A “One Health” surveillance and control of brucellosis in developing countries: Moving away from improvisation

Characterization and evolution of countries affected by bovine brucellosis (1996-2014)

This paper describes the global distribution and temporal evolution of bovine brucellosis due to Brucella abortus during a 19-year period (1996-2014) using the information officially reported to the World Organisation for Animal Health (OIE) by veterinary services of 156 countries. Variables that can influence the health status of bovine brucellosis (i.e., year, per capita Gross Domestic Product (GDP), continent and bovine population) were also analysed. Countries were classified into three categories of health situations: ENZOOTIC: countries infected, which may have been free of brucellosis but for periods of fewer than 3 years; NON-ENZOOTIC: countries where the disease was present but that had at least a 3-year period without the disease; and FREE: countries where the disease remained absent during the whole period. The countries free from bovine brucellosis, or in the process of eradication, were located in Oceania and Europe, while the more affected regions were Central and South America, Africa and parts of Asia. Among the Non-Enzootic countries, the results showed that a very high proportion managed to control the disease during the period of study, with a sharp decline in the percentage of infected countries from 71% in 1996 to 10% in 2014. Among the Enzootic countries, a much smaller proportion managed to control the disease, with a slight drop in the percentage of infected countries from 92% in 1996 to 80% in 2014. A relationship was found between the status of the disease and the availability of economic resources; thus, countries with a high GDP per capita tended to be free from bovine brucellosis. On the other hand, countries with a larger bovine population showed a greater probability to have the disease present. An increase in surveillance programmes and implementation of control policies were observed during the period of study.

Human brucellosis caused by raw dairy products: A review on the occurrence, major risk factors and prevention

Despite considerable efforts made to address the issue of brucellosis worldwide, its prevalence in dairy products remains difficult to estimate and represents an important public health issue in many areas of the globe today. This is partly explained by the increasing tendency for consumption of raw dairy products, making the prevention and control of this zoonosis even more critical. This review summarizes reports published since the early 2000s on human brucellosis caused by contaminated dairy products and the systems of evaluation and assessment which are used to improve the diagnosis, surveillance, control and prevention of the disease. For this purpose, five comprehensive electronic databases were investigated and relevant studies were identified for systematic review. The design and quality of the studies revealed notable variation, especially in the methods used for the detection and characterization of Brucella spp. This report provides helpful information about the health risk associated with the consumption of raw milk and relevant preventive strategies.

Herd-level risk factors associated with Brucella sero-positivity in cattle, and perception and behaviours on the disease control among agro-pastoralists in Tanzania

Brucellosis is endemic in Tanzania, particularly in agro-pastoral areas. This study investigated the herd-level sero-prevalence and risk factors for Brucella sero-positivity in cattle, and perception and behaviours associated with brucellosis control among agro-pastoralists in Morogoro Region, Tanzania. A cross-sectional study involving herd milk diagnosis by indirect enzyme-linked immunosorbent assay and questionnaire survey was conducted in 124 farms. Questions included potential risk factors, knowledge of brucellosis, willingness-to-pay for cattle vaccination, and item count technique (ICT) for selling behaviour of cows that experienced abortion. Risk factor analysis for Brucella sero-positivity in cattle and analysis of factors associated with willingness-to-pay were conducted using classical tests and generalised linear models. Most farmers had little knowledge about brucellosis (disease name: 13.7%, symptoms: 3.2%, transmission from cattle to human: 2.4%, and Brucella vaccine: 2.4%). The proportion of Brucella sero-positive herd was 44.4% (55/124, 95%CI: 35.5-53.5). No risk factors for Brucella sero-positivity were identified; however, using a veterinary service was identified as a preventive factor (OR = 0.39, 95%CI: 0.18-0.84, p =  0.02). For scenarios of vaccinating all cattle and only calves, 59.7% and 89.5% of farmers were willing to pay for vaccination, respectively. Being a Maasai tribe member was a hesitating factor for vaccinating all cattle (OR = 0.39, 95%CI: 0.19-0.83, p =  0.01) and using a veterinary service was an encouraging factor for vaccinating calves (OR = 4.0, 95%CI: 1.2-13.0, p =  0.02). The ICT found that 45.1% of farmers sold cows that experienced abortion. This estimate was not statistically different from that obtained by direct questioning (34.1%, SE = 7.5%, binomial p value = 0.27, factor score = 1.32), suggesting that farmers did not hesitate to sell such cows. The Maasai conducted more risky behaviours for human infection such as drinking raw milk (p = 0.06) or blood (p <  0.01) and helping delivery with bare hands (p = 0.03) than other tribes. Community-based brucellosis control programmes with calf vaccination may be feasible in the study areas. A One Health approach including the promotion of health education and expansion of veterinary services is crucial for disease control.

Prevalence and risk factors of brucellosis among febrile patients attending a community hospital in south western Uganda

Human brucellosis, a chronic disease contracted through contact with animals and consuption of unpasteurized dairy products is underreported in limited-resource countries. This cross-sectional study aimed to determine the prevalence and risk factors of brucellosis among febrile patients attending a community hospital in South western Uganda. A questionnaire that captured socio-demographic, occupational and clinical data was administered. Blood samples were tested for Brucella antibodies using Rose Bengal Plate Test (RBPT) and blood culture with standard aerobic BACTEC bottle was done. Of 235 patients enrolled, prevalence of brucellosis (RBPT or culture confirmed) was 14.9% (95% CI 10.6-20.1) with a culture confrmation in 4.3% of the participants. The factors independently associated with brucellosis were consumption of raw milk (aOR 406.15, 95% CI 47.67-3461.69); history of brucellosis in the family (aOR 9.19, 95% CI 1.98-42.54); and selling hides and skins (aOR 162.56, 95% CI 2.86-9256.31). Hepatomegaly (p < 0.001), splenomegaly (p = 0.018) and low body mass index (p = 0.032) were more common in patients with brucellosis compared to others. Our findings reveal a high prevalence of brucellosis among febrile patients and highlight a need for implementing appropiate tests, public awareness activities and vaccination of animals to control and eliminate the disease.

