kits. Data on putative risk factors for seropositivity of these pathogens in cattle were collected using a questionnaire. The overall apparent animal-level seroprevalence of brucellosis and leptospirosis was, respectively, 36.9% (95% CI 34.1-39.8) and 23.5% (95% CI 21.1-26.0). Brucella spp. seroprevalence was higher in zone 1 than in zones 2 and 3 (χ2 = 25.1, df = 2, P < 0.001). Zones 1 and 2 had significantly higher Leptospira spp. seroprevalence than zone 3 (χ2 = 7.0, df = 2, P = 0.029). Results of multivariable analyses identified animal sex (female) and zones (high interface area) as significant predictors (P < 0.05) of animal-level seropositivity of Brucella spp. For Leptospira spp., important predictors of animal-level seropositivity were animal sex (female), zones (moderate interface area) and herds utilizing a communal grazing reserve. The seroprevalences of Brucella spp. and Leptospira spp. in cattle were higher in areas with moderate to high wildlife-livestock interactions than those with rare interactions.

Knowledge of pastoralists on livestock diseases and exposure assessment to brucellosis within rural and peri-urban areas in Kajiado, Kenya

Background: Livestock diseases impact the livelihoods of pastoralists. Brucellosis, a neglected zoonotic disease is highly prevalent in this system with an estimated 16% of livestock population in sub-Saharan Africa infected with the disease. The objective of this study was to assess knowledge of livestock diseases and the risk of exposure to brucellosis among pastoralists living in Kajiado County of Kenya. Methods: The study sites included pastoralist communities living in rural and peri-urban areas within the County. Both primary and secondary data were collected using participatory methods including pairwise ranking, proportional piling and probing and a review of the published literature. Exposure risk assessment was conducted according to the CODEX Alimentarius framework: Hazard identification, hazard characterization, exposure assessment and risk estimation. Results: According to pastoralists, livestock diseases that frequently occurred in their flocks and herds were contagious caprine pleuropneumonia, lumpy skin disease and foot and mouth disease; but zoonoses, including anthrax and brucellosis, were also mentioned during focus group discussions. Potential pathways of exposure to brucellosis and other zoonoses included consumption of unpasteurized milk, handling infected aborted materials without protective measures and consumption of raw meat and raw blood. Consumption of unpasteurized milk and handling infected aborted materials without protectives were linked with high risk of exposure to household members living in rural areas, with the risk level within the peri-urban areas ranked very low to low for most of these risk practices. Conclusions: The results call for enhanced public education targeting vulnerable groups to mitigate risks of disease spread and other impacts of brucellosis within the affected pastoralist production systems.

Multilocus variable number tandem repeat analysis (MLVA)-typing of Brucella abortus isolates of India reveals limited genetic diversity

Multilocus variable number tandem repeat analysis (MLVA) technique has wide applications in studying phylogenies and short-term epidemiology of pathogens. The technique has been extensively used worldwide in molecular epidemiology of Brucella genus. Only one study on this aspect is reported from India despite its economic and public health significance in country. The present study isolated B. abortus from domesticated bovines of Jammu region of Jammu and Kashmir state, India, and applied MLVA for 16 loci (MLVA-16). MLVA results were compared with the results of a previous study and with MLVA data of Indian isolates present in http://microbesgenotyping.i2bc.paris-saclay.fr/database. In the study, 136 samples from bovines (cattle and buffaloes) of 47 farms of Jammu region were processed for isolation. Eleven isolates of B. abortus biovar 1 from 6 farms were obtained. In MLVA-16 analysis, although the isolates were classified in a single cluster, 5 genotypes were obtained with a specific genotype being prevalent on each farm. The study identifies that MLVA-16 is capable to differentiate B. abortus strains in an area having high genetic similarity among isolates. On comparing the results with previous study and database, the isolates were found to have high genetic similarity indicating that the genetic diversity of B. abortus in India is very limited. It probably indicates that India is contaminated recently with B. abortus. To test this hypothesis, analysis of whole genome sequencing data of diverse collection of Indian B. abortus strains is required.

Acute Febrile Illness Caused by Brucella abortus Infection in Humans in Pakistan

Brucellosis is a zoonosis of great and worldwide public health concern that can cause a severe febrile illness in humans. In Pakistan, brucellosis is a critical problem in both animals and humans. This study aimed to gain insight into its prevalence and to analyze the potential risk factors of patients with acute febrile illness (AFI) of an unknown cause, at the hospitals of Rawalpindi and Islamabad in Pakistan. In total, 446 blood samples were collected from patients and screened for brucellosis using the Rose Bengal Plat Test (RBPT). All the serum samples were investigated for Brucella DNA using specific real-time PCR. Age, sex, occupation, urbanicity, socioeconomic status and history of animal contact were recorded and assessed as potential risk factors. The proportion of acute febrile illness patients for whom brucellosis could be suspected was 10.1% by the RBPT. Brucella DNA was detected in 26 (5.8%) cases and identified as B. abortus. Contact with infected animals, consumption of raw milk and socioeconomic status showed a highly significant (p < 0.05) correlation with seropositivity. Elderly patients (19.7% RBPT and 12.1% PCR) and females (13% RBPT and 9.3% PCR) were of high risk of brucellosis. Patients suffering from brucellosis-related manifestations should be screened for brucellosis, especially those in contact with animals or those consuming their unprocessed products, given the increased risk. The results of this study, which highlight that Brucella abortus as an important cause of acute febrile illnesses in humans, aid the development of effective control strategies for human brucellosis in Pakistan.

