Brucellosis in an adult female from Fate Bell Rock Shelter, Lower Pecos, Texas (4000-1300 BP)

OBJECTIVE

This project is a case study discussing the differential diagnosis of multiple osteolytic vertebral lesions typical of brucellosis from an adult female from Fate Bell Rock Shelter in the Lower Pecos, Texas (4000-1300 BP).

MATERIALS

One middle to late adult female with exceptional preservation of the vertebrae.

METHODS

All skeletal remains were observed with low power magnification and the vertebrae were examined in greater detail using computed tomography (CT).

RESULTS

Pathological conditions involving multiple osteolytic vertebral lesions such as tuberculosis, echinococcosis, and neoplastic conditions were reviewed but brucellosis is the most likely diagnosis based on the pattern and distribution of characteristic lesions.

CONCLUSIONS

Aside from this study, only one other case of brucellosis has been recognized in prehistoric North American hunter-gatherer skeletal remains.

SIGNIFICANCE

This individual represents the first case of brucellosis in a hunter-gatherer from prehistoric North America diagnosed using both macroscopic skeletal analysis and computed tomography (CT).

LIMITATIONS

Poor preservation of vertebrae make cross comparison of remains and differential diagnosis difficult.

SUGGESTIONS FOR FURTHER RESEARCH

Further review and paleopathological research is needed regarding Coxiella burnetti (Q-fever) infection as a possible contributing factor to osteolytic lesions.

[Technical assistance in crisis times: Brucelosis in the country programs for Spain of the world health organization (1951-1972)]

OBJECTIVE

Brucellosis was one of the most important health problems in post-Civil War Spain and in subsequent years. The objective of the study was to reconstruct the first programs that the WHO set up in this country, to address this problem, between 1951 and 1972 and their main outcomes.

METHODS

On the basis of primary sources of diverse origin, especially unpublished reports on Spain from foreign experts, from the WHO Historical Archive, the contents related to the disease were analyzed, contextualizing them within the framework of both the history of Spanish Public Health during the period studied and the international public health strategies for the prevention and control of brucellosis between 1951 and 1972.

RESULTS

Spain 0001 (E1), Spain 0012 (E12) programs were located. The first of them (E1), dedicated to the problem of endemoepidemic diseases (brucellosis, rabies and Q fever), developed between 1952 and 1956, offered assistance in the work of control of these diseases carried out by public health laboratories. The second was preceded by visits of experts between 1956-1958 and formally started in 1969 and ended in 1972. This program was specifically devoted to the fight against brucellosis and included the start-up of laboratory and epidemiological work, the training of specialists, vaccination experiences in goats and sheep and the initiation of studies on immunizations in humans.

CONCLUSIONS

The presence of consultants and experts from the WHO, from the highest scientific authority in the field of brucellosis such as Sandford Elberg or Martin Kaplan, was decisive in, at least, two aspects: first, to have an external view that would allow to know the reality of the Spanish health situation in the matter of the control of this zoonosis and, secondly, to start up and develop laboratory techniques and training of specialists with the aim of creating, at least, a center of reference for the preparation of vaccines, which the experts placed, ideally, in the National School of Health in Madrid.

Changing Epidemiology of Human Brucellosis, China, 1955-2014

Brucellosis, a zoonotic disease, was made statutorily notifiable in China in 1955. We analyzed the incidence and spatial–temporal distribution of human brucellosis during 1955–2014 in China using notifiable surveillance data: aggregated data for 1955–2003 and individual case data for 2004–2014. A total of 513,034 brucellosis cases were recorded, of which 99.3% were reported in northern China during 1955–2014, and 69.1% (258, 462/374, 141) occurred during February–July in 1990–2014. Incidence remained high during 1955–1978 (interquartile range 0.42–1.0 cases/100,000 residents), then decreased dramatically in 1979–1994. However, brucellosis has reemerged since 1995 (interquartile range 0.11–0.23 in 1995–2003 and 1.48–2.89 in 2004–2014); the historical high occurred in 2014, and the affected area expanded from northern pastureland provinces to the adjacent grassland and agricultural areas, then to southern coastal and southwestern areas. Control strategies in China should be adjusted to account for these changes by adopting a One Health approach.

Trend Analysis and Affecting Components of Human Brucellosis Incidence During 2006 to 2016

INTRODUCTION

Brucellosis is communicable between humans and animals. In spite of having an active health care system. Iran is considered as an endemic area and it stands in the fourth place in world ranking. One of the common methods for identifying the disease incidence is a regression analysis. Therefore, the aim of the study was to investigate the trend of brucellosis incidence during 2006 to 2016 and the components affecting such disease.