Evaluation of DNA vaccine encoding BCSP31 surface protein of Brucella abortus for protective immunity

Brucellosis is a highly contagious and zoonotic disease and has a considerable impact on animal health and economy of a country, principally in Pakistan, where rural income largely depends upon livestock farming and dairy products. The disease burden is more in underdeveloped/developing countries due to the low economy and limited access to the diagnostic facilities. In Pakistan, the prevalence of Brucella abortus is very high, so it is the need of the hour to control this disease through more advanced methods. This study was designed with the aim to construct the DNA based vaccine of gene encoding antigenic surface protein (BCSP₃₁). For this purpose, the BCSP₃₁ gene was amplified, purified and ligated in pTZ57 R/T (cloning vector). Dubbed BCSP₃₁-pTZ57 R/T vector was transformed into competent cells (DH5α). After plasmid extraction, the plasmid and pET-28a vector was restricted with EcoRI and BamHI. Again, ligation was done and dubbed pET-28a-BCSP₃₁ transformed into E. coli (BL21). After expression, the protein was purified and used for evaluation of immunogenic response. The protective and immunogenic efficacy of the vaccine was evaluated in rabbits (n = 20). The rabbits were divided into four equal groups. Groups A-C were given purified protein diluted in normal saline @ 750, 1500 and 3000 μg/0.2 mL, respectively through intraconjunctival route. Group D was given 0.2 mL normal saline through intraconjunctival route. Specific immunoglobulin G (IgG) responses were measured through indirect ELISA on a weekly basis. The titer of IgG against the antigen was significantly (p < 0.05) higher in vaccinated groups A-C as compared to group D (control group) in a dose dependent manner. Moreover, log units of protection produced by DNA based vaccine in the rabbits (3.02) also indicated the protective efficacy of the DNA vaccine against B. abortus challenge. The response of this vaccine in rabbit suggested its potential effectiveness against Brucella abortus in large animals.

Animal brucellosis control or eradication programs worldwide: A systematic review of experiences and lessons learned

Brucellosis is one of the most common zoonoses worldwide, causing huge economic losses in the animal industry and posing a serious threat to human health. Although the World Health Organization (WHO) and World Organization for Animal Health (OIE) has recommended strategies or measures to control or eradicate brucellosis, only some developed countries have achieved freedom from animal brucellosis. In developing countries, brucellosis remains a serious problem, and the importance of its control has attracted little attention. The strategies and measures are difficult to implement effectively in countries with limited resources because the eradication of brucellosis is an expensive, time-consuming and labor-intensive project. Therefore, more effort is needed to explore the appropriate strategies and measures in developing countries. In this study, we collected the available publications regarding brucellosis control or eradication programs in different countries and areas, and summarized the main strategies and measures, supplementary measures, effects, and lessons learned during their implementation. Results showed that the freedom from animal brucellosis was only achieved in three countries among the 23 included countries and areas after the implementation of the programs, which had lasted several decades. Either alone or together, vaccination and test-and-slaughter programs can effectively reduce brucellosis prevalence. Supplementary measures involve a number of aspects, and their effective implementation is crucial to the success of disease control and cannot be ignored. While disease control or eradication requires extensive resources, some studies have shown that a well-designed and well-implemented disease control or eradication program is economically effective. Experience has revealed that even if significant results have been achieved, the project could not be terminated without careful consideration due to the potential for recurrence.

Brucella spp. at the Wildlife-Livestock Interface: An Evolutionary Trajectory through a Livestock-to-Wildlife "Host Jump"?

Brucella infections in wildlife have gained a lot of interest from the scientific community and different stakeholders. These interests are often different and sometimes conflicting. As a result, different management perspectives and aims have been implemented (One Health, public health, veterinary public health, maintenance of a brucellosis free status in livestock, sustainable wildlife harvesting by hunters, wildlife and environmental health). When addressing Brucella infection in wildlife, the most important features of Brucella infection should be considered and the following questions need to be answered: (1) Is Brucella infection a result of a spillover from livestock or is it a sustainable infection in one or more wildlife host species? (2) Did the epidemiological situation of Brucella infection in wildlife change over time and, if so, what are the main drivers of change and does it impact the wildlife population dynamics? (3) Does Brucella infection in wildlife represent a reservoir of Brucella strains for livestock? (4) Is Brucella infection in wildlife of zoonotic concern? These questions point to the fundamental biological question of how animal (domestic and wildlife)/Brucella spp. partnerships are established. Will we be able to decipher an evolutionary trajectory through a livestock-to-wildlife "host jump"? Whole genome sequencing and new "omics" techniques will help in deciphering the molecular basis of Brucella host preference and open new avenues in brucellosis management aimed at preventing opportunities for Brucella host jumps.

A One Health Evaluation of the University of Copenhagen Research Centre for Control of Antibiotic Resistance

We applied the evaluation framework developed by the EU COST Action "Network of Evaluation of One Health" (NEOH) to assess the operations, supporting infrastructures and outcomes of a research consortium "University of Copenhagen Research Centre for Control of Antibiotic Resistance" (UC-CARE). This 4-year research project was a One Health (OH) initiative with participants from 14 departments over four faculties as well as stakeholders from industry and health authorities aiming to produce new knowledge to reduce the development of antimicrobial resistance (AMR). This was a case study focusing on assessing beneficial and counter-productive characteristics that could affect the OH outcomes. The study was also used to provide feedback to NEOH about the evaluation framework. The framework and evaluation tools are described in the introduction paper of this special journal issue. Data for the evaluation were extracted from the funding research proposal, the mid-term UC-CARE project evaluation report and supplemented with opinions elicited from project participants and stakeholders. Here, we describe the underlying system, theory of change behind the initiative and adapted questions from the NEOH tools that we used for semi-open interviews with consortium members throughout the evaluation process. An online survey was used to obtain information from stakeholders. The NEOH evaluation tools were then used for the qualitative and quantitative evaluation of the OH characteristics of UC-CARE. Senior UC-CARE researchers were interested and willing to be interviewed. Young scientists were more difficult to engage in interviews, and only 25% of stakeholders answered the online survey. Interviewees mentioned that the main benefit of UC-CARE was an increased awareness and general understanding of AMR issues. All interviewees stated that the adopted OH approach was relevant given the complexity of AMR. However, some questioned the applicability, and identified potentially counter-productive issues mainly related to the information sharing, collaboration and working methods across the consortium. A more integrated project organization, more stakeholder involvement and time for the project, flexibility in planning and a dedicated OH coordinator were suggested to allow for more knowledge exchange, potentially leading to a higher societal impact.