Risk factors associated with the occurrence of Brucella canis seropositivity in dogs within selected provinces of South Africa

The growing population of free-roaming dogs in informal communities in South Africa may increasingly place humans at risk of possible zoonotic infections including, but not limited to, Brucella canis. Worldwide, the prevalence of B. canis infection has increased during the last two centuries, resulting in increased reports of dog and human infections. This study investigated the risk factors associated with B. canis infection in dogs in three predefined areas: Gauteng, the Eastern Cape and Western Cape provinces, of South Africa. Dogs aged 7 months and older presented to welfare organisations and breeders in the study areas were selected for sampling. A comprehensive questionnaire on dog ownership, general health and vaccination status was completed prior to sampling. One blood sample of 8 mL was collected aseptically per dog. Then, equal amounts (4 mL) were transferred to the different vacutainer tubes. The 2-mercaptoethanol-tube agglutination tests were used after validation. Fifty-two dogs out of the combined sample of 1191 dogs from the three study areas tested positive for B. canis, representing an overall occurrence of 4.4%. A binomial logistic regression model was fitted to identify risk factors associated with B. canis in dogs within the study areas. Dog age (0.371; p 0.05) and external parasite infestation (0.311; p 0.05) were significantly associated with the B. canis infection. Ownership and sterilisation need to be further investigated as possible risk factors because both had odds ratios of 1684 and 1107, respectively, in the univariate model.

Cohort profile: Famenin Brucellosis Cohort Study

BACKGROUND

To achieve preventive and controlling activities of Brucellosis, we aimed this study as the first prospective cohort survey on brucellosis in Iran. This cohort in different phases from 2016 until 2020 going to investigate about brucella infection in selected population of Famenin, a city located in Hamadan province, west of Iran.

STUDY DESIGN

A prospective cohort study.

METHODS

At the first phase of study, Famenin inhabitants including urban and rural people were studied during September to December in 2016. All identified household's people referred to specified health centers and clinically visited. Blood sampling was done, then these subjects were joined and the follow-up was initiated. At the next step, taken blood samples were examined using Wright kits and 2ME test for diagnosis the seroprevalence of brucellosis. Participants will be followed up for next years to examine clinical profiles of brucellosis and complete investigation about the main risk factors to reach strategies to control and reduce human and animal brucellosis.

RESULTS

In the first phase, according to statistical analysis, 3363 persons including 47clusters were enrolled and considered for future studies. All participants were interviewed and demographic questioners were successfully completed. Finally, 2367 blood samples were entered in serology analysis. The seroprevalence of brucellosis based on serologic titers of Wright and 2ME test was 6.59% (95% CI: 5.62%: 7.66%) and 3.46 %( 95% CI: 2.72%: 4.20%) respectively.

CONCLUSION

In the first phase, an extensive range of data and information were collected as the basic data for following phases of the cohort.

Seroprevalence of brucellosis in Western Rajasthan: A study from a tertiary care centre

Brucellosis is a significant bacterial zoonotic disease with a high seroprevalence in low-to-middle-income countries where there is a significant contact of humans with animals. This prospective study was conducted to observe the seroprevalence of brucellosis in 75 symptomatic patients with pyrexia of unknown origin (PUO) and 75 high-risk individuals (10 veterinarians, 15 milkmen and 50 healthy contacts of symptomatic patients) with possible exposure to brucellosis. Serum samples collected from these patients and individuals were subjected to rose Bengal test (RBT) and ELISA for the detection of IgM and IgG antibodies. RBT was positive in 50 samples (40 PUO and 10 high risk), of which 25 (33.3%) PUO cases had detectable IgM antibodies, whereas IgG antibodies were detected in 20 patients. None of samples from high-risk individuals was reactive for IgM/IgG antibodies by ELISA. The overall seroprevalence in this study was 16.7% (33.3% in PUO patients). Being a predominantly livestock rearing area, brucellosis is a significant health-care problem in this part of India with this entity being linked to 33% of PUO cases.

An exploratory study of factors associated with human brucellosis in mainland China based on time-series-cross-section data from 2005 to 2016

Objective

Many studies focused on reasons behind the increasing incidence and the spread of human brucellosis in mainland China, yet most of them lacked comprehensive consideration with quantitative evidence. Hence, this study aimed to further investigate the epidemic mechanism and associated factors of human brucellosis so as to provide thoughts for future countermeasures in China and the rest of the world.

