Surveillance and control of bovine brucellosis in the Republic of Korea during 2000–2006

Current Status of Q Fever and the Challenge of Outbreak Preparedness in Korea: One Health Approach to Zoonoses

Human Q fever, a zoonosis caused by Coxiella burnetii, presents with diverse clinical manifestations ranging from mild self-limited febrile illnesses to life-threatening complications such as endocarditis or vascular infection. Although acute Q fever is a benign illness with a low mortality rate, a large-scale outbreak of Q fever in the Netherlands led to concerns about the possibility of blood transfusion-related transmission or obstetric complications in pregnant women. Furthermore, a small minority (< 5%) of patients with asymptomatic or symptomatic infection progress to chronic Q fever. Chronic Q fever is fatal in 5-50% of patients if left untreated. In South Korea, Q fever in humans was designated as a notifiable infectious disease in 2006, and the number of Q fever cases has increased sharply since 2015. Nonetheless, it is still considered a neglected and under-recognized infectious disease. In this review, recent trends of human and animal Q fever in South Korea, and public health concerns regarding Q fever outbreaks are reviewed, and we consider how a One Health approach could be applied as a preventive measure to prepare for zoonotic Q fever outbreaks.

Spatial analysis to assess the relationship between human and bovine brucellosis in South Korea, 2005-2010

The first case of human brucellosis in South Korea was reported in 2002, and cases of human infection continue to occur. Although an association between human and bovine brucellosis has been identified, the spatial relationship has not been studied in South Korea. Here, we analysed the spatial patterns of human and bovine brucellosis retrieved from the human and veterinary surveillance data, as well as the spatial correlation between human and bovine brucellosis and associated factors that contribute to its occurrence. The risk of human brucellosis was analysed using a Bayesian spatial model with potential risk factors. Our results show that, for both human and bovine brucellosis, hotspots were clustered in the southeast regions of Korea, whereas coldspots were clustered in the northwest regions of Korea. Our study suggests that the risk of human brucellosis increases in rural regions with the highest risk of bovine brucellosis. Collaborative strategies between human and veterinary health sectors (e.g, public health intervention and region-specific eradication programs for bovine brucellosis) would reduce the burden of brucellosis in South Korea.

The impact of expanded brucellosis surveillance in beef cattle on human brucellosis in Korea: an interrupted time-series analysis

BACKGROUND

Korean surveillance program for bovine brucellosis was improved by extending it to beef slaughterhouses and by pre-movement testing of bulls on May 2005 (Intervention 1). The bovine brucellosis surveillance program was further extended to beef cattle farms with more than 10 heads of cattle on June 2006 (Intervention 2).

METHODS

To quantify the temporal relationship between bovine and human brucellosis, a time-series analysis was conducted using Korean national notification data reported between January 2004 and December 2014.

RESULTS

Our findings indicate that while during the pre-intervention phase (January 2004 to March 2005) there was no significant temporal relationship between the incidences of bovine and human brucellosis, significant temporal relationships were observed after Intervention 1 (June 2005 to June 2006, no lag, β = 0.57, p = 0.04), and Intervention 2 (July 2006 to June 2007, 1-month lag, β = 0.65, p = 0.03). Furthermore, significant changes in incidence in human were observed after Intervention 1 (β = - 0.17 per 10 million-people, p = 0.03) and Intervention 2 (β = - 0.19 per 10 million-people, p = 0.04).

CONCLUSIONS

These findings indicated the changes of a nationwide comprehensive surveillance programme targeting all cattle is required for effective reduction in the human population.

Large-scale study of herd-level risk factors for bovine brucellosis in Brazil

Bovine brucellosis is an important zoonosis caused by Brucella abortus that negatively impacts livestock productivity. In 2001, Brazil launched a new national program aimed at eradicating animal brucellosis that included large-scale studies of the prevalence and risk factors to support strategic decision-making. These studies were implemented by the animal health authorities and were underpinned by the scientific coordination of the University of São Paulo and the University of Brasília. The state-level results were published and revealed important differences in herd prevalence among regions. The risk factors varied across states and did not clearly explain the observed spatial disease spread. This study used a consolidated herd-level database of 14 states and 17,100 herds, from the prevalence surveys' data, to gain insights into herd profiles and cattle production practices that might be associated with the risk of brucellosis. At the time of data collection, the study area comprised just over 56 million bovine females aged over 24 months and approximately 1.8 million herds. After an exploratory univariable analysis, all factors with p≤0.20 were included in a multiple logistic regression model, using the design-based method in order to take herd sampling weights into account. The number of females in the herd markedly increased the risk of infection; compared with smaller herds (less than 30 females), the odds ratio was 3.42 [CI 95% 2.98-3.91] for herds with 31 to 100 females, 5.68 [4.92-6.55] for herds with 101 to 400 females, and 13.14 [10.94-15.78] for herds with more than 400 females. The risk was higher for extensive cattle production farms (OR=1.23 [1.07-1.42]) and for farms that purchased replacement stock from cattle traders (OR=1.27 [1.08-1.47]) or directly from other farms (OR=1.19 [1.07-1.32]). The exclusive use of artificial insemination (OR=0.57 [0.4-0.81]) and regular veterinary support (OR=0.68 [0.6-0.77]) appeared to be protective factors. These findings are consistent with the regional prevalence trends observed in the study and provide key guidance for the planning of the national effort to control and eradicate brucellosis. High vaccination coverage of heifers is recommended, especially when targeted to areas where large-scale extensive cattle production predominates. The smaller, more intensive herds, are good candidates for disease accreditation schemes.