Comparisons of brucellosis between human and veterinary medicine

Brucellosis is the world's most widespread zoonosis, but also ranks as one of the seven most neglected diseases, according to the World Health Organization. Additionally, it is recognized as the world's most common laboratory-acquired infection. There are a reported 500,000 incident cases of human brucellosis per year. However, true incidence is estimated to be 5,000,000 to 12,500,000 cases annually. Once diagnosed, focus is directed at treating individual patients with antibiotic regimes, yet overall neglecting the animal reservoir of disease. Countries with the highest incidence of human brucellosis are Syria (1,603.4 cases per 1,000,000 individuals), Mongolia (391.0), and Tajikistan (211.9). Surveillance on animal populations is lacking in many developed and developing countries. According to the World Animal Health Information Database, Mexico had the largest number of reported outbreaks, 5,514 in 2014. Mexico is followed by China (2,138), Greece (1,268), and Brazil (1,142). The majority of these outbreaks is Brucella abortus, the etiologic agent of bovine brucellosis. Brucellosis is an ancient disease that still plagues the world. There are still knowledge gaps and a need for better diagnostics and vaccines to make inroads towards control and eradication.

Detection of Brucella spp. in milk from seronegative cows by real-time polymerase chain reaction in the region of Batna, Algeria

Aim:

The aim of this study was to detect Brucella spp. DNA in milk samples collected from seronegative cows using the real-time polymerase chain reaction (PCR) assay for diagnosis of brucellosis in seronegative dairy cows to prevent transmission of disease to humans and to reduce economic losses in animal production.

Materials and Methods:

In this study, 65 milk samples were investigated for the detection of Brucella spp. The detection of the IS711 gene in all samples was done by real-time PCR assay by comparative cycle threshold method.

Results:

The results show that of the 65 DNA samples tested, 2 (3.08%) were positive for Brucella infection. The mean cyclic threshold values of IS711 real-time PCR test were 37.97 and 40.48, indicating a positive reaction.

Conclusion:

The results of the present study indicated that the real-time PCR appears to offer several advantages over serological tests. For this reason, the real-time PCR should be validated on representative numbers of Brucella-infected and free samples before being implemented in routine diagnosis in human and animal brucellosis for controlling this disease.

The serostatus of Brucella spp., Chlamydia abortus, Coxiella burnetii and Neospora caninum in cattle in three cantons in Bosnia and Herzegovina

Background

Dairy production in Bosnia and Herzegovina exhibits limited productivity, which may partly, be explained by extensive reproductive problems of non-infectious and infectious origin. Brucella spp., Chlamydia abortus, Coxiella burnetii and Neospora caninum are common infectious causes of decreased reproductive outcomes in cattle worldwide. Little is, however, known about the disease status of herds with reduced reproductive performances. A cross-sectional study was designed to document the status of these pathogens in dairy cattle in Bosnia and Herzegovina. A total of 1970 serum samples were collected from cattle in farms located in three cantons (regions). Enzyme linked immunosorbent assays were used to screen for seropositivity against four selected pathogens.

Results

The overall seroprevalence was estimated at both the herd level and at individual level for each pathogen. At the individual animal level, the prevalence for C. abortus, C. burnetii, N. caninum and Brucella spp. was 52.1% (95% CI: 41.2–62.7), 8.8% (95% CI: 5.3–14.2), 9.2% (95% CI: 6.0–12.3 and 0.2% (95% CI: 0.1–0.5), respectively. The corresponding estimates for herd level were 87.9% (95% CI: 82.6–91.8), 19.6% (95% CI: 14.6–25.8), 35.2% (95% CI: 28.8–42.1), and 1.5% (95% CI: 0.5–4.6). A substantial overlap was observed in the presence of N. caninum, C. abortus and C. burnetii at individual and herd level.

Conclusion

Our study demonstrated a high level of antibodies to Chlamydia abortus. Considering the association of this agent with reproductive disorders in cattle, future studies should be directed to the epidemiological traits of this infection. Additionally, the relatively high levels of exposure to C. burnetii and N. caninum found in this study highlights the need for targeted control of infectious causes of reproductive disorders in dairy cattle of the studied areas. Given the low seroprevalence, Brucella spp. does not seem to represent a problem in the reproductive health of cattle in the studied areas.

Electronic supplementary material

The online version of this article (10.1186/s12917-018-1361-z) contains supplementary material, which is available to authorized users.

Brucellosis in livestock and wildlife: zoonotic diseases without pandemic potential in need of innovative one health approaches

Human brucellosis remains the commonest zoonotic disease worldwide with more than 500 000 new cases annually. Understanding the biology of Brucella infections and the transmission patterns at the wildlife/livestock/human interface is of paramount importance before implementing any brucellosis control or eradication program in animals, even more so should interventions be justified within One Health. In addition to calling for transdisciplinary collaboration, One Health formally aims to conserve the environment and to promote the well-being of animals. In this opinion paper, the One Health approach of brucellosis is reviewed in the industrialized and the low and middle income countries, highlighting pitfalls and shortcomings of serological studies and discussing the role of urban and peri-urban farming for the re-emergence of brucellosis in the developing world. The role of wildlife as a potential reservoir is highlighted and different management strategies are discussed. Lastly, beyond its role in the control of brucellosis, the ethical dimension of culling wildlife to control disease emergence or spill-back of infections in livestock is discussed. Core transdisciplinary competencies such as values and ethics are critically important in guiding the development of One Health curricula and in continuing professional education, as they describe the knowledge, skills, and attitudes required to be effective. A conceptual framework needs to be developed from inception to knowledge translation. Importantly, transdisciplinary competencies should be developed as an adjunct to discipline-specific areas of expertise, not as a replacement. A profound understanding of the biology of infectious agents is and will always remain a pre-requisite for any sound One Health approach.

Seroprevalence of Brucellosis among Patients Attending a District Hospital in Rwanda

Studies on human brucellosis in Rwanda are scarce, and the incidence is likely to be higher than official estimates. In a recent study using Rose Bengal Test (RBT) on women who had aborted or had still births in Huye district, 25% were Brucella seroprevalent. Thus, purpose of the present study was to investigate the Brucella seroprevalence in patients presenting with the key signs and symptoms of brucellosis. Cross-sectional study was done in Nyagatare District in the Eastern Province of Rwanda. A total of 198 patients were recruited from Nyagatare District Hospital, blood samples were collected, and sera analyzed with RBT. A questionnaire was used to explore the risk factors. A total of 12 patients (6.1%; 95% confidence interval [CI] = 0.662-7.820) were Brucella seropositive. Infection was significantly associated with drinking unboiled milk (odds ratio [OR] = 8.3; 95% CI = 2.4-29.2) and having had recurrent fever (OR = 5.6; 95% CI = 1.5-21.3). Drinking unboiled milk is a risk factor for Brucella infection. Provision of adequate resources and trainings to staff in brucellosis diagnosis is needed to reduce recurrence of fevers probably because of misdiagnosis. Public awareness creation on transmission routes of brucellosis is to be intensified.

