High index of suspicion for brucellosis in a highly cosmopolitan city in southern China

Clinical and epidemiological aspects of spondylodiscitis in a tertiary care hospital in South India

This study aims to bridge the informational gap regarding the clinical and epidemiological aspects of spondylodiscitis in India, addressing the dearth of substantial evidence in this domain. This study was conducted in a tertiary care hospital over three years, involving 145 adult patients diagnosed with spondylodiscitis. Among them, 28 (19.3%) had Brucellar spondylodiscitis with a younger mean age of 40.1 years, 76 (52.4%) had tubercular spondylodiscitis with a higher mean age of 50.7 years, and 27 (18.6%) had pyogenic spondylodiscitis. Common symptoms included pain while walking (82.1% Brucellar, 93.4% TB, 77.8% pyogenic), fever (39.3% Brucellar, 38.2% TB, 33.3% pyogenic), and limb weakness (25% Brucellar, 46.1% TB, 66.7% pyogenic). CRP (mg/L) levels were elevated in Brucellar (mean 58.75) and pyogenic (mean 60.4) spondylodiscitis patients, with debridement and decompression performed in 50% Brucellar, 55.3% tubercular, and 70.4% pyogenic patients. The study reveals the clinical and epidemiological aspects of spondylodiscitis in South India, contributing to the enrichment of existing knowledge in diagnosis and management.

Investigation of the Seroprevalence of Brucella Antibodies and Characterization of Field Strains in Immunized Dairy Cows by B. abortus A19

(1) Background: One method of eradicating brucellosis is to cull cattle that test positive for antibodies 12 months after being vaccinated with the 19-strain vaccine. Variations in immunization regimens and feeding practices may contribute to differences in the rate of persistent antibodies. We conducted this study to investigate the real positive rate of Brucella antibody in field strains of Brucella spp. after immunization over 12 months in dairy cows. This research aims to provide data to support the development of strategies for preventing, controlling, and eradicating brucellosis. (2) Method: We employed the baseline sampling method to collect samples from cows immunized with the A19 vaccine for over 12 months in Lingwu City from 2021 to 2023. Serological detection was conducted using the RBPT method. An established PCR method that could distinguish between 19 and non-19 strains of Brucella was utilized to investigate the field strains of Brucella on 10 dairy farms based on six samples mixed into one using the Mathematical Expectation strategy. (3) Results: We analyzed the rates of individual seropositivity and herd seropositive rates in dairy cattle in Lingwu City from 2021 to 2023 and revealed that antibodies induced by the Brucella abortus strain A19 vaccine persist in dairy herds for more than 12 months. We established a PCR method for identifying both Brucella A19 and non-A19 strains, resulting in the detection of 10 field strains of Brucella abortus from 1537 dairy cows. By employing a Mathematical Expectation strategy, we completed testing of 1537 samples after conducting only 306 tests, thereby reducing the workload by 80.1%. (4) Conclusions: There was a certain proportion of cows with a persistent antibody titer, but there was no evidence that all of these cattle were naturally infected with Brucella. The established PCR method for distinguishing between Brucella abortus strain 19 and non-19 strains can be specifically utilized for detecting natural Brucella infection in immunized cattle. We propose that relying solely on the detection of antibodies in cattle immunized with the A19 vaccine more than 12 months previously should not be solely relied upon as a diagnostic basis for brucellosis, and it is essential to complement this approach with PCR analysis to specifically identify field Brucella spp. Brucella abortus was the predominant strain identified in the field during this study. Detection based on the Mathematical Expectation strategy can significantly enhance detection efficiency.

Wild animal and zoonotic disease risk management and regulation in China: Examining gaps and One Health opportunities in scope, mandates, and monitoring systems

Emerging diseases of zoonotic origin such as COVID-19 are a continuing public health threat in China that lead to a significant socioeconomic burden. This study reviewed the current laws and regulations, government reports and policy documents, and existing literature on zoonotic disease preparedness and prevention across the forestry, agriculture, and public health authorities in China, to articulate the current landscape of potential risks, existing mandates, and gaps. A total of 55 known zoonotic diseases (59 pathogens) are routinely monitored under a multi-sectoral system among humans and domestic and wild animals in China. These diseases have been detected in wild mammals, birds, reptiles, amphibians, and fish or other aquatic animals, the majority of which are transmitted between humans and animals via direct or indirect contact and vectors. However, this current monitoring system covers a limited scope of disease threats and animal host species, warranting expanded review for sources of disease and pathogen with zoonotic potential. In addition, the governance of wild animal protection and utilization and limited knowledge about wild animal trade value chains present challenges for zoonotic disease risk assessment and monitoring, and affect the completeness of mandates and enforcement. A coordinated and collaborative mechanism among different departments is required for the effective monitoring and management of disease emergence and transmission risks in the animal value chains. Moreover, pathogen surveillance among wild animal hosts and human populations outside of the routine monitoring system will fill the data gaps and improve our understanding of future emerging zoonotic threats to achieve disease prevention. The findings and recommendations will advance One Health collaboration across government and non-government stakeholders to optimize monitoring and surveillance, risk management, and emergency responses to known and novel zoonotic threats, and support COVID-19 recovery efforts.

