Serological surveillance of human brucellosis in Ganzhou City， Jiangxi Province from 2018 to 2021 / 上海预防医学

ObjectiveTo describe the serological surveillance results of human brucellosis in Ganzhou City， Jiangxi Province from 2018 to 2021， characterize the epidemic and current situation of brucellosis， and to provide scientific evidence for effective prevention and control of brucellosis. MethodsSurveillance data of human brucellosis serological testing was collected in Ganzhou City from 2018 to 2021. Spatial， temporal， and demographic distribution was further determined. ResultsFrom 2018 to 2021， a total of 42 humans serologically positive for brucellosis were reported from 18 counties （cities and districts） in Ganzhou City， including 26 males and 16 females with a gender ratio of 1.6∶1. The number of serologically positive cases showed a decreasing trend， with the positive rate decreasing from 46.43% in 2018 to 33.33% in 2021. Majority of the cases （54.00%） aged 40‒ years old. Furthermore， the number of serologically positive cases varied by month； majority of the cases （80.95%） was from April to August. Additionally， a total of 10 counties （cities and districts） reported serologically positive cases of brucellosis， among which the top 3 counties （cities and districts） by cumulative number of positive cases were Zhanggong District （18 cases）， Dayu County（5 cases）， and Longnan City（4 cases）. ConclusionSerologically positive cases of human brucellosis decrease in Ganzhou， in which the incidence of male cases is generally higher than female cases. The seasonality of human brucellosis is in spring and summer. At-risk population is 40‒ years old. Additionally， at-risk areas are southwest and central areas of Ganzhou.

Aspectos clínicos y epidemiológicos de la brucelosis humana en tres provincias cubanas (2013-2016) / Clinical and epidemiological aspects of human brucellosis in three Cuban provinces (2013-2016)

Fundamentos: La brucelosis es una zoonosis presente en Cuba. Su prevención es posible mediante la aplicación de estrategias de intervención encaminadas a cambiar las conductas que predisponen para la adquisición de la infección. Con la finalidad de aportar información a médicos de asistencia y decisores de salud, en esta investigación se analizan aspectos clínicos y epidemiológicos de casos notificados con brucelosis humana en tres provincias cubanas que se ubican en las regiones del occidente, centro y oriente del país. Métodos: Se realizó un estudio retrospectivo y descriptivo entre enero de 2013 y junio de 2016. Se analizaron 65 encuestas clínico-epidemiológicas de casos notificados con brucelosis humana, procedentes de tres provincias cubanas. Las variables que se exploraron fueron: edad, sexo, síntomas clínicos, ocupación, contacto directo con reservorios animales, consumo de lácteos no pasteurizados e ingestión de carne semicruda; para su análisis se utilizaron medidas de estadística descriptiva como frecuencias absolutas y porcentajes. Resultados: Entre los individuos notificados con brucelosis humana sobresalió el sexo masculino (66 por ciento), las edades entre 25 y 54 años (66,1 por ciento), el contacto directo con reservorios animales de Brucella spp. (78,5 por ciento) y, como síntomas predominantes, el malestar general (58,5 por ciento), los dolores articulares (56,9 por ciento) y la fiebre (55,4 por ciento). Conclusión: Las variables clínico-epidemiológicas descritas muestran comportamientos similares a los reportados en periodos anteriores en Cuba y en otros países donde la enfermedad es endémica, lo que sugiere la necesidad de incrementar las estrategias para la prevención, vigilancia y control de la brucelosis humana en Cuba(AU)

Introduction: Brucellosis is a zoonosis in Cuba. Preventing this disease is possible through intervention strategies aimed at changing predisposing behaviors to the infection. This research analyzes clinical and epidemiological aspects of reported cases of human brucellosis in three Cuban provinces located in the western, central, and eastern regions of the country to provide information to medical doctors and health decision-makers. Methods: A retrospective, descriptive study was conducted between January 2013 and June 2016. The clinical-epidemiological surveys of 65 reported cases of human brucellosis from three Cuban provinces were analyzed. The variables studied were: age, sex, symptoms, occupation, direct contact with animal reservoirs, and consumption of unpasteurized dairy products or half-cooked meat. Descriptive statistical measures such as absolute frequency and percentage were used for the analysis. Results: Male sex (66 percent), age between 25 and 54 years (66.1 percent), and direct contact with animal reservoirs of Brucella spp. (78.5 percent) prevailed among the individuals reported with human brucellosis. General malaise (58.5 percent), joint pain (56.9 percent), and fever (55.4 percent) were the prevailing symptoms. Conclusion: The outcomes of the clinical-epidemiological variables described were similar to those previously reported in Cuba and in other countries where the disease is endemic. It suggests the need to increase the strategies for the prevention, surveillance and control of human brucellosis in Cuba(AU)