Exploring the Diversity of Field Strains of Brucella abortus Biovar 3 Isolated in West Africa

Brucellosis is one of the most widespread bacterial zoonotic diseases in the world, affecting both humans and domestic and wild animals. Identification and biotyping of field strains of Brucella are of key importance for a better knowledge of the epidemiology of brucellosis, for identifying appropriate antigens, for managing disease outbreaks and for setting up efficient preventive and control programmes. Such data are required both at national and regional level to assess potential threats for public health. Highly discriminative genotyping methods such as the multiple locus variable number of tandem repeats analysis (MLVA) allow the comparison and assessment of genetic relatedness between field strains of Brucella within the same geographical area. In this study, MLVA biotyping data retrieved from the literature using a systematic review were compared using a clustering analysis and the Hunter-Gaston diversity index (HGDI). Thus, the analysis of the 42 MLVA genotyping results found in the literature on West Africa [i.e., from Ivory Coast (1), Niger (1), Nigeria (34), The Gambia (3), and Togo (3)] did not allow a complete assessment of the actual diversity among field strains of Brucella. However, it provided some preliminary indications on the co-existence of 25 distinct genotypes of Brucella abortus biovar 3 in this region with 19 genotypes from Nigeria, three from Togo and one from Ivory Coast, The Gambia, and Niger. The strong and urgent need for more sustainable molecular data on prevailing strains of Brucella in this sub-region of Africa and also on all susceptible species including humans is therefore highlighted. This remains a necessary stage to allow a comprehensive understanding of the relatedness between field strains of Brucella and the epidemiology of brucellosis within West Africa countries.

Whole genome sequencing of Brucella melitensis isolated from 57 patients in Germany reveals high diversity in strains from Middle East

Brucellosis, a worldwide common bacterial zoonotic disease, has become quite rare in Northern and Western Europe. However, since 2014 a significant increase of imported infections caused by Brucella (B.) melitensis has been noticed in Germany. Patients predominantly originated from Middle East including Turkey and Syria. These circumstances afforded an opportunity to gain insights into the population structure of Brucella strains. Brucella-isolates from 57 patients were recovered between January 2014 and June 2016 with culture confirmed brucellosis by the National Consultant Laboratory for Brucella. Their whole genome sequences were generated using the Illumina MiSeq platform. A whole genome-based SNP typing assay was developed in order to resolve geographically attributed genetic clusters. Results were compared to MLVA typing results, the current gold-standard of Brucella typing. In addition, sequences were examined for possible genetic variation within target regions of molecular diagnostic assays. Phylogenetic analyses revealed spatial clustering and distinguished strains from different patients in either case, whereas multiple isolates from a single patient or technical replicates showed identical SNP and MLVA profiles. By including WGS data from the NCBI database, five major genotypes were identified. Notably, strains originating from Turkey showed a high diversity and grouped into seven subclusters of genotype II. MLVA analysis congruently clustered all isolates and predominantly matched the East Mediterranean genetic clade. This study confirms whole-genome based SNP-analysis as a powerful tool for accurate typing of B. melitensis. Furthermore it allows special allocation and therefore provides useful information on the geographic origin for trace-back analysis. However, the lack of reliable metadata in public databases often prevents a resolution below geographic regions or country levels and corresponding precise trace-back analysis. Once this obstacle is resolved, WGS-derived bacterial typing adds an important method to complement epidemiological surveys during outbreak investigations. This is the first report of a detailed genetic investigation of an extensive collection of B. melitensis strains isolated from human cases in Germany.

Detection and characterization of Brucella spp. in bovine milk in small-scale urban and peri-urban farming in Tajikistan

Brucellosis is one of the most common zoonoses globally, and Central Asia remains a Brucella hotspot. The World Health Organization classifies brucellosis as a neglected zoonotic disease that is rarely in the spotlight for research and mainly affects poor, marginalized people. Urban and peri-urban farming is a common practice in many low-income countries, and it increases the incomes of families that are often restrained by limited economic resources. However, there is a concern that the growing number of people and livestock living close together in these areas will increase the transmission of zoonotic pathogens such as Brucella. This study investigates the presence of Brucella DNA in bovine milk in the urban and peri-urban area of Dushanbe, Tajikistan. Brucella DNA was detected in 10.3% of 564 cow milk samples by IS711-based real-time PCR. This finding is concerning because consumption of unpasteurized dairy products is common in the region. Furthermore, Brucella DNA was detected in the milk of all seropositive cows, but 8.3% of the seronegative cows also showed the presence of Brucella DNA. In addition, sequence analysis of the rpoB gene suggests that one cow was infected with B. abortus and another cow was most likely infected with B. melitensis. The discrepancies between the serology and real-time PCR results highlight the need to further investigate whether there is a need for implementing complementary diagnostic strategies to detect false serological negative individuals in Brucella surveillance, control, and eradication programmes. Furthermore, vaccination of cattle with S19 in addition to vaccination of small ruminants with Rev 1 might be needed in order to control Brucella infections in the livestock population but further research focusing on the isolation of Brucella is required to obtain a comprehensive understanding of the Brucella spp. circulating among the livestock in this region.

Genetic Diversity of Brucella Reference and Non-reference Phages and Its Impact on Brucella-Typing

Virulent phages have been used for many years to type Brucella isolates, but until recently knowledge about the genetic makeup of these phages remains limited. In this work the host specificity and genomic sequences of the original set (deposited in 1960) of VLA Brucella reference phages Tb, Fi, Wb, Bk2, R/C, and Iz were analyzed and compared with hitherto described brucellaphages. VLA phages turned out to be different from homonymous phages in other laboratories. The host range of the phages was defined by performing plaque assays with a wide selection of Brucella strains. Propagation of the phages on different strains did not alter host specificity. Sequencing of the phages TbV, FiV, WbV, and R/CV revealed nucleotide variations when compared to same-named phages previously described by other laboratories. The phages Bk2V and IzV were sequenced for the first time. While Bk2V exhibited the same deletions as WbV, IzV possesses the largest genome of all Brucella reference phages. The duplication of a 301 bp sequence in this phage and the large deletion in Bk2V, WbV, and R/CV may be a result of recombination caused by repetitive sequences located in this DNA region. To identify new phages as potential candidates for lysotyping, the host range and Single Nucleotide Polymorphisms (SNPs) of 22 non-reference Brucella phages were determined. The phages showed lysis patterns different from those of the reference phages and thus represent novel valuable candidates in the typing set.

