Epidemiological characteristics of brucellosis in Jiaxing City from 2010 to 2021 / 预防医学

Objective@#To investigate the epidemiological characteristics of human brucellosis in Jiaxing City from 2010 to 2021, so as to provide insights into the development of the brucellosis control strategy.@*Methods@#The epidemiological and clinical data of brucellosis patients and epidemiological data of brucellosis outbreaks in Jiaxing City from 2010 to 2021 were collected from Chinese Disease Control and Prevention Information System, and the epidemiological features and outbreaks of brucellosis were analyzed descriptively.@*Results@#Totally 160 brucellosis patients were reported in Jiaxing City from 2010 to 2021, and the incidence of brucellosis appeared a tendency towards a rise (χ2trend=28.564, P=0.002), with annual mean incidence of 0.29/105. No deaths due to brucellosis occurred in Jiaxing City from 2010 to 2021. Brucellosis cases were reported each month, which were concentrated in the first and second quarters, and the greatest number was seen in May (27 cases, 16.88%). The brucellosis cases were predominantly reported in Tongxiang City (114 cases, 71.25%), and 75.00% were male (120 cases) and 70.63% were occupational populations (113 cases). The patients had a median (interquartile range) age of 57 (12) years at onset, and the median duration (interquartile range) from onset to definitive diagnosis was 18 (28) days. The clinical manifestations mainly included fever and weakness, and a total of 18 Brucella melitensis isolates and one B. bovis isolate were cultured.@*Conclusions@#The incidence of brucellosis was rising in Jiaxing City from 2010 to 2021. The brucellosis patients were predominantly reported in Tongxiang City in the first and second quarters, and young, middle-aged men and occupational populations were at a high risk of brucellosis.

The role of the serum tube agglutination test in the monitoring of human brucellosis: evaluation of post-treatment SAT titers

SUMMARY OBJECTIVE: Positive results of the serum tube agglutination test that persist after treatment may be interpreted by clinicians as treatment failures. Therefore, our study examined the value of serum tube agglutination test in demonstrating treatment success. METHODS: In this retrospective study conducted at a single center, the pre- and post-treatment serum tube agglutination test titers of patients diagnosed with brucellosis were compared. RESULTS: The end-of-treatment serum tube agglutination test titer was negative in 24 (18%) of 139 patients diagnosed with brucellosis. The most common complaints of the patients were fever (78.4%), chills (88.5%), sweating (84.9%), anorexia (79.1%), and arthralgia (63.3%). The rate of positive blood culture before the treatment was 68.3%. The absence of fever (p=0.005) and arthralgia (p=0.024) and the pretreatment serum tube agglutination test titer of <1/160 (p=0.014) were significant markers of serological cure. CONCLUSION: Although serum tube agglutination test is an effective and very successful test in the diagnosis of brucellosis, our study shows that serum tube agglutination test is not useful in demonstrating the treatment success of human brucellosis in the early post-treatment period.

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)

RESUMEN 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 %), las edades entre 25 y 54 años (66,1 %), el contacto directo con reservorios animales de Brucella spp. (78,5 %) y, como síntomas predominantes, el malestar general (58,5 %), los dolores articulares (56,9 %) y la fiebre (55,4 %). 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.

ABSTRACT 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%), age between 25 and 54 years (66.1%), and direct contact with animal reservoirs of Brucella spp. (78.5%) prevailed among the individuals reported with human brucellosis. General malaise (58.5%), joint pain (56.9%), and fever (55.4%) 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.

Levantamento sorológico de brucelose em bovinos monitorados no estado da Bahia / Serological survey of brucellosis in cattle monitored in the estate of Bahia

A brucelose é uma doença bacteriana de grande importância para a economia pecuária e para a saúde pública por se tratar de uma zoonose. É uma doença infecto-contagiosa que tem com agente etiológico bactérias do gênero Brucella. Em bovinos, as espécies do gênero é a Brucella abortus, que são cocobacilos gram negativo, intracelulares facultativos, imóveis e não esporulado. A infecção apresenta evolução crônica e acomete animais de todas as idades, sendo mais frequente em indivíduos sexualmente maduros. O objetivo desse trabalho é investigar, por meio da sorologia para brucelose bovina, utilizando a técnica do ELISA indireto, amostras de animais reagentes abatidos em frigoríficos inspecionados no estado da Bahia. Foram utilizados 666 animais, selecionados aleatoriamente no momento do abate. O sangue foi coletado com finalidade de obtenção de soro, todas as amostras foram submetidas à prova de triagem do Antígeno Acidificado Tamponado (AAT), prova do 2mercaptoetanol (2-ME) e ELISA Indireto. Das amostras reagentes no teste do AAT, obteve-se uma prevalência estimada em 1,2%. A prevalência no teste do ELISA foi de 13,21% (n=86). Esse resultado sugere a ocorrência de falsos negativos quando se utiliza a prova do antígeno acidificado tamponado.