Estudio de casos confirmados de brucelosis humana en Puebla, México / Study of confirmed cases of human brucellosis in Puebla, Mexico

INTRODUCCIÓN: La brucelosis humana es un problema zoo-sanitario global. México es uno de los principales países que se ven afectados, el diagnóstico oportuno y las pruebas serológicas confirmatorias son la base para la detección. OBJETIVO: Conocer la frecuencia de casos confirmados de brucelosis en diferentes Unidades de Medicina Familiar del Instituto Mexicano del Seguro Social en el estado de Puebla, México. PACIENTES Y MÉTODOS: Estudio transversal en pacientes de ambos sexos, adultos y pediátricos, con manifestaciones clínicas sugestivas de brucelosis; se realizaron pruebas serológicas para el diagnóstico confirmatorio. RESULTADOS: De un total de 77 pacientes, se obtuvieron 39 (50,6%) casos positivos, 21 (27,3%) casos saliendo de la infección, 9 (11,7%) negativos y 8 (10,4%) con memoria inmunológica; de los casos positivos, 32 (82,1%) eran adultos y 30 (76,9%) fueron del género femenino. CONCLUSIÓN: Del total de muestras, la mitad tuvo diagnóstico de brucelosis, las manifestaciones clínicas de los pacientes estudiados fueron inespecíficas, lo cual resalta la importancia del diagnóstico de laboratorio.

BACKGROUND: Human brucellosis is a global health problem. Mexico is one of the main countries affected; timely diagnosis and serological tests are the basis for detection. AIM: To know the frequency of confirmed cases of brucellosis in different of Family Medicine Units of the Mexican Social Security Institute in the state of Puebla, Mexico. METHODS: Cross-sectional study in patients of both genders, adults and pediatrics, with clinical manifestations suggestive of brucellosis; serological tests were performed for the confirmatory diagnosis. RESULTS: Out of a total of 77 patients, 39 (50.6%) were positive, 21 (27.3%) cases coming out of infection, 9 (11.7%) were negative and 8 (10.4%) were defined with immunological memory; of positive cases, 32 (82.1%) were found in the adult group and 30 (76.9%) were female. CONCLUSION: Around half of samples were confirmed as brucellosis, the clinical manifestations of the patients studied were non-specific, which highlights the importance of laboratory diagnosis.

Identification of a small-scale pig farm infected with Brucella suis linked to a clinical case of human brucellosis in Buenos Aires province, Argentina / Identificación de un establecimiento de producción porcina infectado con Brucella suis a partir de un caso clínico de brucelosis humana en la provincia de Buenos Aires, Argentina

Resumen En este trabajo reportamos un caso de brucelosis humana ocasionada por Brucella suis en una persona que trabajaba en un establecimiento de producción porcina en pequeña escala. La granja no tenía antecedentes de la enfermedad y los animales no registraban signos clínicos al ser examinados. Se obtuvieron muestras de suero de todos los padrillos (n=3), de 16/22 chanchas y 9/25 cachorras y se analizaron mediante las técnicas de aglutinación rápida en placa con antígeno tamponado (BPA) y Rosa de Bengala (RB) y Polarización de la Fluorescencia (FPA). Muestras de tejido de un padrillo y de una hembra serológicamente positivos fueron analizadas por cultivo bacteriológico y por la técnica de Inmunofluorescencia Directa (IFD). Se detectaron anticuerpos específicos en el 53% de los cerdos adultos (10/19), mientras que todas las cachorras fueron seronegativas. Se aisló B. suis biovar 1 de un padrillo. En contraste, la bacteria no fue aislada en ninguno de los tejidos de la cerda seropositiva aunque sí se detectó la bacteria mediante IFD. A partir de los datos bacteriológicos y serológicos se evidencia la presencia de una infección endémica por B. suis. Asimismo, teniendo en cuenta la falta de medidas de prevención y de bioseguridad se concluye que la persona probablemente adquirió la enfermedad por contacto directo con los animales infectados o con el ambiente contaminado con la bacteria.