Methods

Data of human brucellosis incidence and some associated factors in economy, animal husbandry, transportation as well as health and hygiene were collected at provincial level from 2005–2016. Time series plots were first used to visualize the annual incidence and annual rate of change of human brucellosis for each province, then cluster analysis categorized all the 31 provinces of mainland China based on their incidence time series during the study period. In addition, according to the characteristics of data, the dynamic panel data model in combination with supervised principal component analysis was proposed to explore effects of associated factors on human brucellosis.

Results

1. The incidence rate of human brucellosis in mainland China increased three-fold from 1.41 per 100,000 people in 2005 to 4.22 per 100,000 people in 2014, though it went down a little in 2015 and 2016. Incidence rates in the north have always been higher than those in the south, but the latter also experienced an upward trend especially between 2012 and 2016. 2. The 31 provinces of mainland China were categorized into three clusters, and each cluster had its own characteristics of incidence time series. 3. The impact of health and hygiene situations on the prevention and control work of human brucellosis was still very limited and trivial (regression coefficient = -0.02). Therefore, it was plausible to presume that improving the personal average number of medical institutes and the proportion of rural medical expenditure might be helpful in preventing and controlling human brucellosis.

Conclusions

The epidemic status of human brucellosis has changed in both spatial and temporal dimensions in recent years in mainland China. Apart from traditional control measures, more attention should be paid to the improvement of medical healthcare especially in rural areas in the hope of enhancing the control effect.

Epidemiological characteristics, clinical manifestations and laboratory findings in 850 patients with brucellosis in Heilongjiang Province, China

BACKGROUND

Brucellosis has extensive clinical spectrum, clinicians have insufficient understanding of the disease, and the misdiagnosis rate is still high. By collecting and analyzing the clinical characteristics of patients with brucellosis in Heilongjiang Province to provide guidance and reference for clinicians to make timely diagnosis and treatment.

METHODS

The demographic and epidemiological characteristics, clinical features, complications, laboratory findings were retrospectively evaluated in 850 brucellosis patients admitted in the Department of Infectious Diseases of the First Affiliated Hospital of Harbin Medical University and the Second Hospital of Daqing from 2012 to 2017.

RESULTS

Of the 850 patients, the most common clinical manifestations were fever (93.3%), joint pain (69.8%), sweating (45.2%), fatigue (38.6%), and splenomegaly (34.0%). Peripheral arthritis, spondylitis and epididymal-orchitis were the common complications. Of the 398 patients who were followed up and completed treatment, 22 (5.5%) had relapse.

CONCLUSIONS

Brucellosis is a multisystem disease with diverse clinical manifestations. In areas where brucellosis is endemic, the possibility of the disease should be considered in patients with unexplained fever and joints pain. In addition, the high rate of relapse is mainly due to the misdiagnosis of complications, so local CT or MRI examination is necessary for patients with joint pain and low back pain. Timely diagnosis, early detection of complications are essential to improve the prognosis and reduce relapse.

Investigation and characterization of Brucella canis infections in pet-quality dogs and associated human exposures during a 2007-2016 outbreak in Michigan

OBJECTIVE To estimate Brucella canis seropositivity rates for purebred dogs being bred by noncommercial breeders, describe epidemiological findings in infected commercial dog-production facilities, and characterize B canis infection in pet dogs and the risk to human health. DESIGN Retrospective descriptive study. SAMPLE 2,799 canine specimens submitted to the Michigan State University Veterinary Diagnostic Laboratory for B canis testing and records of B canis reports provided to the Michigan Department of Agriculture and Rural Development from 2007 through 2016. PROCEDURES Results of B canis laboratory tests and epidemiological findings for reported cases of B canis were reviewed and summarized. Federal and state public health officials were interviewed regarding human B canis infection. State veterinarians were interviewed regarding canine brucellosis reporting and control procedures. RESULTS Estimated B canis seropositivity was 0.4% among purebred Michigan dogs owned by noncommercial breeders. Infection was confirmed in dogs from 17 commercial dog-production facilities, 3 shelters, and 1 rescue agency. Estimated infection prevalence in production facilities ranged from 2 of 22 (9%) to 5 of 6 (83%). Transfer of infected dogs involved 22 Michigan counties and 11 states. Seven of 20 privately owned infected dogs had diskospondylitis; I also had uveitis. Fifty-three veterinary hospital or diagnostic laboratory personnel had inadvertent exposure to the pathogen. Brucella canis was isolated from 1 commercial production facility owner. CONCLUSIONS AND CLINICAL RELEVANCE B canis was uncommon in purebred dogs being bred by noncommercial breeders but endemic in Michigan commercial facilities producing dogs destined to become household pets. Infected pet dogs caused human B canis exposure, and several pet dogs had debilitating disease not associated with the reproductive system.