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.

Epidemiology of brucellosis among cattle in Korea from 2001 to 2011

In the present study, the outbreak patterns of bovine brucellosis in Korea from 2000 to 2011 were analyzed to understand the epidemiological evolution of this disease in the country. A total of 85,521 brucella reactor animals were identified during 14,215 outbreaks over the 12-year study period. The number of bovine brucellosis cases increased after 2003 and peaked in 2006 before decreasing thereafter. The majority of the bovine brucellosis cases were Korean native cattle, Han Woo. The numbers of human brucellosis cases and cattle outbreaks increased and decreased in the same pattern. The correlation coefficient for human and bovine cases per year was 0.96 (95% confidence interval = 0.86~0.99; p < 10^-3). The epidemiological characteristics of bovine brucellosis appeared to be affected by the intensity of eradication programs that mainly involved a test-and-slaughter policy. Findings from the present study were based on freely available statistics from web pages maintained by government agencies. This unlimited access to information demonstrates the usefulness of government statistics for continually monitoring the health of animal populations.

Seroprevalence investigation of bovine brucellosis in Macenta and Yomou, Guinea

Brucellosis is one of the world's major zoonotic diseases associated with reproductive disorders and a potential infection of human. Brucellosis leads to serious economic losses due to late-term abortion, stillbirth, weak calves, and sterility. In Guinea, the data on brucellosis was only detected as far back as 10 years ago. The purpose of this study was to estimate the prevalence of bovine brucellosis in the provinces of Macenta and Yomou of Guinea. A structured questionnaire was used in the clinical study, and 345 cattle were clinically examined. Three hundred serum samples were initially subjected to the Rose Bengal test (RBT); the positive results of which were confirmed by the complement fixation test (CFT). The investigation indicated that farmers had little information on brucellosis. Hygroma, abortion, sterility, and placental retention were the observed symptoms. Of the 29 RBT-positive samples, 26 were confirmed by CFT. The prevalence of brucellosis in Macenta and Yomou was 12 and 5.33 %, respectively. In both provinces, the prevalence mean was 8.67 %. This study highlighted the immediate necessity to carry out a strengthened surveillance of human and animal brucellosis to obtain as many data as possible in order to establish strategies for prevention and management of brucellosis in Guinea.

Spatio-temporal clusters of incident human brucellosis cases in Ecuador

This study aimed to determine whether variations in the incidence of reported cases of human brucellosis in Ecuador were clustered in space and time. In addition, the effects of cattle and small ruminant population density and other socio-economic factors on the incidence were investigated. Significant space-time clusters were found in the northern and southern highlands and parts of Ecuadorian Amazonia. Customs of people, cattle, goat and sheep population density appeared to influence the incidence of brucellosis. In this study, the incidence of reported cases of human brucellosis was found to be higher in the highlands (sierra) and in municipalities near Peru and Colombia. The results of this study highlight the need for prevention and control measures aimed at abating the incidence of brucellosis among livestock and humans.

Prevalence and risk-mapping of bovine brucellosis in Maranhão State, Brazil

Between 2007 and 2009, a cross-sectional survey was carried out in Maranhão State, Brazil to estimate the seroprevalence of and risk factors for bovine brucellosis. In total, 749 herds and 6779 cows greater than two years of age were blood sampled. At the time of sampling a questionnaire to collect details on possible risk factors for bovine brucellosis was administered to the participating herd manager. A logistic regression model was developed to quantify the association between herd demographic and management characteristics and the herd-level brucellosis status. Spatial analyses were carried out to identify areas of the state where the presence of brucellosis was unaccounted-for by the explanatory variables in the logistic regression model. The estimated herd-level prevalence of brucellosis in Maranhão was 11.4% (95% CI 9.2-14) and the individual animal-level prevalence was 2.5% (95% CI 1.7-3.6). Herds with more than 54 cows older than two years of age, herds that used rented pasture to feed cattle, and the presence of wetlands on the home farm increased the risk of a herd being brucellosis positive. Infected farms were identified throughout the state, particularly in the central region and on the northwestern border. Spatial analyses of the Pearson residuals from the logistic regression model identified an area in the center of the state where brucellosis risk was not well explained by the predictors included in the final logistic regression model. Targeted investigations should be carried out in this area to determine more precisely the reasons for the unexplained disease excess. This process might uncover previously unrecognized risk factors for brucellosis in Maranhão.