Brucellosis and associated risk factors in dairy cattle of eastern Ethiopia

Knowing the status of Bovine brucellosis and associated risk factors is a crucial step in formulating evidence based control scheme. In this study, a total of 967 dairy cows from 307 dairy farms in eastern Ethiopia were serologically tested for Brucella antibodies. The screening was done first using RBPT and positive samples were subsequently subjected to CFT for confirmation. A pre-tested structured questionnaire was used to collect relevant data from 307 dairy cattle owners or attendants to assess their awareness and routine practice. The data were run using univariable logistic regression analysis using STATA version 11.0 for Windows. Accordingly, herd and individual animal seroprevalence were found to be 6.8% (95% CI = 4.28-10.28) and 1.3% (95% CI = 0.72-2.29), respectively. The prevalence of sero-reactors among local breeds was observed to be higher compared to cross breed (p < 0.05). Herd level analysis of the risk factors indicated that in farms with large herd size (>20 animals), the odds ratio (OR) = 9.13, p = 0.00, CI = 3.01-27.69 of having brucellosis was 9.13 times higher than smaller size herds (<20 animals). Intensively managed herds had shown the highest seroprevalence (20.8%) than extensive (6.7%) and semi-intensive (4.2%). Experience of dairy handlers about the disease that cause abortion in late pregnancy was significantly associated (p < 0.001) with the occurrence of brucellosis in the herds. However, about 91% of the dairy cattle owners/attendants lack awareness about disease(s) that causes abortion in late pregnancy. Similarly risk of having brucellosis in those herds experiencing abortion was 6.3 times higher (OR = 6.3, p < 0.001, CI = 2.50-15.92). This study identified some of the handling practices for aborted and retained fetal materials to be risky. Therefore, the study highlights the need of comprehensive brucellosis surveillance in animal and human and institutions of public education and on farm biosafety measures in shaping proper disease control scheme.

Epidemiology of Brucellosis and Genetic Diversity of Brucella abortus in Kazakhstan

Brucellosis is a major zoonotic infection in Kazakhstan. However, there is limited data on its incidence in humans and animals, and the genetic diversity of prevalent strains is virtually unstudied. Additionally, there is no detailed overview of Kazakhstan brucellosis control and eradication programs. Here, we analyzed brucellosis epidemiological data, and assessed the effectiveness of eradication strategies employed over the past 70 years to counteract this infection. We also conducted multiple loci variable-number tandem repeat analysis (MLVA) of Brucella abortus strains found in Kazakhstan. We analyzed official data on the incidence of animal brucellosis in Kazakhstan. The records span more than 70 years of anti-brucellosis campaigns, and contain a brief description of the applied control strategies, their effectiveness, and their impact on the incidence in humans. The MLVA-16 method was used to type 94 strains of B. abortus and serial passages of B. abortus 82, a strain used in vaccines. MLVA-8 and MLVA-11 analyses clustered strains into a total of four and seven genotypes, respectively; it is the first time that four of these genotypes have been described. MLVA-16 analysis divided strains into 28 distinct genotypes having genetic similarity coefficient that varies from 60 to100% and a Hunter & Gaston diversity index of 0.871. MST analysis reconstruction revealed clustering into "Kazakhstani-Chinese (Central Asian)", "European" and "American" lines. Detection of multiple genotypes in a single outbreak confirms that poorly controlled trade of livestock plays a crucial role in the spread of infection. Notably, the MLVA-16 profile of the B. abortus 82 strain was unique and did not change during 33 serial passages. MLVA genotyping may thus be useful for epidemiological monitoring of brucellosis, and for tracking the source(s) of infection. We suggest that countrywide application of MLVA genotyping would improve the control of brucellosis in Kazakhstan.

Experimental Challenge of Atlantic Cod (Gadus morhua) with a Brucella pinnipedialis Strain from Hooded Seal (Cystophora cristata)

Pathology has not been observed in true seals infected with Brucella pinnipedialis. A lack of intracellular survival and multiplication of B. pinnipedialis in hooded seal (Cystophora cristata) macrophages in vitro indicates a lack of chronic infection in hooded seals. Both epidemiology and bacteriological patterns in the hooded seal point to a transient infection of environmental origin, possibly through the food chain. To analyse the potential role of fish in the transmission of B. pinnipedialis, Atlantic cod (Gadus morhua) were injected intraperitoneally with 7.5 x 10⁷ bacteria of a hooded seal field isolate. Samples of blood, liver, spleen, muscle, heart, head kidney, female gonads and feces were collected on days 1, 7, 14 and 28 post infection to assess the bacterial load, and to determine the expression of immune genes and the specific antibody response. Challenged fish showed an extended period of bacteremia through day 14 and viable bacteria were observed in all organs sampled, except muscle, until day 28. Neither gross lesions nor mortality were recorded. Anti-Brucella antibodies were detected from day 14 onwards and the expression of hepcidin, cathelicidin, interleukin (IL)-1β, IL-10, and interferon (IFN)-γ genes were significantly increased in spleen at day 1 and 28. Primary mononuclear cells isolated from head kidneys of Atlantic cod were exposed to B. pinnipedialis reference (NCTC 12890) and hooded seal (17a-1) strain. Both bacterial strains invaded mononuclear cells and survived intracellularly without any major reduction in bacterial counts for at least 48 hours. Our study shows that the B. pinnipedialis strain isolated from hooded seal survives in Atlantic cod, and suggests that Atlantic cod could play a role in the transmission of B. pinnipedialis to hooded seals in the wild.

Serological and molecular investigation for brucellosis in swine in selected districts of Uganda

Brucellosis is a notifiable zoonotic disease affecting livestock, humans, and wildlife in Uganda. Pigs can be infected with human pathogenic Brucella suis biovars 1 and 3 and can be a significant source of brucellosis for humans. Uganda has a rapidly growing pig population, and the pork consumption per capita is the highest in East Africa. The objective of this work was to determine the seroprevalence of brucellosis in Ugandan pigs. A cross-sectional serosurvey of pigs was conducted in three of the major pig-keeping districts in Uganda (Masaka (n = 381 samples), Mukono (n = 398), and Kamuli (n = 414)). In addition, pigs originating from these districts were sampled in the major pig abattoir in Kampala (n = 472). In total, 1665 serum samples were investigated by serological and molecular tests. Only three putative brucellosis-positive samples were detected serologically using indirect ELISA. These sera were found negative for Brucella antibodies by CFT; however, two had antibodies against Yersinia enterocolitica as determined by SAT. Presence of antibodies against Yersiniae was confirmed by Y. enterocolitica antibody-specific ELISA. The two Yersiniae ELISA-positive samples were brucellosis negative using real-time PCR. We tested additional 142 sera from the 1665 samples with real-time PCR. All tested negative. Under this type of production system, we expect a maximum B. suis prevalence of less than 1 % at 95 % confidence level, and therefore, the risk of acquiring brucellosis from the pigs or their products is negligible. However, pigs may harbor the zoonotic Y. enterocolitica. This is the first study to investigate the occurrence of brucellosis in pigs in Uganda and the first study to report Y. enterocolitica antibodies in swine in Uganda.