Brucellosis is a bacterial disease of great importance to the livestock economy and to public health because it is a zoonosis. It is an infectious disease that has etiologic agent with bacteria of the genus Brucella. In cattle, the species of the genus Brucella is Brucella abortus that are gram negative, facultative intracellular, real estate and not sporulated. The infection presents chronic and affects animals of all ages, being more frequent in sexually mature individuals. This study aimed to investigate through serology for brucellosis, using the technique of indirect ELISA, samples from positive animals slaughtered in slaughterhouses inspected in the state of Bahia. A total of 666 animals were used, randomly selected at the time of slaughter. Blood was collected in order to obtain serum, all samples were subjected to a screening test Antigen Buffered Acidified (AAT), proof of 2-mercaptoethanol (2-ME) and Indirect ELISA. Of reagents in the test samples of AAT obtained an estimated prevalence of 1.2%. The prevalence in the ELISA test was 13.21% (n = 86). This result suggests the occurrence of false negatives when using the buffered acidified antigen test.

Reactivación de brucelosis en paciente receptor de trasplante hematopoyético autólogo: reporte de caso / Reactivation of brucellosis in an autologous hematopoietic transplant recipient: a case report

Introducción: La brucelosis es la zoonosis más frecuente, producida por el género brucella, que afecta a varias especies de mamíferos y dentro de ellos a los humanos. Se transmite al hombre por contacto directo con los animales infectados, por sus excretas o por la ingestión de productos no pasteurizados. En los últimos años se ha descrito un incremento de la enfermedad en los pacientes inmunocomprometidos. Objetivo: Describir la reactivación de la brucelosis en paciente receptor de un trasplante hematopoyético, su curso y manejo. Presentación de caso: Se presenta una paciente con linfoma de Hodgkin y antecedentes de brucelosis que recibió un trasplante hematopoyético autólogo mieloablativo. Después de la recuperación hematológica, inició con cuadro de fiebre, diaforesis, dolores articulares y hepato-esplenomegalia. Se le diagnosticó brucelosis, por lo que se inició tratamiento con doxiciclina y rifampicina, con lo que se logró la eliminación de los síntomas y la negativización de las pruebas evolutivas. Conclusiones: La brucelosis puede mantenerse meses o años asintomática y reactivarse después de la inmunosupresión en los pacientes trasplantados. Su sospecha y rápido tratamiento puede lograr la curación y evitar complicaciones(AU)

Introduction: Brucellosis is the most frequent zoonosis, produced by the genus brucella, which affects several species of mammals, including human beings. It is transmitted to persons by direct contact with infected animals, by their excreta or by ingestion of unpasteurized products. In recent years, an increase has been described in immunocompromised patients. Objectives: To describe the reactivation of brucellosis in a hematopoietic transplant recipient patient, its course and management. Case presentation: A patient with Hodgkin's lymphoma and a history of brucellosis is presented; that she received a myeloablative autologous hematopoietic transplant. After haematological recovery, she started with symptoms of fever, diaphoresis, joint pain and hepato-splenomegaly. She was diagnosed with brucellosis, so treatment with doxycycline and rifampin was started, which eliminated the symptoms and made the evolutionary tests negative. Conclusions: Brucellosis can be asymptomatic for months or years and after immunosuppression it can be reactivated in transplanted patients. Suspicion and prompt treatment can bring about a cure and avoid complications(AU)

Brucellosis and sacroiliitis: A differential diagnosis to keep in mind / Sacroiliitis por brucelosis: Un diagnóstico diferencial para tener presente

ABSTRACT Brucellosis is a zoonosis that causes a multi-organ granulomatous infection. It has diverse and non-specific clinic features that can make diagnosis difficult. Medical personnel often do not recognize it early. Delayed treatment is associated with high morbidity and even mortality. Its timely diagnosis requires a high index of suspicion. The case is presented of a 35-year-old male zootechnologist, previously healthy, with a progressive picture of two months of evolution of irradiated low back pain to the left hip, nocturnal diaphoresis, and unintentional weight loss. Elevation of acute phase reactants was documented and magnetic resonance imaging found signs of iliopsoas tendonitis and inflammatory changes in the left sacroiliac joint. The IgG and IgM antibodies using an immunoassay forbrucella were positive. After establishing antibiotic treatment, a marked clinical improvement, with resolution of the inflammatory process was evident.