Abstract Here we report a case of human brucellosis due to Brucella suis in a person who worked in a small-scale pig farm. The farm had no history of clinical brucellosis, and signs of the disease were not observed upon clinical examination of the animals. Serum from all the 3 boars, 16/22 sows and 9/25 gilts was obtained for serological examination by Buffered Plate Agglutination Test (BPAT), Rose Bengal Test (RBT) and Fluorescent Polarization Assay (FPA). Bacteriological culture and Direct Fluorescence Antibody Test (DFAT) were performed in tissue samples from a seropositive boar and a sow. Specific antibodies were detected in 53 % (10/19) adult pigs, while all sampled gilts were seronegative. B. suis biovar 1 was isolated from one boar. In contrast, while the bacterium was not isolated from any tissue from a seropositive sow, it was detected by DFAT. From the bacteriological and serological evidence of B. suis endemic infection in the pig farm and the lack of preventive measures and biosecurity practices, it is concluded that the person most likely acquired the disease from the infected animals or by contact with contaminated environment in the farm.

Sero-epidemiology and risk factor analysis of human brucellosis in Punjab, Pakistan: a cross sectional study

@#Human brucellosis is a neglected zoonotic problem worldwide with a high degree of morbidity in humans and is mostly overlooked due to other febrile conditions. The aim of this study was to evaluate the sero-prevalence and risk factors of human brucellosis among subjects living in Punjab, Pakistan. In this cross-sectional study, human blood samples were collected from seven districts of Punjab, Pakistan. Information regarding personal data, demographic data and potential risk factors was collected through a structured questionnaire. Detection of anti-Brucella antibodies was done through Rose Bengal Plate Test (RBPT) and Enzyme Linked Immunosorbent Assay (ELISA). Descriptive analysis, Chi square test and Odds ratio was applied using STATA software version 12. The sero-prevalence of human brucellosis was 13.13% with significantly higher percentage in males 17.23% and age group 25-40 years 16.50% (P=< 0.001). The demographic factors positively associated with human brucellosis were lack of education (P = 0.003; OR = 1.85) and farming as an occupation (P =<0.001; OR = 2.50) Similarly, among the risk factors studied, keeping animals at home (P =<0.001; OR = 2.03), slaughtering of animals (P =<0.001; OR = 15.87) and consuming raw milk (P =<0.001; OR = 5.42) were the factors strongly connected with human brucellosis. A massive awareness should be given to livestock farmers and individuals directly linked to animals regarding risk factors and transmission of brucellosis. Consumption of unpasteurized milk and its products should be condemned to curtail this neglected disease.

Primer caso confirmado de brucelosis humana por Brucella melitensis, una zoonosis presente en Colombia / First confirmed case of human brucellosis by Brucella melitensis, a zoonosis present in Colombia

Resumen La brucelosis, principal zoonosis a nivel mundial tiene alta prevalencia en varios países de Latinoamérica. Se asocia con la exposición a ganado infectado por distintas especies del género Brucella. B. melitensis la más virulenta para el humano, causa con frecuencia complicaciones de predominio osteoarticular. En Colombia se cree que la infección por B. melitensis es una entidad ausente, a pesar de su plausibilidad biológica en nuestro contexto; sin embargo, son escasos los estudios sobre su ocurrencia y mínimo el índice de sospecha de la enfermedad, por lo cual creemos está subdiagnosticada. Presentamos el primer caso confirmado de brucelosis por B. melitensis en Colombia en una joven embarazada, con diagnóstico incidental, en quien el análisis retrospectivo de su cuadro clínico alertó sobre puntos clave que pueden impactar en el diagnóstico y tratamiento oportuno de la enfermedad. Se plantean preguntas de prevalencia real de esta entidad en Colombia.

Summary Brucellosis, the principal zoonoses globally is highly prevalent in different countries of Latin America. It is associated with the exposition of livestock infected with different Brucella species, being B. melitensis the most virulent for humans, and frequently causing osteoarticular complications. In Colombia it is believed that B. melitensis infection is an absent entity, despite its biological plausibility in our context; however, there are few studies on its occurrence and a minimum index of suspicion of the disease, which is why we believe it is underdiagnosed. We present the first confirmed case of brucellosis by B. melitensis in Colombia diagnosed in a young pregnant patient, with an incidental diagnosis, in whom a retrospective analysis of her clinical outcome warned of key points that may impact on the diagnosis and timely treatment of the disease. We present several questions surrounding the real prevalence of this entity in Colombia.