One Health: competing perspectives in an emerging field

Over the last decade, One Health has attracted considerable attention from researchers and policymakers. The concept argues that the fields of human, animal and environmental health ought to be more closely integrated. Amid a flurry of conferences, projects and publications, there has been substantial debate over what exactly One Health is and should be. This review summarizes the main trends in this emerging discussion, highlighting the fault lines between different perspectives on One Health. Some have shown that One Health's call to synthesize knowledge from different disciplines can lead to better interventions. Others, however, argue that One Health's challenge to existing practice must go further, and set out a vision that foregrounds the social and economic drivers of disease. Meanwhile, recent examples of One Health in practice highlight the potential but also the challenges of institutionalizing cooperation. We also discuss the promise and pitfalls of using complexity theory to tackle multifaceted problems, and consider how the One Health concept has been brought to bear on other issues, such as emerging new technologies. Ultimately, One Health is an important and worthwhile goal, and requires a debate that clarifies both the competing uses and the political nature of the project.

Analysis of the First Temperate Broad Host Range Brucellaphage (BiPBO1) Isolated from B. inopinata

Brucella species are important human and animal pathogens. Though, only little is known about mobile genetic elements of these highly pathogenic bacteria. To date, neither plasmids nor temperate phages have been described in brucellae. We analyzed genomic sequences of various reference and type strains and identified a number of putative prophages residing within the Brucella chromosomes. By induction, phage BiPBO1 was isolated from Brucella inopinata. BiPBO1 is a siphovirus that infects several Brucella species including Brucella abortus and Brucella melitensis. Integration of the phage genome occurs adjacent to a tRNA gene in chromosome 1 (chr 1). The bacterial (attB) and phage (attP) attachment sites comprise an identical sequence of 46 bp. This sequence exists in many Brucella and Ochrobactrum species. The BiPBO1 genome is composed of a 46,877 bp double-stranded DNA. Eighty-seven putative gene products were determined, of which 32 could be functionally assigned. Strongest similarities were found to a temperate phage residing in the chromosome of Ochrobactrum anthropi ATCC 49188 and to prophages identified in several families belonging to the order rhizobiales. The data suggest that horizontal gene transfer may occur between Brucella and Ochrobactrum and underpin the close relationship of these environmental and pathogenic bacteria.

First isolation, identification, phenotypic and genotypic characterization of Brucella abortus biovar 3 from dairy cattle in Tanzania

BACKGROUND

Brucellosis is a disease of worldwide public health and economic importance. Successful control is based on knowledge of epidemiology and strains present in an area. In developing countries, most investigations are based on serological assays. This study aimed at investigating a dairy herd experiencing abortions in order to establish within-herd seroprevalence to Brucella spp., identify, characterize Brucella strains by Multiple Loci Variable Number of Tandem Repeats Analysis (MLVA-VNTR) and investigate possible spillover to other species.

RESULTS

The within-herd seroprevalence in cattle (n = 200) was 48 % (95 % CI 41-55), using an indirect ELISA, while the Rose Bengal Test (RBT) yielded lower prevalence (21.5 %; 95 % CI 16-27). Two sheep (n = 35) and one goat (n = 50) were seropositive using ELISA while none of the dogs (n = 6) was positive with the RBT. Three Brucella were isolated from an aborted fetus and associated membranes. Real time PCR (IS711), Bruce-ladder and classical biotyping classified the isolates as B. abortus biovar 3. MLVA-VNTR revealed two different but closely related genotypes. The isolates showed unique profiles, providing the first genotypic data from Tanzania. These genotypes were not related to B. abortus biovar 3 reference strain Tulya originally isolated from a human patient in Uganda in 1958, unlike the genotypes isolated and characterized recently in Kenya. High within-herd prevalence, isolation of the pathogen and abortion confirm that B. abortus is circulating in this herd with cattle as reservoir hosts. A low seroprevalence in sheep and goats suggests a spillover of B. abortus from cattle to small ruminants in the herd.

CONCLUSIONS

This is the first isolation and characterization of B. abortus biovar 3 from a dairy cow with abortion in Tanzania. The origin of the Tanzanian genotypes remain elusive, although they seem to be related to genotypes found in Europe, Turkey and China but not related to B. abortus biovar 3 reference strain or genotypes from Kenya. Importantly, replacement heifers are commonly sourced from large farms like this to smallholder farmers, which poses risk of spread of bacteria to other herds. B. abortus is a significant zoonotic risk and animal health problem in this production system, therefore further studies on humans is recommended.

Brucella melitensis Biovar 1 and Brucella abortus S19 Vaccine Strain Infections in Milkers Working at Cattle Farms in the Khartoum Area, Sudan

BACKGROUND

Human brucellosis is a preventable zoonoses that may become persistent, causing, if left untreated, severe localized disease. Occupational exposure to infected animals or animal products and consumption of fresh contaminated dairy are main risk factors.

METHODS

One hundred farmworkers employed at two cattle farms one in Khartoum North and one in Omdurman were screened for the presence of specific antibodies and seropositive workers were invited to donate a blood sample for blood culture. Molecular typing was used to characterize Brucella isolates.

RESULTS

Ten percent of farmworkers tested seropositive and while Brucella melitensis biovar 1 was isolated from the blood of three individuals, an isolate identical to the B. abortus S19 vaccine strain was isolated from a fourth person. All four bacteremic individuals were employed as milkers and did not have obvious disease.

CONCLUSIONS

The isolation of the highly infectious pathogen B. melitensis from seropositive workers is consistent with the notion that the pathogen may persist in the blood without causing overt disease. While vaccination with strain S19 is essential for the control of bovine brucellosis the vaccine strain may be transmitted to the human population and protective measures remain important to prevent exposure also in view of the presence of B. melitensis. To create awareness for this potentially severe disease more information on the prevalence of the pathogen in different risk groups and in livestock in the Sudan is needed.