RESUMEN La brucelosis es una zoonosis que genera una infección granulomatosa multiorgánica. Tiene una clínica diversa e inespecífica que puede hacer difícil el diagnóstico. Con frecuencia, el personal médico no la reconoce de forma temprana. El retraso en el tratamiento se asocia con una gran morbilidad e incluso mortalidad. Su diagnóstico oportuno requiere un alto índice de sospecha. Se presenta el caso de un hombre de 35 arios, zootecnista, previamente sano, con un cuadro progresivo de dos meses de evolución de dolor lumbar irradiado a cadera izquierda, diaforesis nocturna y pérdida no intencional de peso. Se documentó elevación de reactantes de fase aguda y en la resonancia magnética se encontraron signos de tendinitis del psoas y cambios inflamatorios en la articulación sacroilíaca izquierda. Los anticuerpos IgG e IgM por inmunoensayo para Brucella fueron positivos, y luego de instaurar tratamiento antibiótico se evidenció marcada mejoría clínica con resolución del proceso inflamatorio.

An uncommon case of brucellosis with ocular presentation / Um caso incomum de brucelose com apresentação ocular

ABSTRACT We report an unusual case of brucellosis presented with headache, diminished vision, papillitis and multiple peripapillary hemorrhages accompanied by subretinal fluid extending up to macula. Diagnosis of brucellosis was made based on positive polymerase chain reaction of cerebrospinal fluid sample for Brucella species DNA, accompanied by a raised titer of anti-brucella antibodies. Patient showed remarkable improvement on triple drug therapy in form of doxycycline, rifampicin and ceftriaxone.

RESUMO Relatamos um caso incomum de brucelose apresentada com cefaleia, visão diminuída, papilite e múltiplas hemorragias peripapilares acompanhadas por fluido sub-retinal, estendendo-se até a mácula. O diagnóstico de brucelose foi feito com base na reação em cadeia da polimerase positiva de amostra de líquido cefalorraquidiano para DNA de espécies de Brucella, acompanhada por um título elevado de anticorpos antibrucela. O paciente apresentou melhora notável com a terapia tripla com drogas na forma de doxiciclina, rifampicina e ceftriaxona.

Epidemiological characteristics and spatial clustering analysis of brucellosis in Shandong Province from 2015 to 2020 / 中华地方病学杂志

Objective:To learn about the epidemiological and spatial clustering characteristics of brucellosis in Shandong Province, and to provide a reference for scientific prevention and control of brucellosis.Methods:The epidemic data of human brucellosis in Shandong Province from January 2015 to December 2020 were collected from the Infectious Disease Reporting Information Management System of China Disease Control and Prevention Information System, and the data were analyzed by descriptive epidemiology and spatial clustering analysis.Results:A total of 18 811 cases of human brucellosis were reported in Shandong Province from 2015 to 2020, and the average annual incidence rate was 3.16/100 000. Human brucellosis occurred in every month of the year, and the peak incidence was from March to August, accounting for 66.31% (12 474/18 811). The top 5 counties (districts) with average annual incidence rates were Lijin County (32.39/100 000), Kenli District (11.02/100 000), Wudi County (10.35/100 000), Zhanhua District (9.59/100 000) and Shanghe County (8.80/100 000). There were 13 436 males and 5 375 females, with a male-female sex ratio of 2.50 ∶ 1.00; the age was mainly concentrated in 30-69 years old, accounting for 83.23% (15 656/18 811); farmer was the main occupation, accounting for 85.82% (16 144/18 811). The results of global spatial autocorrelation analysis showed that the annual incidence rates of brucellosis in Shandong Province showed a spatial clustering distribution from 2015 to 2020; and the local spatial autocorrelation analysis showed that the high incidence of human brucellosis was mainly concentrated in the north of Shandong Province.Conclusions:The incidence of brucellosis in Shandong Province is mainly concentrated in spring and summer, most of them are farmers, and the high incidence areas have spatial clustering. Key prevention and control measures should be taken for high incidence seasons, high-risk population and northern high clustering areas to reduce the incidence of brucellosis.