MATERIALS AND METHODS

This was a trend study which was conducted on the total of 144 brucellosis cases were recorded in the registration software in CDC of Iranian, Ministry of Health. We analyzed the changes in brucellosis incidence during 2006 to 2016 in Juybar province by the join point regression. Moreover, comparing the changes of incidence in one year intervals was also taken into account.

RESULTS

The average age of patients was 18±29 years. About 60% of the patients were men, and 85.4% had used non-pasteurized dairy and meat products. The contact with animals had a significant difference between the two genders (P= 0.006). During 2006 to 2016, brucellosis incidence had a decreased trend about 15%. This trend had a breakpoint in a way that during 2006 to 2008, 66.2% decrease and during 2008 to 2016, 7% increase was observed that none of these annual percentage changes (APC) were statistically significant at p= 0.05. Also, APC of brucellosis incidence in groups below 20 and between 20 to 50 years old had a decrease in a way that in groups under 20, it had 26.7% decrease and it was statistically significant.

CONCLUSION

It is necessary to provide appropriate education training, information on the Human Brucellosis for the young and individuals with high risk professions. Moreover, some health behaviors such as not using non-pasteurized dairy, animals' vaccinations, and awareness of the disease symptoms are needed.

Human Brucellosis in Febrile Patients Seeking Treatment at Remote Hospitals, Northeastern Kenya, 2014-2015

During 2014–2015, patients in northeastern Kenya were assessed for brucellosis and characteristics that might help clinicians identify brucellosis. Among 146 confirmed brucellosis patients, 29 (20%) had negative serologic tests. No clinical feature was a good indicator of infection, which was associated with animal contact and drinking raw milk.

Historical perspective of brucellosis: a microbiological and epidemiological overview

The historical process of brucellosis extends back to humankind's first contact with animals. Although brucellosis is a sporadic disease observed in animals in certain regions of the world, it is an important disease in humans that can affect many organs and systems due to the consumption of contaminated milk or milk products. Studies have shown that the presence of Brucella dates back to 60 million years ago. In 450 BC, Hippocrates described a disease similar to brucellosis. Since Hippocrates' time, brucellosis has been characterized by fever. Our aim is to investigate selfless work undertaken by scientists on the epidemiology, diagnosis and clinical findings of brucellosis until today, and to gain a historical perspective about the disease that is as old as human history, still has importance today, causes economic losses in treated animals and harms human health.

[Not Available]

Mediterranean fever or brucellosis was an endemic disease at the beginning of the 20th century in the Mediterranean area. Étienne Burnet, a pastorian researcher, studied this zoonosis in the Pasteur Institute of Tunis between 1920 and 1928 and enhanced our knowledge with various experiences on the genius Brucella, particularly melitensis variety. He developed the so-called Burnet's test or melitine IDR diagnose test. The thermo-agglutination of paramelitensis group, now known as the S forms colonies, led him question the variability of this non-specific character. He showed that thermo-agglutination is associated with specific antigenic properties and is common with other bacteria's species and could be acquired cross over colonies culture... The authors attempt to reconstitute the context of these experiences and to show the actuality of evolutionary Burnet's conception of living micro-organisms.

Florence Nightingale (1820-1910) and Sir John Forbes (1787-1861): neighbours in Old Burlington Street, Westminster

The year 2010 marks the centenary of the birth of Florence Nightingale and will, no doubt, be universally remembered. Her life and nursing career have recently been fully described by Bostridge. It is less well known that her neighbour from November 1856 was the distinguished Scottish physician Sir John Forbes MD Edin FRCP Lond FRS DCL Oxon. Although they never met, they exchanged copies of each other's books and shared a mutual respect.

[Paleopathology of Herculaneum's population (79 D.C.)]

In 1982, some occasional excavations in the area corresponding to the ancient beach of Ercolano brought to light the rests of around 250 individuals, victims of the eruption of the Vesuvius. This exceptional recovery constitutes an essential patrimony for the reconstruction of the paleobiology and the paleopathology of the human populations in Roman epoch, in relationship not only to the style of life but also to the social and economic status. Notwithstanding the bone alterations due to the exposition to high temperature, the human remains present traces of illness. Among these we find rheumatic pathologies and arthrosis of the vertebral column. The high frequency of occupational markers (enthesopaties and sindesmopaties) suggests that the most part of the population (juveniles included) exercised hand work. Among the infectious pathologies we report cases of the tuberculosis and brucellosis.