Epidemiological, Clinical and Laboratory Characteristics of Patients with Brucella Infection in Anhui Province, China

Background

Brucellosis is currently one of the most widespread zoonotic diseases caused by Brucella genus, and the Brucella melitensis is the major pathogen. The number of people infected with Brucella has gradually increased in Anhui Province.

Purpose

To retrospectively evaluate the epidemiological, clinical, and laboratory data of brucellosis patients in Anhui Province.

Patients and Methods

A total of 109 brucellosis patients were admitted to the First Affiliated Hospital of Anhui Medical University from January 2012 to March 2021. Data from all patients were retrieved from the hospital’s electronic medical system. The final results were grouped and compared according to the presence or absence of bacteremic brucellosis and three phases of brucellosis.

Results

The most common symptoms among all 109 brucellosis patients were fever (89.0%), followed by chills (52.3%), arthralgia (48.6%), and weight loss (30.3%), and laboratory results presented with anemia (65.1%), elevate of C-reactive protein (CRP) (91.7%), erythrocyte sedimentation rate (ESR) (86.2%), aspartate aminotransferase (AST) (40.4%), and lactate dehydrogenase (LDH) (43.1%). The percentage of fever (96.1%), arthralgia (58.8%), anorexia (35.3%), leukopenia (31.4%), and the AST (51.0%) were higher in bacteremic than nonbacteremic group. Additionally, the median level of LDH (332.0 mg/L, IQR, 209.0–553.0) was higher in bacteremic than nonbacteremic group. Nevertheless, the albumin (36.0 mg/L, IQR, 33.9–38.2) was lower in the bacteremic group. The percentage of fever (94.9%) and the median LDH level (316.0 U/L (IQR,218.0–517.5)) in the acute phase of brucellosis were higher than the percentage of fever (72.0%) and the median LDH level (209.0 U/L (IQR,162.0–276.0)) in the subacute phase of brucellosis.

Conclusion

Brucellosis has become an important public health issue in Anhui Province. Brucellosis is a disease with diverse clinical manifestations. Our data showed that unexplained fever, arthralgia, and elevated AST and LDH should be considered as a diagnosis of bacteremia brucellosis for early treatment intervention.

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INTRODUCTION

Brucellosis, the most common zoonosis globally, is considered a major public health problem.

OBJECTIVE

A retrospective study was carried out over 21 years (1998-2018) to determine the epidemiological features of human brucellosis in the province of El-Oued (south-eastern Algeria).

RESULTS

1,832 confirmed cases of human brucellosis were reported during the study period, with an average incidence rate of around 12.26 cases per 100,000 inhabitants. The annual distribution of the incidence was characterized by an increasing trend and a strong fluctuation ; its values ranged between 2.27 and 24.96 per 100,000 inhabitants. The monthly distribution showed that the highest incidence rates were recorded from mid-February to July, with a peak of 2.74 cases per 100,000 inhabitants in April.Human brucellosis has affected all municipalities. The highest incidence rate was observed in border municipalities such as Ben Guecha and Oum Tiour (89.76 and 66.14 per inhabitants, respectively).The incidence in the male population was higher than that of the female at 14.63 versus 9.83 per 100,000 inhabitants, respectively, noting that it increases with age. Individuals over 65 years are the most at risk, with an incidence rate of 22.32 per 100,000 inhabitants.

CONCLUSION

Along with strengthening preventive measures in the population, eliminating brucellosis in animals is the most effective method to protect humans against infection.

ONE Health Approach to Address Zoonotic Brucellosis: A Spatiotemporal Associations Study Between Animals and Humans

Background: Brucellosis is one of the most significant zoonosis over the world, threatening both veterinary and human public health. However, few studies were focused on nationwide animal brucellosis and made association with human brucellosis. Methodology and Principal Findings: We conducted a bilingual literature search on Brucella or brucellosis in China on the two largest databases (China National Knowledge Infrastructure and PubMed) and conducted a systematic review. A total of 1,383 Chinese and 81 English publications, published between 1958 and 2018 were identified. From them, 357 publications presenting 692 datasets were subjected to the meta-analysis. The overall prevalence rate is 1.70% (95% CI: 1.66-1.74), with a declining (until the late 1990s) and rising trend (starting the early 2000s). Interestingly, the animal with highest prevalence rate is canine (8.35%, 95% CI: 7.21-9.50), and lowest in cattle (1.22%, 95% CI: 1.17-1.28). The prevalence of Brucella in animals was unequally distributed among the 24 examined regions in China. Conclusions: Brucellosis is a reemerging disease for both humans and animals in China. The observed data suggests that dogs and yaks are the leading reservoirs for Brucella, and the provinces with highest prevalence rates in animals are Hubei, Sichuan, Inner Mongolia, Fujian, and Guizhou. Accordingly targeted intervention policy should be implemented to break the Brucella transmission chain between animals and humans in China.