Seropositivities against brucellosis, coxiellosis, and toxoplasmosis and associated factors in pregnant women with adverse pregnancy outcomes: A cross-sectional study

Background

Brucellosis, coxiellosis, and toxoplasmosis can be transmitted from infected ruminants to pregnant women and may induce adverse pregnancy outcomes; however, there are to date few studies. This study aimed to examine the seropositivities of immunoglobulin G (IgG) against those three pathogens among pregnant women with adverse pregnancy outcomes, and to explore the associated factors.

Methods

A cross-sectional study was conducted in southern Thailand, where goat production is common. A total of 105 pregnant Thai women who had adverse pregnancy outcomes and serum samples collected at first antenatal care visit before their 28^th gestational week from June 2015 to June 2016 were included. The seropositivities of IgG anti-Brucella abortus, Toxoplasma gondii, and Coxiella burnetii antibodies were tested by using commercial enzyme-linked immunosorbent assay (ELISA) kits. Associated factors with seropositivity were analyzed using multiple logistic regression.

Results

Most women were Muslim aged 20–34 years and 32.4% had a prior history of one or more adverse pregnancy outcomes. One-third of the women had been exposed to goats or raw goat products. Of the 105 serum samples, the seropositivity of anti-T. gondii IgG was highest (33/105, 31.4%), followed by anti-C. burnetii IgG (2/105, 1.9%), and anti-B. abortus IgG (1/105, 1.0%), respectively. None of the pregnant women were found to be co-seropositive for those three pathogens.

Conclusions

One-third of women with adverse pregnancy outcomes showed positive antibodies for toxoplasmosis, coxiellosis and brucellosis. A dose-response relationship between seropositivity of anti-T. gondii IgG and age was noticed.

Hepatic Brucelloma Diagnosis and Long-Term Treatment, France

We report a case of hepatic brucelloma in France. This diagnosis may be suspected in any patient who has a liver abscess after traveling to a brucellosis-endemic area. Brucella spp. may be detected by PCR in the liver tissue or suppuration. Abscess drainage and prolonged antimicrobial therapy help achieve healing.

Global dynamics of a multi-stage brucellosis model with distributed delays and indirect transmission

The mechanisms of brucellosis transmission are diverse and complex, especially the role of young animals in the spread of brucellosis has not been well studied. In this article, a new deterministic system that incorporates various stages of susceptible individuals and time delay of infection is proposed. Under general biological assumptions, the qualitative properties and stability of the system are studied, the results illustrate that the global dynamics of equilibrium points depend on the basic reproduction number R₀: If R₀≤1, animal brucellosis will eventually die out; and if R₀>1, animal brucellosis is persistent and eventually tends to the endemic steady state. These results suggest that distributed time delay is harmless for the dynamics of the spread of brucellosis when R₀ is greater than one or less than or equal to one. Finally, periodic phenomena are found by numerical analysis if the assumptions are not true.

Risk of adverse pregnancy outcomes and seroprevalence for brucellosis in pregnant women exposed to goats or raw goat products in southern Thailand: a prospective cohort study

BACKGROUND

Pregnant women infected with brucellosis have been shown to have higher odds of having been exposed to goats and raw goat products and adverse pregnancy outcomes. However, information on these associations in asymptomatic pregnant women is limited, particularly in the brucellosis-endemic areas. This study aimed to assess the association of a history of exposure to goats and/or raw goat products and the serological status of anti-Brucella abortus immunoglobulin G (IgG) with adverse pregnancy outcomes among pregnant women, and explore factors associated with having exposure to goats and/or raw goat products.

METHODS

A prospective cohort study was conducted among pregnant women from July 2015 to July 2016 at Songkhla province in southern Thailand. All pregnant women who came for antenatal care (ANC) visits were approached. Blood samples from the women who agreed to participate were randomly tested for anti-Brucella abortus IgG. The women were then followed for adverse pregnancy outcomes.

RESULTS

Of 666 pregnant women, the majority (74.4%) were aged 20-34 years and Muslim (89.2%), 30.6% indicated exposure to goats or raw goat products, and 17.3% had adverse pregnancy outcomes. Women rearing goats at home or having neighbors rearing goats were more likely to be exposed to goats or raw goat products by cutaneous contact. Of 465 women having a blood test, 3.7% had seropositive results for anti-Brucella abortus IgG. No association with adverse pregnancy outcomes was found in the women reporting any exposure to goat and raw goat products. Having the first ANC visit at the first trimester and history of preterm birth or low birth weight newborn were independent risk factors of adverse pregnancy outcomes. Women who had positive serological results were more likely to have a history of drinking raw goat milk than those who had negative results significantly.

CONCLUSIONS

Although no association between past exposure with goats and raw goat products and adverse pregnancy outcomes was found, women with past exposure showed positive anti-Brucella abortus IgG. Counseling on avoiding consumption of raw goat milk would be beneficial to prevent goat-related infection in pregnant women in this area.

Status and influencing factors of farmers' private investment in the prevention and control of sheep brucellosis in China: A cross-sectional study

Background

Brucellosis is one of the most common zoonoses worldwide, causing direct losses to the livestock industry and threatening human health. Little is known about the status and factors affecting farmers’ private investment in the prevention and control of sheep brucellosis in China.