Financial analysis of brucellosis control for small-scale goat farming in the Bajío region, Mexico

Brucellosis is an endemic disease in small-scale goat husbandry systems in Mexico. It is a zoonosis and the economic consequences can be large, although estimates are not available for the Mexican goat sector. Our objective was to conduct a financial analysis of brucellosis control in a prominent dairy goat production area of the Bajío region, Mexico. We used three models: (1) a brucellosis transmission model at village flock level (n=1000 head), (2) a flock growth model at smallholder flock level (n=23 head) using output of model 1 and (3) cost-benefit analysis of several brucellosis control scenarios based on output of model 2. Scenarios consisted of test-and-slaughter or vaccination or a combination of both compared to the base situation (no control). The average net present values (NPV) of using vaccination over a 5-year period was 3.8 US$ (90% CI: 1.3-6.6) and 20 US$ (90% CI: 11.3-28.6) over a 10-year period per goat. The average benefit-cost ratios over a 5-year period and 10-year period were 4.3 US$ (90% CI: 2.2-6.9) and 12.3 US$ (90% CI: 7.5-17.3) per goat, respectively. For the total dairy goat population (38,462 head) of the study area (the Bajío of Jalisco and Michoacán) the NPV's over a 5-year and 10-year period were 0.15 million US$ and 0.8 million US$. However, brucellosis prevalence was predicted to remain relatively high at about 12%. Control scenarios with test-and-slaughter predicted to reduce brucellosis prevalence to less than 3%, but this produced a negative NPV over a 5-year period ranging from -31.6 to -11.1 US$ and from -31.1 to 7.5 US$ over a 10-year period. A brucellosis control campaign based on vaccination with full coverage is economically profitable for the goat dairy sector of the region although smallholders would need financial support in case test-and-slaughter is applied to reduce the prevalence more quickly.

A case-control study of risk factors for bovine brucellosis seropositivity in Peninsular Malaysia

Bovine brucellosis was first reported in Peninsular Malaysia in 1950. A subsequent survey conducted in the country revealed that the disease was widespread. Current knowledge on the potential risk factors for brucellosis occurrence on cattle farms in Malaysia is lacking. Therefore, we conducted a case-control study to identify the potential herd-level risk factors for bovine brucellosis occurrence in four states in the country, namely Kelantan, Pahang, Selangor and Negeri Sembilan. Thirty-five cases and 36 controls of herds were selected where data on farm management, biosecurity, medical history and public health were collected. Multivariable logistic regression identified that Brucella seropositive herds were more likely to; have some interaction with wildlife (OR 8.9, 95% CI = 1.59–50.05); originated from farms where multiple species such as buffalo/others (OR 41.8, 95% CI = 3.94–443.19) and goat/sheep (OR 8.9, 95%Cl = 1.10–71.83) were reared, practice extensive production system (OR 13.6, 95% CI 1.31–140.24) and have had episodes of abortion in the past (OR 51.8, 95% CI = 4.54–590.90) when compared to seronegative herds. Considering the lack of information on the epidemiology of bovine brucellosis in peninsular Malaysia and absence of information on preventing the inception or spread of the disease, this report could contribute to the on-going area-wise national brucellosis eradication program.

Meta-analysis of Brucella seroprevalence in dairy cattle of Ethiopia

This meta-analysis estimates a single-group summary (effect size) for seroprevalence of Brucella spp. exposure in dairy cattle of Ethiopia. It also attempts to identify study-level variables that could explain the variation in apparent seroprevalence. The literature search was restricted to studies published in English language from January 2000 to December 2013. A template was designed to retrieve the most biologically plausible and consistent variables from the articles. A total of 29 published papers containing 40 animal-level studies were used in the analyses. The single-group summary of Brucella seroprevalence in cattle was estimated to reach 3.3 % with 95 % confidence interval (CI) (2.6-4.2 %). Of all the variables considered, region was the only specific factor identified to explain about 20 % of between-study variation. Accordingly, the region-based meta-analysis forest plot revealed the highest prevalence in central Ethiopia followed by southern part. The lowest prevalence estimate was observed in the western part of the country. The visual inspection of the funnel plot demonstrated the presence of possible publication bias which might dictate shortage of studies with higher prevalences or variance inflation due to infectiousness of Brucella. In conclusion, the quantitative review showed the seroprevalence to be low but widely distributed. More importantly, the review underscores the need for isolation and characterization of the circulating Brucella spp. to capture the type of Brucella spp. involved and its distribution in cattle in Ethiopia.

Advancement of knowledge of Brucella over the past 50 years

Fifty years ago, bacteria in the genus Brucella were known to cause infertility and reproductive losses. At that time, the genus was considered to contain only 3 species: Brucella abortus, Brucella melitensis, and Brucella suis. Since the early 1960s, at least 7 new species have been identified as belonging to the Brucella genus (Brucella canis, Brucella ceti, Brucella inopinata, Brucella microti, Brucella neotomae, Brucella ovis, and Brucella pinnipedialis) with several additional new species under consideration for inclusion. Although molecular studies have found such high homology that some authors have proposed that all Brucella are actually 1 species, the epidemiologic and diagnostic benefits for separating the genus based on phenotypic characteristics are more compelling. Although pathogenic Brucella spp have preferred reservoir hosts, their ability to infect numerous mammalian hosts has been increasingly documented. The maintenance of infection in new reservoir hosts, such as wildlife, has become an issue for both public health and animal health regulatory personnel. Since the 1960s, new information on how Brucella enters host cells and modifies their intracellular environment has been gained. Although the pathogenesis and histologic lesions of B. abortus, B. melitensis, and B. suis in their preferred hosts have not changed, additional knowledge on the pathology of these brucellae in new hosts, or of new species of Brucella in their preferred hosts, has been obtained. To this day, brucellosis remains a significant human zoonosis that is emerging or reemerging in many parts of the world.

Brucellosis in low-income and middle-income countries

PURPOSE OF REVIEW

Human brucellosis is a neglected, underrecognized infection of widespread geographic distribution. It causes acute febrile illness and a potentially debilitating chronic infection in humans, and livestock infection has substantial socioeconomic impact. This review describes new information regarding the epidemiology of brucellosis in the developing world and advances in diagnosis and treatment.