Epidemiological analysis of human brucellosis in Ningxia Hui Autonomous Region from 2004 to 2019 / 中华地方病学杂志

Objective:To learn about the epidemiological characteristics and trends of brucellosis in Ningxia Hui Autonomous Region (Ningxia), and to provide reference for formulation of brucellosis prevention strategies and identification of key areas.Methods:The case data from 2004 to 2019 were collected from the "China Disease Prevention and Control Information System Infectious Disease Monitoring and Reporting System", and descriptive epidemiological methods were used to analyze the distribution of cases (time, population, and regional distribution).Results:From 2004 to 2019, a total of 15 337 human brucellosis cases and 1 death case were reported in Ningxia. The average annual incidence rate was 15.21/100 000, ranging from 0.02/100 000 to 44.83/100 000. The difference in incidence rate in different years was statistically significant (χ 2 = 14 731.60, P < 0.001). Among them, from 2004 to 2010, the incidence rate was low, with an average annual incidence rate of 1.32/100 000; from 2011 to 2019, it entered a high incidence stage, with an average annual incidence rate of 24.83/100 000. Brucellosis occured in every month of the year, and the onset time was mainly in March to September, accounting for 71.60% (10 981/15 337); seasonal indexes from April to August was all > 100%, with obvious seasonality. The age of onset mainly concentrated in 20 - < 70 years old, accounting for 89.60% (13 742/15 337); males were significantly more than females, with a sex ratio of 2.66 ∶ 1.00 (11 141/4 196); the occupations were mainly farmers and herdsmen, accounting for 86.03% (13 194/15 337). Since 2014, cases had been reported in 22 counties (districts, cities) in the region, all of which were all severely endemic areas; the top three counties (districts) with incidence rate were Yanchi County (103.73/100 000), Hongsibao District (56.01/100 000) and Tongxin County (29.18/ 100 000), respectively, the difference between different regions was statistically significant (χ 2 = 3.80, P < 0.001). Conclusions:The incidence rate of brucellosis in Ningxia is on the rise, and the epidemic situation is severe. It is recommended to carry out active and effective intervention measures in areas with high incidence of brucellosis to curb the further spread of brucellosis.

Epidemiological analysis of human brucellosis in Ordos City, Inner Mongolia Autonomous Region from 2016 to 2020 / 中华地方病学杂志

Objective:To analyze the epidemic status and characteristics of human brucellosis in Ordos City, and to provide basis for formulating perfect prevention and control countermeasures of brucellosis.Methods:The data of reported human brucellosis cases in Ordos City from 2016 to 2020 were collected through the Chinese Disease Prevention and Control Information System. Descriptive epidemiological method was used to analyze the distributions of time, region and population.Results:Totally 2 861 cases of human brucellosis were reported in Ordos City from 2016 to 2020. The average annual incidence rate was 27.68/100 000 and no deaths. The incidence rate of human brucellosis decreased year by year from 2016 to 2018 (24.11/100 000, 20.82/100 000, 20.11/100 000). But the incidence rate began to pick up in 2019 (24.59/100 000) and rose to 48.53/100 000 in 2020. The incidence peak was from March to August (1 882 cases). The cases had been reported in all over 9 banners (districts) of the city. The cumulative number of reported cases from more to less was Hangjin Banner, Dalat Banner, Otog Front Banner, Jungar Banner, Otog Banner, Dongsheng District, Wushen County, Ejin Horo Banner and Kangbashi District. The cases were predominantly male, and the sex ratio of male to female was 2.23∶1.00 (1 974 ∶ 887). The onset was mainly young and middle-aged adults, and the age was mainly 30-69 years old (2 541 cases). Farmers accounted for 65.26% (1 867 cases) in all reported cases, followed by herdsmen, accounting for 18.98% (543 cases).Conclusions:There is an obvious upward trend of human brucellosis in Ordos City in recent years, mainly among young and middle-aged male farmers. Health education for key populations should be strengthened, as well as personal protection during high-risk operations.

Two cases of brucellosis complicated with liver abscess or pancytopenia / 中华全科医师杂志

Two brucellosis patients with rare complications are presented in this report. In case 1, abdominal CT showed two liver abscesses with the maximum diameter>5.0 cm, no puncture and drainage were given. After treatment with anti brucellosis drugs, the abscess lesions disappeared completely. Case 2 had pancytopenia, the platelet count was reduced to 14×10 9/L. After anti brucellosis drug treatment the peripheral blood routine returned to normal. These two cases of rare complications of brucellosis suggests that early identification, diagnosis and treatment can improve the clinical outcomes of the patients.

Prevalencia de Brucelosis en trabajadores de la industria cárnica en el Perú / Prevalence of Brucellosis in meat industry workers in Peru