Methodology/Principal findings

From April to October 2017, a cross-sectional, house-based study was conducted in 7 Chinese provinces. A total of 1037 households included in the study were analyzed. The average amount of private investment in the prevention and control of brucellosis was $0.73±0.54 per sheep. Multivariable analysis showed that factors facilitating private investment included older age of householder (OR = 1.07, 95%CI: 1.03–1.11), herd size >100 (OR = 2.49, 95%CI: 1.38–4.51), a higher percentage of income from sheep farming comparing to the total household income (OR = 1.14, 95%CI: 1.11–1.16), higher score of brucellosis knowledge (OR = 3.85, 95%CI: 1.40–10.51), actively learning related knowledge (OR = 2.98, 95%CI: 1.55–5.74), actively participating in related training courses (OR = 3.07, 95%CI: 1.52–6.18), care about other people’s attitudes (OR = 1.75, 95%CI: 1.35–2.28), concern about the health of neighbors’ livestock (OR = 1.75, 95%CI: 1.23–2.51). The analysis found a discouraging factor for private investment, supporting culling policy (OR = 0.67, 95%CI: 0.49–0.91).

Conclusions/Significance

In addition to providing interventions related to farmers’ knowledge, attitudes and practices, guidance must be offered to help farmers understanding the importance of private investment in the prevention and control of brucellosis.

Brucellosis is one of the most common zoonoses worldwide. The disease is endemic in China and the prevention and control of brucellosis mainly depends on government investment. From the perspective of economic theory, private investment can help supplement public investment. Thus, it is important to describe the status of farmers’ private investment in brucellosis prevention and control in epidemic areas and to explore the factors influencing this investment.

Distribution of Brucella field strains isolated from livestock, wildlife populations, and humans in Italy from 2007 to 2015

Brucellosis is a major public health problem still prevalent as a neglected endemic zoonosis requiring proactive attention in many communities worldwide. The present study involved analysis of Brucella field strains submitted for typing to the Italian National Reference Laboratory for Brucellosis from 2007 to 2015. Strains were identified at the species and biovar levels by classic and molecular techniques according to the World Organisation for Animal Health Manual. In total, 5,784 strains were typed: 3,089 Brucella abortus (53.4%), 2,497 B. melitensis (43.2%), 10 B. ovis (0.2%), 181 B. suis (3.1%), and 7 B. ceti (0.1%). The 2,981 strains from cattle were typed as B. abortus biovars 1, 3, and 6 (90.1%) and B. melitensis biovar 3 (9.9%). The 318 strains from water buffalo were typed as B. abortus biovars 1, 3 (95.9%) and B. melitensis biovar 3 (4.1%). The 2,279 strains from sheep and goats were typed as B. abortus biovars 1 and 3 (4.3%); B. melitensis biovars 1, 3, (95.3%); and B. ovis (0.4%). The 173 strains from wild boar were typed as B. suis biovar 2 (98.3%) and B. melitensis biovar 3 (1.7%). The 11 strains from pigs were typed as B. suis biovar 2. The 13 strains from humans were typed as B. melitensis biovar 3. The two strains from horses were typed as B. abortus biovar 1, while the seven strains from dolphins were typed as B. ceti. This additional knowledge on the epidemiology of brucellosis in Italy may be useful to formulate policies and strategies for the control and eradication of the disease in animal populations. The animal species affected, biovars typed, geographical origins, and spatial distributions of isolates are herein analyzed and discussed.

[PECULIARITIES OF THE PREVALENCE OF POLYMORPHISM (C-589T) OF THE IL-4 GENE AND ITS RELATIONSHIP WITH SERUM IL-4 LEVEL IN PATIENTS WITH ACUTE BRUCELLOSIS IN THE REPUBLIC OF AZERBAIJAN]

The aim of the study was to determine the frequency of polymorphism of IL-4 (C-589T) in patients with acute brucellosis in the Republic of Azerbaijan and to establish its correlation with serum IL-4 levels. One hundred seventy eight patients with clinical symptoms of brucellosis were examined. According to the criteria for inclusion in a study of 178 patients, only 120 persons- (the main group) - fully met all criteria. The control group consisted of 30 practically healthy persons. Also, all patients in both groups were tested for IL-4 (C-589T) polymorphism and level of interleukin-4 (IL-4). It has been established that carriers of the allele T of the polymorphic (C-589T) IL-4 gene are at increased risk for brucellosis (OR=4.26, 95% CI [2.01-9.05]], whereas in the case of carrier allele C, on the contrary, is a reduced risk of developing brucellosis. The combination of genotypes C/T + T/T among patients with brucellosis was determined 3.1 times more than in practically healthy individuals (OR=10.31, 95% CI [1.55-19.18], χ2=29.21, p<0.0001). It was found that among the carriers of the C/C genotype, IL-4 level was 1.44 higher in brucellosis than in T/T genotype carriers and 1.2 times higher in comparison with the C/T genotype. Among carriers of the C/T genotype, there is a significantly increased risk of brucellosis (χ2=29.73; p=4.0E-7; OR=9.63; 95% CI [3.43-27.03] while cariousness of the homozygous genotype C/С, on the contrary, has a protective effect on the development of brucellosis (OR=0.10, 95% CI 0.04-0.25).