Características epidemiológicas y diagnóstico de brucelosis en pacientes del instituto de medicina tropical, periodo 2017-2019 / Epidemiological characteristics and diagnosis of brucellosis in patients of the tropical medicine institute period 2017-2019

La brucelosis es una zoonosis que en humanos está relacionada íntimamente con la enfermedad en animales domésticos y de interés económico. Presenta 2 patrones: urbano-alimentario (consumo de leche y quesos no pasteurizados) y el rural-laboral (exposición profesional al ganado infectado). El objetivo consistió en conocer las características epidemiológicas y las técnicas que arriban al diagnóstico de Brucelosis, en un consultorio del Instituto de Medicina Tropical, del 2017 al 2019. Se realizó un estudio de tipo descriptivo y corte transverso. Se realizó el análisis de 44 pacientes con diagnóstico de Brucelosis. El 25 % de los pacientes requirieron internación. El rango de edad estuvo entre 7 a 61 años, con una media de 29 años, y una moda de 22. Las puertas de entrada fueron: por contacto con cabras positivas en el campo de práctica, faenadores, veterinarios, vacunadores, y por ingesta de leche sin pasteurizar. Las muestras serológicas por reacción de Huddleson fueron positivas a bajas diluciones; Aglutinación en tubo: 31 muestras positivas; aglutinación con 2 mercaptoetanol: 11 muestras positivas. Se llegó a la identificación de cepas Brucella melitensis biotipo 1: en 13 pacientes. Nuestro estudio indica la presencia de brucelosis humana, fundamentalmente por contacto directo debido a razones profesionales y /o laborales. La vigencia de Brucelosis deriva de una situación endémica en el ganado, y por tanto se deberán intensificar las medidas del saneamiento del ganado (vacunación) y la educación de la población de riesgo.

Brucellosis is a zoonosis in humans that is closely related to the disease in domestic and of economic interest- animals. It presents 2 main patterns: urban-alimentary (for consumption of unpasteurized milk and cheeses) and the rural-occupational (for professional exposure to infected cattle). The objective was to know the frequency of cases and the different laboratory techniques that arrives to the diagnosis of Brucellosis, in the Tropical Medicine Institute (IMT by its acronym in Spanish) during the period of 2017 to 2019. It has been made a descriptive and cross-sectional investigation. It was based on the analysis of 44 patients diagnosed with Brucellosis. 25% of the patients (11) required hospitalization. The age range was between 7 to 61 years, with a mean of 29 years old and a mode of 22. The portals of entry were: by contact with positive goats in the field of practice, slaughterhouses, veterinarians, vaccinators, and consume of unpasteurized milk. The serological samples by Huddleson reaction were positive with low dilutions; tube agglutination: 31 positive samples; agglutination with 2 mercaptoethanol: 11 positive samples. Biotype 1 of Brucella melitensis: identified in 13 patients. Our study indicates the existence of human brucellosis, mainly through direct contact due to professional and/or occupational reasons. This incidence must derive from an endemic situation in cattle, and therefore the measures of sanitation of cattle (vaccination) and education of the population at risk should be intensified

Spatial-temporal distribution of human brucellosis in mainland China from 2004 to 2017 and an analysis of social and environmental factors

BACKGROUND@#This study aimed to describe the changing distribution of human brucellosis between 2004 and 2017 in mainland China and seek scientific evidence of the relationship between socio-economic, environmental, and ecological factors and human brucellosis incidence.@*METHODS@#The annual numbers of brucellosis cases and incidence rates from 31 provinces in mainland China between 2004 and 2017 were obtained from the Data-Center for China Public Health Science. The number of monthly brucellosis cases in 2018 was obtained from the Chinese Center for Disease Control and Prevention. The electronic map of the People's Republic of China was downloaded from the National Earth System Science Data Sharing Platform. Human population density, gross domestic product (GDP), and an inventory of cattle and sheep at the end of each year from 2004 to 2017 were obtained from the National Bureau of Statistics of China. Annual rainfall data from 31 provinces in the People's Republic of China from 2004 to 2017 were collected from the China Meteorological Data Service Center. The risk distribution and changing trends of human brucellosis were mapped with ArcGIS. A cluster analysis was employed to identify geographical areas and periods with statistically significant incidence rates. Multivariate linear regression was used to determine possible factors that were significantly correlated with the presence of human brucellosis cases.@*RESULTS@#Human brucellosis cases have spread throughout the whole country. Human brucellosis cases occurred mostly from March to August and were concentrated from April to July. The inventory of sheep, GDP, and climate were significantly correlated with the presence of brucellosis cases in mainland China.@*CONCLUSIONS@#The geographical expansion of human brucellosis in mainland China was observed, so did the high-incidence clusters between 2004 and 2017. Most of the cases were reported during the early spring to early summer (February-August). Results from the multivariate linear regression suggested that the inventory of sheep, GDP, and climate were significantly associated with the incidence of human brucellosis in mainland China.