The curious affair of the identity of Fioravanti Sammut (b. 1863) and Temistocle Zammit (d. 1935)

Dr Zammit's experiments showed that brucellosis was transmitted by the milk of goats that did not show signs of infection or ill health. The British forces in Malta banned the use of goats' milk and brucellosis was eliminated in those forces. This research was published in the Proceedings of the Royal Society and earned him an Honorary DLitt from Oxford University and the Kingsley Medal of the Liverpool School of Tropical Medicine. The King knighted him. He was the great Maltese polymath but there is a mystery concerning his name.

Surgeon Captain Sheldon F. Dudley and the person to person spread of brucellosis by inhalation

Analysis of brucellosis epidemics in ships of the Mediterranean fleet in the nineteenth century are most easily explained by aerosol transmission in grossly overcrowded, hot and humid confined spaces.

[Contribution of paleopathology to defining the pathocoenosis of infectious diseases (Part one)]

Studying the remains of mummies obtained by archaeological research may provide key information concerning historical pathocoenosis. Paleopathology makes it possible to recognise, characterise and connect different features involved in human pathocoenosis, such as epidemiology, in a historical perspective, and cultural development, via the introduction of new livestock farming techniques and agriculture in general. Several distinct pathologies may produce direct and indirect changes in the skeleton of affected individuals. Therefore bone remains represent very important sources of information to study such diseases. Changes related to trauma and nutrition deficiency as well as secondary signs, induced by tuberculosis, brucellosis, leprosy, syphilis, malaria, periostitis and aspecific osteomyelitis, persist in bones. In addition, other diseases may cause indirect alterations and subsequent secondary bone in the skeleton via different mechanisms. A secondary bone dimorphism may be induced by poliomyelitis. Aspecific lesions may arise in a skeletal bone and then cause secondary alterations in near-bone segments. Reviewing studies of paleopathologic research found in the literature, we emphasize the relationship between the appearance of major infectious diseases and the development of human activities; whereas it is clear that the introduction of livestock farming had a key role in the pathocoenosis of distinct infections such as tuberculosis, brucellosis and leprosy, some doubts and uncertainty remain in relation to the origin of others with epidemiologically important pathologies, such as syphilis.

Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations

The authors provide evidence-based guidance on treating human brucellosis, and discuss the future clinical trials that would help address the controversies surrounding treatment.

Eponymous doctors associated with Edinburgh, Part 2--David Bruce, John Cheyne, William Stokes, Alexander Monro Secundus, Joseph Gamgee

This, the second in a three-paper series with this title, looks at famous doctors who trained in Edinburgh and their eponyms. With one possible exception, none seems to have sought the eponym, nor awarded it to themselves, nor used it for self-promotion. Unlike those in the first paper, all eponyms in this paper are still in use and their brevity is in contrast to the lengthy description needed if the eponym is not used. Examples are Cheyne-Stokes respiration, Stokes-Adam attacks, Brucellosis and Gamgee dressing. Monro Secundus is included because of his vehement defence of his professional reputation and research findings when he suspected others of trying to detract credit from him, a characteristic seldom reported for the others.

Bacteria in two-millennia-old cheese, and related epizoonoses in Roman populations

A tremendous volcanic eruption destroyed all the life around Mount Vesuvius during the night between 24 and 25 August, 79 AD. Two famous towns, Pompeii and Herculaneum, were completely buried under volcanic products. At Herculaneum, about 25m of volcanic mud killed about 250 people who had fled to the beaches in an attempt to escape (Bisel, S. C.,Rivista di Studi Pompeiani, 1, 123-124, 1987). An anthropological examination of the skeletons of these "fugitives" reveals the bone lesions typical of brucellosis in 17.4% of adults (Capasso, L., International Journal of Osteoarchaelogy, 9, 277-288, 1999). This very high incidence of brucellosis was theoretically linked to the consumption of ovine milk and its derivates, which is also indicated by both literary and figurative sources. A single carbonized cheese was found in Herculaneum; its analysis clearly reveals the excellent state of preservation of the milk curds. For the first time, we demonstrate the presence of a variety of bacteria, possibly Lactobacillus, that also includes cocco-like forms that seem to be morphologically and dimensionally consistent with Brucella. The long interval spent by the organic remains under the volcanic mud and high temperatures they suffered preclude the possibility of identifying the bacteria through molecular methods.