La brucelosis es una enfermedad zoonótica causada por especies de Brucella a través de animales domésticos infectados. En áreas endémicas, ciertas ocupaciones tales como veterinarios, carniceros y trabajadores de mataderos son considerados de alto riesgo en relación con la brucelosis. Evaluamos la seroprevalencia de brucelosis en personas con ocupaciones de alto riesgo en tres mataderos de ganado bovino en Perú. Para cada uno de ellos se completó un cuestionario que incluía datos demográficos, antigüedad en el empleo y uso de equipo de protección personal, luego se obtuvieron muestras de sangre y se analizaron mediante la técnica de ELISA para detectar anticuerpos IgM anti Brucella. En general, 49 de 173 (28,32%) participantes exhibieron serorreactividad para la brucelosis. Cefalea, dolor en las articulaciones, sudores nocturnos, fiebre y anorexia fueron síntomas comunes en los casos seropositivos. Además, el 63,27% de los participantes seropositivos estaban asintomáticos. La prevalencia de brucelosis en estos grupos ocupacionales en relación a la ausencia de manifestaciones clínicas en un número significativo de ellos fue alta, por lo que los exámenes clínicos periódicos en estos grupos parecen ser esenciales para el sistema de vigilancia de la brucelosis. Se debe alentar el uso regular y constante de equipo de protección personal, especialmente anteojos protectores, entre los trabajadores del matadero de ganado para reducir la infección por brucelosis(AU)

Brucellosis is a zoonotic disease caused by Brucella species through infected domestic animals. In endemic areas, certain occupations such as veterinarians, butchers, and slaughterhouse workers are considered high risk for brucellosis. We evaluated the seroprevalence of brucellosis in people with high-risk occupations in three cattle slaughterhouses in Peru. A questionnaire including demographic data, length of employment, and the use of personal protective equipment was completed for each of them, then blood samples were obtained and analyzed using the ELISA test to detect anti-Brucella IgM antibodies. Overall, 49 of 173 (28, 32%) participants exhibited seroreactivity for brucellosis. Headache, joint pain, night sweats, fever, and anorexia were common symptoms in seropositive cases. Furthermore, 63.27% of seropositive participants were asymptomatic. The prevalence of brucellosis in these occupational groups in relation to the absence of clinical manifestations in a significant number of them was high, thus periodic clinical examinations in these groups appear to be essential to the brucellosis surveillance system. Regular and consistent use of equipment should be encouraged of personal protection, especially goggles, among cattle slaughterhouse workers for reduce brucellosis infection(AU)

Seropositividad de Brucella abortus en ganado bovino de Aguazul- Casanare / Seropositivity of Brucella abortus in cattle from Aguazul- Casanare

Resumen Introducción. La Brucelosis bovina, es una enfermedad bacteriana e infecto contagiosa, causada por Brucella abortus. Se transmite a través de la ingestión de forrajes y aguas contaminadas con descargas vaginales infectadas, que conlleva a una patología del sistema reproductor en bovinos, que impactan la sanidad pecuaria y la economía de la agroindustria. Objetivo. Evaluar el comportamiento de la brucelosis bovina en el municipio de Aguazul, Casanare (Colombia) y los factores asociados al desarrollo de esta enfermedad. Metodología. Estudio descritptivo de 26.187 muestras de suero sanguíneo de ganado bovino evaluadas, que corresponden a 260 predios del municipio de Aguazul. Se empleó técnicas serológicascomo rosa de bengala, fluorescencia polarizada y ELISA competitiva para la evaluación de positividad a Brucella abortus y se evaluaron las pérdidas económicas asociadas a positividad en los ensayos de laboratorio. Resultados y conclusiones. La positividad a brucelosis bovina correspondió al 1%, que corresponde a hembras menores de 24 meses de edad y entre 37 a 48 meses y, machos entre los 57 a 68 meses de edad. Se sugiere consolidar esfuerzos en investigación para evaluar los factores que contribuyen a la seropositividad en el ganado y el riesgo para la propagación y mantenimiento de la enfermedad.

Abstract Introduction. Bovine brucellosis is a contagious bacterial and infectious disease caused by Brucella abortus. It is transmitted through the ingestion of forage and water contaminatedwith infected vaginal discharges, which leads to a pathology of the reproductive system inbovines, which impacts livestock health and the economy of agribusiness. Aim. To evaluatethe behavior of bovine brucellosis in the municipality of Aguazul, Casanare (Colombia) and the factors associated with the development of this disease. Methodology. Descriptive study of 26,187 bovine blood serum samples evaluated, corresponding to 260 farms in the municipality of Aguazul. Serological techniques such as rose bengal, polarized fluorescence, and competitive ELISA were used to evaluate positivity to Brucella abortus and the economic losses associated with positivity in laboratory tests were evaluated. Results and conclusions. The positivity to bovine brucellosis corresponded to 1%, which corresponds to females under 24 months of age and between 37 to 48 months and males between 57 to 68 months of age. It is suggested to consolidate research efforts to evaluate the factors that contribute to seropositivity in cattle and the risk for the spread and maintenance of the disease

Comparison of random forests and SARIMA in Predicting Brucellosis Incidence / 公共卫生与预防医学

Objective To compare the effects of random forest and SARIMA (Seasonal Autoregressive Integrated Moving Average) on predicting incidence rate of brucellosis. Methods Using Brucellosis cases reported in the China Disease Prevention and Control Information System from 2005 to 2017, two models, random forest and SARIMA, were established for training and forecasting, and the forecasting results of the two models were compared. Results The R2 (R Squared) and RMSE (Root Mean Squared Error) of SARIMA model and random forest model are 0.904, 0.034351, 0.927 and 0.03345 respectively. Conclusion Both models have high prediction accuracy and can predict the incidence of brucellosis. Random forest prediction is a little bit better than SARIMA model and has more practical value.