Comparative Evaluation of Rose Bengal Plate test and ELISA in lab Diagnosis of Human Brucellosis

Human brucellosis is a major bacterial zoonosis reported worldwide. It is mainly an occupational disease reported in farmers, veterinarians, slaughterhouse workers, animal handlers and meat inspectors. Unavailability of automated blood culture systems makes isolation difficult and diagnosis mainly depends on serological and molecular methods. Materials and Methods: In a prospective study, a total of 127 serum samples, 28 from pyrexia of unknown origin (PUO) cases and 99 from high risk cases like veterinary personnel, butchers, nomads, farmers and gawalas, were serologically tested by Rose Bengal Plate Test (RBPT) and enzyme-linked immumosorbent assay (ELISA) and results were analyzed. Results: Out of 127 samples, 20 were tested positive by RBPT while 24 tested positive by ELISA. None of the PUO cases and veterinary personnel tested positive by RBPT or ELISA. Positivity was more among males, urban area, history of animal contact and consumption of raw milk. ELISA was found to be more sensitive and specific than RBPT. Conclusion: In our study significant prevalence of brucellosis was found among occupationally exposed persons. Most of the positive cases were found to be asymptomatic and those who were symptomatic had non-specific complaints. The findings signified silent presence of disease in our society. RBPT can be used as a rapid screening test in the peripheral resource poor labs and in absence of culture ELISA can be used for further confirmation.

Evaluación del sistema Brucellacapt® para el diagnóstico serológico de la brucelosis humana en Cuba / Evaluation of the system Brucellacapt® for serological diagnosis of human brucellosis in Cuba

Introducción: En el diagnóstico microbiológico de la brucelosis, los métodos serológicos son los más utilizados. Brucellacapt® ofrece la ventaja de detectar en cualquier momento de la enfermedad anticuerpos aglutinantes y no aglutinantes contra Brucellaspp. Objetivos: Evaluar y aplicar el sistema serológico comercial Brucellacapt® para la detección de anticuerpos contra Brucella spp. Métodos: Se realizó una investigación en servicios y sistemas de tipo observacional con un estudio de caso control anidado, en el periodo de enero de 2015 a junio de 2016, en el Laboratorio Nacional de Referencia de Espiroquetas y Brucelas. Se evaluaron 50 sueros de casos y 100 de controles por Brucellacapt®. Se aplicó Brucellacapt® en 695 sueros de casos con sospecha clínica o epidemiológica de la enfermedad, los cuales fueron confirmados por ELISA. Resultados: Brucellacapt® mostró 100 por ciento de sensibilidad, 83 por ciento de especificidad, 54,6 por ciento de reactividad y 16,4 por ciento de positividad en las muestras estudiadas. Se confirmó por ELISA la presencia de anticuerpos IgM (21, 2 por ciento), IgG (6,1 por ciento) e IgM + IgG (7,6 por ciento). Doscientas cuarenta y seis muestras y otras siete fueron reactivas y positivas respectivamente, solo por Brucellacapt®. Conclusiones: Brucellacapt® contribuyó a la detección de anticuerpos en los sueros de pacientes sospechosos de la enfermedad con valores aceptables de sensibilidad y especificidad diagnóstica. Este resultado sugiere su implementación en la red nacional de laboratorios cubanos para fortalecer el diagnóstico y la vigilancia de la brucelosis humana en Cuba(AU)

Introduction: Serological methods are the most commonly used for the microbiological diagnosis of brucellosis. Brucellacapt® has the advantage of detecting agglutinating and non-agglutinating antibodies against Brucella spp. at any point in the evolution of the disease. Objectives: Evaluate and apply the commercially available serological system Brucellacapt® for detection of antibodies against Brucella spp. Methods: A nested case-control observational study was conducted of services and systems from January 2015 to June 2016 at the Spirochaete and Brucella National Reference Laboratory. Evaluation was performed of 50 serum samples from cases and 100 from controls using Brucellacapt®. The system was also used in 695 serum samples from clinically or epidemiologically suspected cases, which were confirmed by ELISA. Results: Brucellacapt® showed 100 percent sensitivity, 83 percent specificity, 54.6 percent reactivity and 16.4 percent positivity in the samples studied. Presence of the following antibodies was confirmed by ELISA: IgM (21.2 percent), IgG (6.1 percent) and IgM + IgG (7.6 percent). Two hundred forty-six samples and another seven were reactive and positive, respectively, only by Brucellacapt®. Conclusions: Brucellacapt® contributed to antibody detection in serum samples from suspected cases, with acceptable diagnostic sensitivity and specificity values. This result suggests its implementation in the Cuban national network of laboratories to strengthen the diagnosis and surveillance of human brucellosis in Cuba(AU)