[History of the eradication of bovine brucellosis in the Czech Republic]

In the Czech republic, the program of recovery of the livestock from brucellosis caused by the micro-organisms Brucella abortus was successfully completed in 1964. The campaign started in 1959 by the exploration of the complete cattle population by agglutination tests. Incidence of the disease was 211 positive cases for each 100 thousands, prevalence was 0.676% (20,481 animal in 654 foci of 34 districts). The prevalence was significantly higher in large cattle units. Tens of new cases of the human brucellosis infections were reported. The process of sanitation was first based on the elimination of infected animals. In the later phase the more radical method was employed--the whole herds with infected individuals were eliminated and replaced. During the recovery program more than 41 thousands of infected animals were eliminated. It required solving many complex methodological, legislative, organisational, economical and social problems. Serological test applied to more the half of the livestock population together with epizootiological, epidemiological and laboratory investigation helped to detect all foci. Eradication brought about substantial improvement of the productive and reproductive features of the cattle and eliminated the risks of infection with this zoonosis to the human population.

Alice C. Evans: breaking barriers

Despite severe and persistent criticism of her research, Alice Evans persevered in her pioneering work on the bacterial contamination of milk, identifying the organism that caused undulant fever and demonstrating that drinking unpasteurized cow's milk could transmit the disease, undulant fever, to humans. The opprobrium that Alice Evans endured was unrelenting, even after her election as the first President of the Society of American Bacteriologists, (now the American Society for Microbiology), but she remained undeterred, a true heroine of American microbiology and a magnificent public health worker.

Florence Nightingale. Her Crimean fever and chronic illness

Florence Nightingale's Crimean fever and chronic illness have intrigued historians for more than a century and a half. The purpose of this article is threefold: (a) to discuss the facts that point to the cause of Nightingale's Crimean fever as brucellosis, (b) to show that her debilitating illness for 32 years (1855-1887) was compatible with the specific form of chronic brucellosis, and (c) to present new evidence that she was still having severe symptoms in December 1887, when it was previously felt that she had no severe symptoms after 1870.

Alice Evans, an early woman scientist at NIH

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[Historical brief on the fever of Malta]

Malta fever (brucellosis) is an infectious disease of cattle (chiefly goats) which can infect man. Although the disease is not limited to Malta, occurring also in other mediterranean countries as well as in Asia and America, it was originally described in 1863 in Malta where the responsible bacteria (Brucella melitensis) was discovered in 1887 by D. Bruce. Ten years later Wright & Smith (1897) showed that the agglutination test originally established for typhoidic patients could be used for the diagnosis of Malta fever. Finally the conclusions of the Commission for the investigation of Mediterranean fever (1905-1907) are briefly recalled.

Florence Nightingale's fever

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The economics of imperialism and health: Malta's experience

The thesis of this article is that the prevalence of disease and premature death depends more on national, class, and gender relationships than on medical and biological factors. The political and economic realities of life in the British Colony of Malta revealed here clearly determined the severity of both infant mortality rates and the attacks of brucellosis. A brief history sets the background for an in-depth study of the interaction between socioeconomic conditions and disease in the first half of the 20th century. Britain's adherence to imperialist "free" trade policies and refusal to consider Malta's economy beyond its use as a military base had resulted in the "underdevelopment" of Malta's traditional cotton agroindustry and the erosion of household economic stability. Persistently high infant mortality rates and the absence of preventive disease measures were a clear manifestation of continuing exploitative imperialist policies. In this scenario, the devastation of the Second World War became a catalyst for change.

The centenary of the sinking of the Mediterranean Fleet flagship, HMS Victoria. What was the role of Malta fever?

This article commemorates the centenary of the tragic loss of the battleship HMS Victoria and 358 of her crew, together with the Commander-in-Chief of the Mediterranean Fleet, Vice-Admiral Sir George Tryon, as a result of an enigmatic order by Tryon himself. It also investigates the medical aspects and explores the contention that Tryon was suffering from Malta or Mediterranean fever (Brucellosis).

The history of brucellosis in Maryland and the District of Columbia

The history of brucellosis began in Europe; however, a number of early studies and publications originated in medical centers in Maryland and the District of Columbia. As a result of efforts by researchers in these locales, physicians came to understand the transmission of the disease, and continued clinical investigations helped to develop significant therapeutic and preventive measures that have made brucellosis a rare disease in the United States.

The corps disease: brucellosis and its historical association with the Royal Army Medical Corps

Brucellosis (also known as Malta, Mediterranean or Undulant Fever) has aptly been nicknamed the Corps Disease because of the major role played by the Royal Army Medical Corps in elucidating its nature and discovering its mode of spread, thus leading to its prevention and eradication. This history of brucellosis, incorporating a complete bibliography of all references to the disease in the Journal of the Royal Army Medical Corps from 1903 to 1992, documents the fascinating story of this association.

Epidemiologic classics

Epidemiology is the study of the relationships of the various factors determining the frequency and distribution of disease in a human community; the field of medicine concerned with the determination of the specific causes of localized outbreaks such as hepatitis,..., or any other disease of recognized etiology.