Temporal trends in the incidence and demographics of cancers, communicable diseases, and non-communicable diseases in Saudi Arabia over the last decade

OBJECTIVES

To describe the trends in the incidence rates of 5 most common cancers, communicable diseases, and non-communicable diseases in Saudi Arabia over the last decade.  Methods: The incidence rates of cancers (2001-2014), communicable diseases (2003-2016), and non-communicable diseases (1990-2017) were retrieved, classified, and analyzed retrospectively during November 2017, based on data available with the Ministry of Health and were analyzed at the Imam Abdulrahman Bin Faisal University in Dammam, Kingdom of Saudi Arabia. Results: Age-standardized incidence rate (ASR) (per 100,000 population) of breast cancer among women increased dramatically from 11.8 in 2001 to 22.7 in 2014, indicating a 92.4% increase over the decade. Colorectal cancer incidence was the highest among men, and its ASR per 100,000 population increased from 5.0 to 10.6 in men and from 5.0 to 8.2 in women. Among communicable diseases, incidences of hepatitis B, measles, chickenpox, and brucellosis decreased while dengue fever increased. An alarming increase was observed in the incidence rate of non-communicable diseases namely, obesity, diabetes, and hypertension. Conclusion: The incidence rate of non-communicable diseases increased over the decade and was associated with increased mortality and disability, reduced quality of life, and increased health-care costs, indicating an urgent need to establish prevention and control programs. The rising trend in the incidence of cancers may also become a health care issue in Saudi Arabia in the coming years.

Outbreak of Brucella melitensis infection in Eastern Sicily: risk factors, clinical characteristics and complication rate

Brucellosis is one of the most common zoonoses in the world, especially in Southern Italy, where many cases are still recorded every year. 128 cases of brucellosis were observed in Messina (Sicily) in 2016, representing a tenfold increase in the number of cases of brucellosis expected. The aim of this multicenter retrospective study was to analyze clinical and microbiological aspects of a brucellosis outbreak in the province of Messina in 2016, the incidence of its complications and the treatment combinations applied. The principal transmission route was through the ingestion of unpasteurized fresh cheese. The mean latency period between the onset of the symptoms and diagnosis was 35.58±42.75 days. A late diagnosis increases the risk of developing complications. Drug-resistant strains of B. melitensis to Trimethoprim/ Sulfamethoxazole and Ciprofloxacin were found in blood cultures of 58.4% patients. Brucellosis is still present in Sicily. A diagnostic delay predisposes to complications requiring prolonged therapies. The finding of Brucella melitensis strains resistant to the most widespread treatments is worrisome and needs further investigation. Moreover, the use of alternative combination antibiotic therapy is recommended.

A systematic review and meta-analysis of the prevalence of osteoarticular brucellosis

BACKGROUND

Infection of bones and joints remains one of the most commonly described complications of brucellosis in humans and is predominantly reported in all ages and sexes in high-risk regions, such as the Middle East, Asia, South and Central America, and Africa. We aimed to systematically review the literature and perform a meta-analysis to estimate the global prevalence of osteoarticular brucellosis (OAB).

METHODOLOGY

Major bibliographic databases were searched using keywords and suitable combinations. All studies reporting the incidence and clinical manifestations of osteoarticular brucellosis in humans, and demonstrated by two or more diagnostic methods (bacteriological, molecular, serological, and/or radiographic) were included. Random model was used, and statistical significance was set at 0.05.

PRINCIPAL FINDINGS

A total of 56 studies met the inclusion criteria and were included in the systematic review and meta-analysis. There was an evidence of geographical variation in the prevalence of osteoarticular disease with estimates ranging from 27% in low-risk regions to 36% in high-risk regions. However, the difference was not significant. Thus, brucellosis patients have at least a 27% chance of developing osteoarticular disease.

CONCLUSIONS

The prevalence of OAB is not dependent on the endemicity of brucellosis in a particular region. Hence, further research should investigate the potential mechanisms of OAB, as well as the influence of age, gender, and other socioeconomic factor variations in its global prevalence, as this may provide insight into associated exposure risks and management of the disease.

Reemergence of Human Brucellosis in Israel

BACKGROUND

The epidemiology of human brucellosis (HB) continues to evolve.

OBJECTIVES

To describe the current epidemiology of HB in Israel in general and in the population at risk.

METHODS

We calculated the incidence of HB in Israel for the period 2009-2015, overall and for the Arab population. Data are based on mandatory reporting of HB in Israel, defined clinically with either laboratory confirmation or epidemiological linkage to a laboratory-confirmed case. We mapped the geographic distribution of HB throughout the study period according to localities. We specified localities with high incidence (≥ 10 per 100,000 population) and mapped the distribution of dense localities with time.