Validation of Two Rapid Serological Tests for Human Brucellosis Detection

As brucellosis have several non-specific clinical phases, the search for reliable diagnosis of the disease is necessary. Therefore, for serological determination of brucellosis, rapid immunofiltration tests designated as ERIFA and NERIFA and ELISAs were developed and evaluated for diagnostic purposes. The sera were collected from Clinical Microbiology Department of Kars State Hospital between 2007 and 2009. These sera were used for determination of sensitivity of ELISAs, ERIFA and NERIFA in comparison to rose bengal test, Brucellacapt and serum agglutination tests. In the study, highest sensitivity was detected by ELISA, ERIFA and NERIFA, respectively. Specificity was highest with ELISA as 95.2% and with both ERIFA and NERIFA as 92.9% and the lowest was with RBT as 90.5%. When two ELISAs were compared based on the IgG sensitivity, there was no difference (p0.05) when IgM was accepted as a criteria for comparison. The current study reports the first evaluation of ERIFA and NERIFA in human beings. It is concluded that the RIFA models can be accepted as an ancillary test for diagnosis of human brucellosis in endemic countries.

Validation of Two Rapid Serological Tests for Human Brucellosis Detection

As brucellosis have several non-specific clinical phases, the search for reliable diagnosis of the disease is necessary. Therefore, for serological determination of brucellosis, rapid immunofiltration tests designated as ERIFA and NERIFA and ELISAs were developed and evaluated for diagnostic purposes. The sera were collected from Clinical Microbiology Department of Kars State Hospital between 2007 and 2009. These sera were used for determination of sensitivity of ELISAs, ERIFA and NERIFA in comparison to rose bengal test, Brucellacapt and serum agglutination tests. In the study, highest sensitivity was detected by ELISA, ERIFA and NERIFA, respectively. Specificity was highest with ELISA as 95.2% and with both ERIFA and NERIFA as 92.9% and the lowest was with RBT as 90.5%. When two ELISAs were compared based on the IgG sensitivity, there was no difference (p0.05) when IgM was accepted as a criteria for comparison. The current study reports the first evaluation of ERIFA and NERIFA in human beings. It is concluded that the RIFA models can be accepted as an ancillary test for diagnosis of human brucellosis in endemic countries.

Analysis on human brucellosis from national reports in China, 2006-2016 / 中华劳动卫生职业病杂志

Objective@#To characterize the features of human brucellosis from national reports of occupational diseases and infectious diseases in China during 2006-2016, and explore the correlations between human brucellosis with the livestock and their products.@*Methods@#From January to October 2018, the data of human brucellosis were extracted from China's annual national reports of occupational diseases and infectious diseases from government circulars during 2006-2016. The data on the number of livestock and the output of livestock products were obtained from China Statistical Yearbook, China Animal Industry Yearbook and China Animal Industry and Veterinary Yearbook. The standards of Diagnosis of occupational infectious disease (GBZ 227-2017) and Diagnostic criteria for brucellosis (WS 269-2007) were compared. The statistics were analyzed using Excel 13.0 and SPSS software 22.0. The linear regression and multiple regression were used to explore the relationships between human brucellosis with the number of livestock and the output of livestock products.@*Results@#The diagnosis of human brucellosis in national reports of occupational diseases was based on GBZ 227-2017, which referred to WS 269-2007. There is an increasing trend from 2006 to 2009, and then declined to 2011, but rebounded from 2012 onwards in human brucellosis in national reports of occupational diseases. The general trend showed an increase during the 2006-2014 period, and then a decrease onwards in human brucellosis in national reports of infectious diseases. The Spearman correlation from SPSS showed the rs value of 0.936 (P<0.001) between human brucellosis cases in national reports of occupational diseases and infectious diseases in China from 2006 to 2016. Human brucellosis had a seasonal and periodic trend, and the cases revealed an epidemic period from April to August, with a peak in June. Human brucellosis cases were positively correlated with the number of cattle and buffaloes, hogs, sheep and goats (P<0.05) , and the output of pork, beef and mutton (P<0.05) . And human brucellosis cases in national reports of infectious diseases were positively associated with the output of sheep wool (β=0.814) , goat wool (β=0.603) , and cashmere (β=0.562) .@*Conclusion@#Human brucellosis both in national reports of occupational diseases and infectious diseases remain severe in China. There are relationships between human brucellosis with the number of livestock and the output of livestock products.