Epidemic trend and epidemiological characteristics of human brucellosis in Chengyang District of Qingdao City from 2016 to 2020 / 中华地方病学杂志

Objective:To investigate the epidemic trend and epidemiological characteristics of human brucellosis in Chengyang District of Qingdao City, and to provide a theoretical reference for formulating scientific prevention and control measures.Methods:The data of confirmed and clinically diagnosed brucellosis cases with current address in Chengyang District of Qingdao City reported by China Disease Control and Prevention Information System from January 2016 to December 2020 were collected, and the epidemic trend, three-dimensional distribution, clinical characteristics, case consultation and disease outcome and epidemiological history of human brucellosis were descriptively analyzed.Results:From 2016 to 2020, 23 cases of human brucellosis were reported in Chengyang District of Qingdao City, with an annual incidence of 0.52/100 000, and the incidence was decreasing year by year (χ 2trend = 7.83, P = 0.005). The onset time was mainly distributed in spring and summer, of which spring (1, 5 and 5 cases respectively from March to May) accounted for 47.83% (11/23), and summer (1, 4 and 1 cases respectively from June to August) accounted for 26.09% (6/23). There were 13 cases of males and 10 cases of females, the ratio of male to female was 1.30 ∶ 1.00; the age of onset was (52.52 ± 14.67) years old, mainly from 40 to 65 years old, accounted for 65.22% (15/23); farmers accounted for 69.57% (16/23). The largest number of reported cases was in Chengyang Street (6 cases), followed by Xiazhuang Street (4 cases) and Liuting Street (4 cases), accounted for 60.87% (14/23). The main clinical manifestations were fever (21 cases, 91.30%), followed by muscle and joint soreness (18 cases, 78.26%), fatigue (18 cases, 78.26%), and hyperhidrosis (15 cases, 65.22%). The median time interval from onset to diagnosis was 27 days, and 82.61% (19/23) of the cases were diagnosed as brucellosis at the acute stage. After follow-up, 21 cases (91.30%) reached the recovery standard, and 2 cases (8.70%) improved. Verified by the epidemiological investigation, 23 cases of human brucellosis had multiple routes of infection. The main mode of infection was direct contact, including feeding suspected sick animals (8 cases, 34.78%), contacting urine, feces and other excrement of suspected sick animals (8 cases, 34.78%), delivering suspected sick animals/disposing the apoblema (5 cases, 21.74%), and slaughtering/contacting raw lamb (4 cases, 17.39%). Conclusions:From 2016 to 2020, the incidence of human brucellosis in Chengyang District of Qingdao City has decreased year by year. It occurs frequently in spring and summer, mainly in middle-aged and elderly male farmers. The main clinical manifestation is fever and there are multiple ways of infection. It is recommended to take multiple measures to strengthen health education, behavioral intervention and regular monitoring.

Epidemiological characteristics of human brucellosis in Xianyang City, Shaanxi Province from 2011 to 2020 / 中华地方病学杂志

Objective:To analyze the epidemic characteristics of human brucellosis in Xianyang City, Shaanxi Province, to grasp the epidemic trend and provide scientific basis for further prevention and control of human brucellosis.Methods:Descriptive epidemiological methods were used to statistically analyze the incidence data and epidemic data of human brucellosis in Xianyang City, Shaanxi Province from 2011 to 2020 in the "Infectious Disease Surveillance System of China Disease Control and Prevention Information System".Results:A total of 864 human brucellosis cases had been reported in Xianyang City from 2011 to 2020, and there was no dead case. The annual incidence began to increase rapidly from 2014, the highest annual incidence in 2019 was 5.79/10 5. There were statistical differences between the incidence of different years (χ 2 = 900.40, P < 0.001). Human brucellosis cases in Xianyang City were mainly concentrated in dairy goat breeding counties, with a total of 571 cases reported, accounting for 66.09%. Cases were reported in all months of the year, and the peak incidence of human brucellosis was from April to August, accounting for 64.35% (556/864). The age of cases was mainly concentrated in the 40 - 69 years old group, accounting for 68.29% (590/864); the ratio of male to female was 2.40 ∶ 1.00 (610 ∶ 254). The occupation was mainly farmers, accounting for 83.45% (721/864). There had been an increase in the proportion of scattered children, students and preschool children. The total serological positive rate was 3.14% (283/9 009) in Xianyang City, and pathogenic culture showed variant strains. The median of interval between onset time and diagnosis time was 8 days. Conclusion:The prevalence of human brucellosis in Xianyang City, Shaanxi Province shows an overall upward trend, which needs to be paid more attention to and control efforts should be strengthened.