RESULTS

The incidence of HB in the general population in Israel increased sharply from 1.9 per 100,000 in 2009 to a peak of 7.3 per 100,000 in 2014. Each year, 95-100% of cases occurred among Arabs, thus the incidence in the Arab population increased from 10 per 100,000 in 2009 to 33.5 per 100,000 in 2014. Throughout this period 133 different localities reported at least one case of HB, and of these 20 were high-incidence localities during one year at least. During the period 2009-2013 the number of affected localities ranged from 35 to 44 per year and the disease was local, while in 2014 there were 82 localities distributed across the country.

CONCLUSIONS

We demonstrate the importance of analyzing incidence in the population at risk for a disease. HB is an urgent public health issue in the Arab population in Israel, mandating an immediate and long-term eradication and control program.

Wildlife Management Practices Associated with Pathogen Exposure in Non-Native Wild Pigs in Florida, U.S

Land use influences disease emergence by changing the ecological dynamics of humans, wildlife, domestic animals, and pathogens. This is a central tenet of One Health, and one that is gaining momentum in wildlife management decision-making in the United States. Using almost 2000 serological samples collected from non-native wild pigs (Sus scrofa) throughout Florida (U.S.), we compared the prevalence and exposure risk of two directly transmitted pathogens, pseudorabies virus (PrV) and Brucella spp., to test the hypothesis that disease emergence would be positively correlated with one of the most basic wildlife management operations: Hunting. The seroprevalence of PrV-Brucella spp. coinfection or PrV alone was higher for wild pigs in land management areas that allowed hunting with dogs than in areas that culled animals using other harvest methods. This pattern did not hold for Brucella alone. The likelihood of exposure to PrV, but not Brucella spp., was also significantly higher among wild pigs at hunted sites than at sites where animals were culled. By failing to consider the impact of dog hunting on the emergence of non-native pathogens, current animal management practices have the potential to affect public health, the commercial livestock industry, and wildlife conservation.

Seroprevalence and risk factors of brucellosis among slaughtered indigenous cattle, abattoir personnel and pregnant women in Ngaoundéré, Cameroon

BACKGROUND

Brucellosis is a neglected debilitating zoonosis with a high prevalence in many developing countries. Bovine brucellosis is widespread in Cameroon but the epidemiological situation of human brucellosis is not known. A cross sectional study was carried to determine the seroprevalence and factors associated with bovine and human Brucellosis among abattoir personnel and pregnant women in Ngaoundéré, Cameroon.

METHODS

Serum sample from 590 abattoir cattle and 816 plausible occupational risk and vulnerable humans to brucellosis (107 abattoir personnel and 709 pregnant women) were collected and screened for anti-brucella antibodies using Rose Bengal Plate Test (RBPT) and ELISA tests. Structured questionnaires were used to collect data on socio-demographics and risk-factors. The differences in proportions between seropositive and seronegative reactors were tested using odds-ratio and χ2tests.

RESULTS

Bovine brucellosis seroprevalence was at 3.40% (n = 590; 3.4% for RBPT, 5.93% for i-ELISA). Human Brucella seroprevalence was at 5.6% among abattoir personnel (n = 107; 5.6% for RBPT, 12.15% for Brucella IgG ELISA) and 0.28% in pregnant women (n = 709; both tests). Breed (P < 0.00001) was associated with increased risk of brucellosis in cattle and the seroprevalence was highest among the Djafoun (OR = 16.67, 95%CI: 4.49-28.85) and Akou (OR = 16.96, 95% CI: 0.10-23.91) cattle compared to the other breeds. There was a moderate positive correlation (R2 = 0.5025) of Brucella IgG concentrations (> 200 U/ml) and clinical data for Brucella IgG ELISA seropositive humans. Several potential factors were associated (P > 0.05) with increased risk of human brucellosis seroprevalence among the abattoir personnel. The abattoir personnel were essentially males; the seropositive respondents were male and did not use protective equipment at work. Handling of foetus and uterine contents (OR = 13.00, 95%CI: 1.51-111.88) was associated with increased risk of human brucellosis.

CONCLUSIONS

Antibrucella antibodies are prevalent in cattle (3.40%), among abattoir personnel (5.60%) and in pregnant women (0.28%) in Ngaoundéré, Cameroon. The study reports the first evidence of human brucellosis in Cameroon and therefore, an indication of a real public health problem. Public awareness campaigns and health education especially among livestock professional and in agropastoral communities should be highlighted to disseminate knowledge, associated risk factors and control measures of brucellosis.

Interferon-γ receptor-1 gene promoter polymorphisms and susceptibility for brucellosis in Makkah region

BACKGROUND

Genetic polymorphisms that affect the production levels of certain cytokines and/or their receptors may determine the risk, severity or protection in some infectious diseases like brucellosis.

OBJECTIVES

The aim of this study was to investigate the association of certain known Interferon-γ Receptor-1 (IFN-γ R1) gene promoter polymorphisms and the susceptibility to infection with Brucellosis in Saudi population.