Analysis on epidemic of human brucellosis in Jiangxi Province from 2011 to 2017 / 中华疾病控制杂志

Objective To investigate the epidemic characteristics of human brucellosis in Jiangxi province from 2011 to 2017，thereby providing reference for future prevention and control work. Methods We analyzed the case information reported in the National Notifiable Infectious Diseases Reporting Information System of Jiangxi Province during 2011-2017 by combining with the monitoring data. Results A total of 239 cases were recorded over these six years, with an average incidence rate of 0.08/100 000. Most cases and agglomerations were concentrated in the Nanchang area (48 cases/4 cases), with the case distribution ranging from 1 in 2011 to all in 2016, and the number of counties(districts) involved had increased from 1 in 2011 to 68 in 2017, which increased rapidly year by year ( 2= 94.31, P<0.001). The gender ratio was 3.12 ∶〗1(181 ∶〗58). Most cases were concentrated in the 40-65 age group, while farmers and herdsmen were high-risk population, accounting for 59.83 % (143/239). The incidence of brucellosis peaked from May to September (May peak and September peak). In 2012-2017, 7 160 blood samples were collected from risk population, with 95 being positive for Brucella (1.33 %). From 2013 to 2017, 62 strains of the Brucella, 4 were Brucella melitensis type1, 54 were Brucella melitensis type3 and 4 were Brucella suis were isolated from 193 cases. Conclusions The human brucellosis was aggravated in Jiangxi province, with the expansion of regional scope. Therefore, more efforts should be focused on regulation to prevent and control brucellosis better.

Cellulitis in human brucellosis: An atypical presentation

@#Introduction: Brucellosis is a zoonotic disease with variable clinical manifestations and atypical presentation in humans. Human brucellosis cases are not seen often in Malaysia. Case Report: This is a case report of 19 years old gentleman who presented with fever, lower limb redness, pain and swelling. He was initially treated as cellulitis. However, based on the recovery of Brucella melitensis from his blood culture, he was later diagnosed to have brucellosis. He had a history of consumption of fresh goat’s milk and uncooked meat which could have been the possible modes of transmission. Brucella serology IgM and IgG were both positive, and anti-Brucella immunocapture agglutination test (BrucellaCapt) was also positive with a titer of 1:2560. He was treated with six weeks of oral doxycycline 100 mg twice daily and oral rifampin 450 mg twice daily. Discussion: This is a case of human brucellosis with atypical cutaneous involvement.

Trends of reported human brucellosis cases in mainland China from 2007 to 2017: an exponential smoothing time series analysis

BACKGROUND@#The main objective of this study was to describe the temporal distribution of monthly reported human brucellosis cases in mainland China and develop an appropriate time series model for short-term extrapolation forecast.@*METHODS@#Surveillance data of the monthly reported human brucellosis cases occurring from April 1, 2007, to March 31, 2017, in mainland China were obtained. The spectrum analysis was first adopted to find the cyclic and seasonal features, the existence of the seasonality and trend was determined by exponential smoothing method and the seasonal-trend decomposition. The candidate models of exponential smoothing included the additive model and multiplicative model; R was selected as the indicator for the selection of candidate model, and the stability of the model was verified by adjusting the training data and test data set. Finally, the extrapolations of monthly incident human brucellosis cases in 2017 were made.@*RESULTS@#From April 1, 2007, to March 31, 2017, a total of 435,108 cases of Brucellosis occurred in mainland China were reported, with an average of 3626 cases per month and a standard deviation of 1834 cases. The R of the exponential smoothing method that based on additive model increased steadily from 0.927 to 0.949 with the increase of the data volume. Ten of 12 actual values fell in the confidence interval of predicted value.@*CONCLUSIONS@#Human brucellosis cases peaked during the months from March to August in mainland China, with clear seasonality. The exponential smoothing based on the additive model method could be effectively used in the time series analysis of human brucellosis in China. Control methods, such as vaccination, quarantine, elimination of infected animals, and good hygiene within the production cycle, should be strengthened with paying more attention to the seasonality. Further research is warranted to explore the drivers behind the seasonality.

Development of a universal probe based microRNA assay and detection of plasma microRNA-146a of human brucellosis / 中国人兽共患病学报

We developed a universal probe based microRNA detection assay and applied it to detect microRNA-146a in human brucellosis,testing the possibility of using it as diagnosis signature.By using orthogonal design,the annealing temperature,probe concentration and commercial kits were optimized and the assay was developed.Total RNAs were isolated from plasma of human brucellosis and healthy control,and microRNA-146a was detected and compared.Results reveal that the optimized universal probe assay was established,which was more specific than the SYBR GreenI assay,and had a wider range of amplification.Compared with healthy control,the application of universal probe assay for the detection of serum microRNA146a in patients with brucellosis was significantly inhibited (P＜0.01).Implying the potential of microRNA-146a as biomarker in diagnosis of brucellosis.It is suggested that universal probe based assay is a universal,specific and sensitive method for microRNA detection.MicroRNA-146a represents a potential biomarker for human brucellosis diagnosis.