Research progress on prime virulence factors and pathogenesis of brucellosis / 中华地方病学杂志

Brucellosis is an infectious zoonosis caused by Brucella infection. It is widely prevalent all over the world and brings great losses to the development of public health, animal husbandry and social economy in China. However, the understanding of the specific clinical indications of brucellosis, the virulence factors of Brucella and its pathogenesis is very limited, which leads some limitations in the clinical diagnosis and treatment of brucellosis. Starting from the current epidemic situation of brucellosis, this article focuses on the virulence factors of Brucella and pathogenesis of brucellosis, and comprehensively summarizes the activity track and state of Brucella in the infected organism during the pathogenesis of brucellosis, so as to provide new ideas for the in-depth study of the pathogenesis of brucellosis, and a comprehensive reference for vaccine development and clinical diagnosis and treatment.

An investigation on awareness of brucellosis prevention and control knowledge among breeders in Chunhua County, Xianyang City, Shaanxi Province before and after the publicity intervention / 中华地方病学杂志

Objective:To understand the changes of brucellosis prevention and control knowledge awareness among breeders in Chunhua County, Xianyang City, Shaanxi Province before and after the publicity intervention.Methods:A multi-stage cluster sampling method was adopted to select 10 townships with more reported cases of human brucellosis in Chunhua County from January 2019 to June 2020, and each township was given priority to select the administrative village with the largest number of reported cases for investigation. At least 20 breeders aged 20 years old and over in each administrative village were selected, and if the number was insufficient, supplementary surveys would be conducted in other administrative villages with the larger number of breeders in the township. Questionnaire survey was conducted on all subjects, including general demographic characteristics, brucellosis prevention and control knowledge and related protective behaviors. After the baseline investigation, 6 months of brucellosis prevention and control knowledge publicity was carried out in the administrative villages included in the investigation, and the awareness rate of brucellosis prevention and control knowledge before and after the publicity intervention was compared to evaluate the effect of publicity intervention.Results:After the publicity intervention, a total of 240 breeders were investigated, and 176 people were aware of brucellosis prevention and control knowledge, with an overall awareness rate of 73.33% (176/240), which was significantly higher than that before the publicity intervention (57.50%, 115/200), and the difference was statistically significant (χ 2 = 12.21, P = 0.005). After the publicity intervention, the awareness rates of breeders on "can cattle and sheep transmit diseases to humans" and "do you know that cattle and sheep can only be purchased after passing the quarantine inspection" were relatively high, they were 95.83% (230/240) and 95.00% (228/240), respectively, and the differences were statistically significant (χ 2 = 50.04, 112.64, P < 0.001) compared with that before the publicity intervention [71.50% (143/200) and 51.00% (102/200)]. The awareness rate of breeders on "how brucellosis is transmitted from livestock to humans" was the lowest, it was 53.33% (128/240), which was not significantly different (χ 2 = 0.82, P = 0.370) from that before the publicity intervention (49.00%, 98/200). Conclusions:After the publicity intervention, the overall awareness rate of brucellosis prevention and control knowledge of breeders in Chunhua County has improved, but the awareness rate of some individual issues is still low. It is suggested to strengthen the pertinence of publicity and education.

Analysis of epidemiological and laboratory results of acute and chronic brucellosis among minors in Heilongjiang from 2016 to 2020 / 中华地方病学杂志