METHODS

A cases-control association study was conducted in 69 individuals with human brucellosis and 94 healthy individuals. Genotyping of IFN-γ R1 - 56 C>T and IFN-γ R1 - 611 A>G polymorphism in both patients and healthy controls was done by PCR- restriction enzyme length polymorphisms (PCR-RFLP) and PCR- confronting two primer pairs (PCR-CTPP) methods and were assessed for potential associations with susceptibility for human brucellosis and their mode of penetrance.

RESULTS

Interestingly, we have designed a PCR-CTPP system to be used for genotyping of IFN-γ R1 - 611 A > G polymorphism. The PCR-CTPP is an accurate method for genotyping of SNPs. Moreover, it is time-saving, inexpensive and easy to perform.

CONCLUSION

Both tested polymorphisms, IFN-γ R1 - 56 C>T and IFN-γ R1 -611 A>G polymorphism had no role in genetic susceptibility to human brucellosis in the study population. The PCR-CTPP can be used for genotyping IFN-γ R1 - 611 A > G polymorphism and other types of mutation.

Clinical features of 2041 human brucellosis cases in China

BACKGROUND

Human brucellosis has become a major public health problem in China. However, the available clinical data on brucellosis cases are limited.

METHODS

We retrospectively reviewed medical charts of 2041 patients with confirmed human brucellosis and prospectively recorded their outcomes by telephone interview. These patients were admitted to the Sixth People's Hospital of the Xinjiang Uygur Autonomous region between 1st January and 31st December 2014. Data on these patients were collected from hospital medical records.

RESULTS

Many patients presented with fatigue (67%), fever (64%), arthralgia (63%) and sweating (54%). High erythrocyte sedimentation rate (ESR) (69%), high C-reactive protein (CRP) (39%), high alanine aminotransferase (ALT) (33%) and high aspartate aminotransferase (AST) (20%) were the most common laboratory findings, especially in acute patients. There was evidence of focal involvement in 90% of patients. A total of 61.5% of brucellosis patients recovered. Multivariate logistic regression analyses suggested that the risk factors key to unfavorable prognosis were: age≥45 years (OR = 1.75, 95% CI 1.36-2.24), back pain (OR = 1.50, 95% CI 1.16-1.94) and joint tenderness (OR = 1.73, 95% CI 1.13-2.65). The increasing duration of the illness increased the risk of poor prognosis.

CONCLUSION

Patients with brucellosis showed different characteristics in different clinical stages. In China, the chronicity rate of human brucellosis is high. The risk of poor prognosis is increased in patients aged 45 years or older, patients who have had brucellosis for a substantial period of time, and patients with back pain or joint tenderness. The clinical management of brucellosis should be improved to include sensitive diagnostic methods for subacute and chronic brucellosis.

Risk factors of brucellosis seropositivity in Bactrian camels of Mongolia

BACKGROUND

More information on brucellosis epidemiology in Bactrian camels is needed due to their growing economic and livelihood importance for herders and renewed efforts in Mongolia to eliminate brucellosis through mass vaccination of ruminants excluding camels. Brucellosis prevalence in camels increased over the past two decades. Random multi-stage cluster surveys were done in the Eastern provinces of Dornod and Sukhbaatar in 2013 and 2014 and in the Southern & Western provinces of Dornogobi, Umnogobi and Khovd in 2014 and 2015. A total of 1822 camels, 1155 cattle, and 3023 small ruminant sera were collected and tested with the Rose Bengal Test. In addition, 195 vaginal swabs and 250 milk samples for bacteriological culture were taken from livestock with history of abortion.

RESULTS

The overall apparent seroprevalence in camels was 2.3% (95% confidence interval 1.6-3.3). The main risk factor for camel seropositivity was being in an Eastern province when compared to Southern & Western provinces (odds ratio 13.2, 95% CI 5.3-32.4). Camel seroprevalences were stable over the two consecutive survey years, despite introduction of ruminant vaccination: 5.7% (95% CI 3.1-10.2%) and 5.8% (3.3-10.1%) in Eastern provinces and 0.4% (0.2-1.2%) and 0.5% (0.1-2.0%) in Southern & Western provinces. We isolated Brucella abortus from camels and cattle. Camel seropositivity was associated to keeping cattle together with camels. Monitoring of vaccination campaigns showed that coverage in cattle was insufficient because animals could not be adequately restrained.

CONCLUSIONS

The present study reveals that brucellosis is present with important seroprevalence in Mongolian camels and was endemic in Eastern provinces. Camel herd seropositivity was most closely associated to infection in cattle. Longer term monitoring is needed to assess whether camel seroprevalance decreases with ongoing vaccination in Mongolia. This should be coupled with further confirmation on Brucella spp. isolates. To date, only Brucella abortus was isolated, but camels are also susceptible to Brucella melitensis. Clear verbal and written information on disease prevention in livestock and household members is important, particularly for remote camel herders who had only moderate knowledge on brucellosis epidemiology and preventive measures.