Investigation of human brucellosis diagnosis and report quality in medical institutions in key areas of Shanxi province / 中华流行病学杂志

Objective To evaluate the accuracy of human brucellosis diagnosis and reporting in medical institutions in Shanxi province, and understand the performance of clinical doctors to diagnose human brucellosis according to diagnostic criteria. Methods Field investigation was conducted in 6 medical institutions in the key areas of human brucellosis in Shanxi province. The diagnosis data of the reported brucellosis cases in 2015 were collected and reviewed retrospectively for the evaluation of the diagnosis accuracy with systematic sampling method. The database was established with Excel 2010 and the descriptive analysis and statistical test were conducted with software R 3.3.2. Results The diagnosis consistent rate of the 377 brucellosis cases reviewed was 70.8% (267/377), the diagnosis consistent rates in medical institutions at city-level and country-level were 77.0%(127/165) and 66.0%(140/212) respectively, the differences had significance (χ2=5.4, P=0.02). Among the reviewed cases, the diagnosis consistent rate of laboratory diagnosis and clinical diagnosis were 87.1%(256/294) and 13.3%(11/83) respectively, and the differences had significance (χ2=170.7, P<0.001) . Among the 21 investigated clinical doctors, the numbers of the doctors who correctly diagnosed the suspected cases, probable cases and lab-confirmed cases were only 3, 0 and 8 respectively. All of the clinical doctors knew that it is necessary to report the brucellosis cases within 24 hours after diagnosis. Conclusion The accuracy of human brucellosis diagnosis in key areas of human brucellosis in Shanxi was low, and the performance of the clinical doctors to diagnose human brucellosis according to diagnostic and case classification criteria was unsatisfied.

Investigation of human brucellosis diagnosis and report quality in medical institutions in key areas of Shanxi province / 中华流行病学杂志

Objective To evaluate the accuracy of human brucellosis diagnosis and reporting in medical institutions in Shanxi province, and understand the performance of clinical doctors to diagnose human brucellosis according to diagnostic criteria. Methods Field investigation was conducted in 6 medical institutions in the key areas of human brucellosis in Shanxi province. The diagnosis data of the reported brucellosis cases in 2015 were collected and reviewed retrospectively for the evaluation of the diagnosis accuracy with systematic sampling method. The database was established with Excel 2010 and the descriptive analysis and statistical test were conducted with software R 3.3.2. Results The diagnosis consistent rate of the 377 brucellosis cases reviewed was 70.8% (267/377), the diagnosis consistent rates in medical institutions at city-level and country-level were 77.0%(127/165) and 66.0%(140/212) respectively, the differences had significance (χ2=5.4, P=0.02). Among the reviewed cases, the diagnosis consistent rate of laboratory diagnosis and clinical diagnosis were 87.1%(256/294) and 13.3%(11/83) respectively, and the differences had significance (χ2=170.7, P<0.001) . Among the 21 investigated clinical doctors, the numbers of the doctors who correctly diagnosed the suspected cases, probable cases and lab-confirmed cases were only 3, 0 and 8 respectively. All of the clinical doctors knew that it is necessary to report the brucellosis cases within 24 hours after diagnosis. Conclusion The accuracy of human brucellosis diagnosis in key areas of human brucellosis in Shanxi was low, and the performance of the clinical doctors to diagnose human brucellosis according to diagnostic and case classification criteria was unsatisfied.

Human brucellosis mimicking axial spondyloarthritis: a challenge for rheumatologists when applying the 2009 ASAS criteria / 华中科技大学学报（医学）（英德文版）

Although the development of the 2009 SpA classification criteria by Assessment of SpondyloArthritis international Society (ASAS) represents an important step towards a better definition of the early disease stage particularly in axial spondyloarthritis (axSpA), the specificity of the criteria has been criticized these days. As the commonest zoonotic infection worldwide, human brucellosis can mimic a large number of diseases, including SpA. This study was performed to determine the frequency of rheumatologic manifestations in patients with brucellosis and the chance of misdiagnosing them as having axSpA in central China. The results showed that clinical manifestations of axSpA could be observed in brucellosis. Over half of patients had back pain, and one fifth of the patients with back pain were less than 45 years old at onset and had the symptom for more than 3 months. Two young males were falsely classified as suffering from axSpA according to the ASAS criteria, and one with MRI proved sacroiliitis was once given Etanercept for treatment. Therefore, differential diagnosis including human brucellosis should always be kept in mind when applying the ASAS criteria, even in traditionally non-endemic areas.