Objective:To analyze the epidemiological and clinical features of acute and chronic brucellosis in minors from 2016 to 2020 in Heilongjiang, and to provide evidence for diagnosis, prevention and treatment of brucellosis in minors.Methods:A retrospective analysis of the medical records of 150 hospitalized patients with brucellosis in minors from January 2016 to December 2020 was conducted in Beidahuang Industry Group General Hospital. According to clinical classification, 125 cases were acute patients and 25 cases were chronic patients. At the same time, 40 outpatient physical examination persons were selected as control group. Epidemiological features, clinical presentation and misdiagnosis of acute and chronic brucellosis in minors were analyzed and compared. The results of routine blood test, liver function test, myocardial enzyme test, whole blood C-reactive protein (CRP) and blood culture were analyzed and compared among acute group, chronic group and control group.Results:From 2016 to 2020, the proportion of brucellosis in minors was 3.26% (37/1 136), 2.50% (28/1 119), 3.31% (36/1 088), 2.80% (35/1 250) and 2.00% (14/701), respectively. In acute and chronic brucellosis, the ratios of male to female were 1.66 ∶ 1.00 (78/47) and 1.27 ∶ 1.00 (14/11); the incidence rate was highest in school age [35.2% (44/125), 44.0% (11/25)] and lowest in infant [2.4% (3/125), 0 (0/25)]; the disease were most common in March and June [52.8% (66/125), 44.0% (11/25)]; the more distribution was in Qiqihar [19.2% (24/125), 28.0% (7/25)], and the most susceptible factor was contact with cattle and sheep [89.6% (112/125), 96.0% (24/25)]. In acute group, there was 1 case of lactation infection. There were 32 cases [25.6% (32/125)] and 8 cases [32.0% (8/25)] with four typical symptoms in the two groups. High fever was the most common type in acute group [41.2% (47/114)]. Knee pain was the most common type [50.0% (36/72), 60.0% (12/20)] in both groups. The incidence of musculoskeletal pain in acute group was higher than that in chronic group (χ 2 = 4.57, P = 0.033). The rates of fatigue and joint pain in chronic group were higher than those in acute group (χ 2 = 4.49, 4.41, P < 0.05). Totally 57.3% (86/150) of patients with brucellosis were misdiagnosed as other diseases [49.3% (74/150)] in acute group and 8.0% (12/150) in chronic group] and colds were the most common, accounting for 38.0% (57/150). The positive rate of blood culture in acute group (48 cases, 38.4%) was significantly higher than that in chronic group (4 cases, 16.0%, χ 2 = 4.62, P = 0.038). Compared with control group, the levels of monocyte, alanine aminotransferase(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP), lactate dehydrogenase(LDH), hydroxybutyrate dehydrogenase(HBDH), creatine kinase isoenzyme(CK-MB), hemoglobin (HGB), mean corpuscular volume(MCV), mean corpuscular hemoglobin (MCH), mean corpuscular-hemoglobin concentration (MCHC), total protein (TP), albumin (ALB) in acute group and chronic group were significantly different ( P < 0.05); compared with the chronic group, CRP and LDH increased, the differences were statistically significant ( P < 0.01). Conclusions:The epidemiological characteristics and clinical symptoms of acute and chronic brucellosis in minors in Heilongjiang are different. Monocyte, erythrocyte, transaminase, TP, ALB and myocardial enzyme are changed significantly, it needs to be monitored regularly and given certain protective measures.

Prevalence of brucellosis among humans and animals in Gansu Province from 2018 to 2020 / 中华地方病学杂志

Objective:To analyze the changes of spatial, seasonal, and age distribution of brucellosis among humans and animals in Gansu Province and to provide a reference for the next step in formulating prevention and control measures.Methods:Reported data of brucellosis of humans and animals in Gansu Province from 2018 to 2020 were collected. The human epidemic data were obtained from "China Disease Control and Prevention Information System", and the positive data of animals were obtained from the monthly report provided by Gansu Animal Disease Control Center. Human brucellosis was classified and analyzed according to year, month, age and region, and livestock brucellosis was classified according to year, month, population and region. ArcGIS 10.2 software was used to analyze the spatial epidemiological characteristics of the data. Measuring Geographic tool was used to calculate the shifting distance of the center of the disease incidence in humans and animals from 2018 to 2020.Results:From 2018 to 2020, a total of 6 375 cases of human brucellosis were reported in Gansu Province. The 40 - 59 age group accounted for 54.96% (3 504/6 375), 1 584 cases were reported in 2018, 1 787 cases were reported in 2019, and 3 004 cases were reported in 2020. The high incidence time of human brucellosis was July and November. A total of 48 180 brucellosis-positive animals (heads) were detected, of which 47 342 were positive sheep, accounting for 98.26% (47 342/48 180). The high incidence time of brucellosis among animals was October. Among the 14 cities (prefectures), the top cities of livestock brucellosis reported were Qingyang City, Zhangye City and Jiuquan City. The center of disease incidence among humans was located in Gulang County, Wuwei City. The center of disease incidence among animals was located in Wuwei City in 2018 and Qingyang City in 2020.Conclusions:The cases of brucellosis in humans and animals in Gansu Province are on the increase. In some areas, there are problems of separation of human and animal epidemics. It is necessary to actively strengthen monitoring and implement measures to prevent and control brucellosis in humans and animals in high-risk areas to curb the spread of the epidemic.