RECENT FINDINGS

The highest recorded incidence of human brucellosis occurs in the Middle East and Central Asia. Fever etiology studies demonstrate brucellosis as a cause of undifferentiated febrile illness in the developing world. Brucellosis is a rare cause of fever among returning travelers, but is more common among travelers returning from the Middle East and North Africa. Sensitive and specific rapid diagnostic tests appropriate for resource-limited settings have been validated. Randomized controlled trials demonstrate that optimal treatment for human brucellosis consists of doxycycline and an aminoglycoside. Decreasing the burden of human brucellosis requires control of animal brucellosis, but evidence to inform the design of control programs in the developing world is needed.

SUMMARY

Brucellosis causes substantial morbidity in human and animal populations. While improvements in diagnostic options for resource-limited settings and stronger evidence for optimal therapy should enhance identification and treatment of human brucellosis, prevention of human disease through control in animals remains paramount.

F1 and tbilisi are closely related brucellaphages exhibiting some distinct nucleotide variations which determine the host specificity

We report on the 41,143-bp genome of brucellaphage F1, a podovirus that infects several Brucella species. The F1 genome is almost identical to the genome of brucellaphage Tb. However, some structural proteins of the phages exhibit extensive polymorphisms and might be responsible for their different host ranges.

Assessment of genetic diversity of zoonotic Brucella spp. recovered from livestock in Egypt using multiple locus VNTR analysis

Brucellosis is endemic in most parts of Egypt, where it is caused mainly by Brucella melitensis biovar 3, and affects cattle and small ruminants in spite of ongoing efforts devoted to its control. Knowledge of the predominant Brucella species/strains circulating in a region is a prerequisite of a brucellosis control strategy. For this reason a study aiming at the evaluation of the phenotypic and genetic heterogeneity of a panel of 17 Brucella spp. isolates recovered from domestic ruminants (cattle, buffalo, sheep, and goat) from four governorates during a period of five years (2002-2007) was carried out using microbiological tests and molecular biology techniques (PCR, MLVA-15, and sequencing). Thirteen strains were identified as B. melitensis biovar 3 while all phenotypic and genetic techniques classified the remaining isolates as B. abortus (n = 2) and B. suis biovar 1 (n = 2). MLVA-15 yielded a high discriminatory power (h = 0.801), indicating a high genetic diversity among the B. melitensis strains circulating among domestic ruminants in Egypt. This is the first report of the isolation of B. suis from cattle in Egypt which, coupled with the finding of B. abortus, suggests a potential role of livestock as reservoirs of several zoonotic Brucella species in the region.

Herd-level risk factors for Campylobacter fetus infection, Brucella seropositivity and within-herd seroprevalence of brucellosis in cattle in northern Nigeria

Brucellosis and campylobacteriosis are economically important diseases affecting bovine reproductive efficiency in Nigeria. A questionnaire-based survey was conducted in 271 cattle herds in Adamawa, Kaduna and Kano states of northern Nigeria using multistage cluster sampling. Serum from 4745 mature animals was tested for Brucella antibodies using the Rose-Bengal plate test and positives were confirmed in series-testing protocol using competitive enzyme-linked immunosorbent assay. Preputial scrapings from 602 bulls were tested using culture and identification for Campylobacter fetus. For each disease, a herd was classified as positive if one or more animals tested positive. For each herd, information on potential managemental and environmental risk factors was collected through a questionnaire administered during an interview with the manager, owner or herdsman. Multiple logistic regression models were used to model the odds of herd infection for each disease. A zero-inflated Poisson model was used to model the count of Brucella-positive animals within herds, with the number tested as an exposure variable. The presence of small ruminants (sheep and/or goats) on the same farm, and buying-in of >3 new animals in the previous year or failure to practice quarantine were associated with increased odds of herd-level campylobacteriosis and brucellosis, as well as increased within-herd counts of Brucella-positive animals. In addition, high rainfall, initial acquisition of animals from markets, practice of gynaecological examination and failure to practice herd prophylactic measures were positively associated with the odds of C. fetus infection in the herd. Herd size of >15, pastoral management system and presence of handling facility on the farm were associated with increased odds, and gynaecological examination with reduced odds of herd-level Brucella seropositivity. Furthermore, the zero-inflated Poisson model showed that borrowing or sharing of bulls was associated with higher counts, and provision of mineral supplement with lower counts of Brucella-positive cattle within herds. Identification of risk factors for bovine campylobacteriosis and brucellosis can help to identify appropriate control measures, and the use of zero-inflated count model can provide more specific information on these risk factors.

The status of bovine brucellosis in Ethiopia with special emphasis on exotic and cross bred cattle in dairy and breeding farms

A cross-sectional study was conducted to investigate the seroprevalence of brucellosis and identify risk factors in exotic and cross bred cattle in Ethiopia. A total of 2334 cattle from 273 farms were tested serially for Brucella antibodies using the Rose Bengal Plate Test (RBPT) and the Compliment Fixation Test (CFT). The overall animal level seroprevalence was 1.9% (95% CI: 1.2, 2.6), with urban and peri-urban dairy 2.4% (95% CI: 1.4, 3.4), commercial 1.5% (95% CI: 0.5, 2.5) and breeding farms 1.5% (95% CI: 0.2, 3.2). The overall farm level prevalence was 10.6% (95% CI: 6.9, 14.3), with 8.6% (95% CI: 4.8, 12.4) in urban and peri-urban dairy followed by 16.9% (95% CI: 7.3, 26.6) in commercial and 20.0% (95% CI: 0.0, 59.4) in breeding farms. At individual animal level, purchased cows and adult age groups were observed to associate with Brucella seropositivity while presence of small ruminants on the farm was the only factor associated with increased risk of herd level Brucella infection. The lack of association between reproductive disorders and Brucella seroprevalence suggest that other causes largely outweigh as causes of the aforesaid disorder in studied production systems and demands an investigation. Finally, the need for isolation and characterization of circulating Brucella spp. and institution of regulatory measures to reinforce farm biosecurity was suggested.

Operationalizing a One Health approach to global health challenges

The One Health approach, which recognizes the interconnectedness of human, animal and ecosystem health, encourages collaboration between diverse disciplines to address complex health problems. The advantages and challenges posed by these interdisciplinary collaborations are described in this review. Learning networks where diverse participants can openly share processes, best practices, and case studies are discussed as a strategy for conducting transdisciplinary One Health research and tackling complex global health problems. The 11 papers in this special issue are also introduced as they illustrate how a One Health approach can be applied to better understand and control zoonotic pathogens, engage community stakeholders in One Health research and utilize wildlife species, most notably sea otters and birds, as sentinels of ecosystem health. Collaboration is rarely without complications; however, drawing on these insights may benefit the process of operationalizing the One Health approach to address today's global health challenges.