A case of brucellosis concomitant with HIV infection in China

Outbreak of occupational Brucella infection caused by live attenuated Brucella vaccine in a biological products company in Chongqing, China, 2020

The northern areas of China are traditional endemic regions for brucellosis in both animals and humans, while occasional outbreaks of brucellosis have been observed in neglected southern provinces. On December 16, 2020, Chongqing Center for Disease Control and Prevention (CQCDC) received a report of 15 Brucella seropositive employees in a biological products company. The CQCDC and the local health administrative department launched an investigation that included identification of cases, laboratory testing of samples, and employees' interview to identify the cause of this incident. A case-control study was implemented to compare high-risk factors between cases and serology-negative personals. Human and animal serum samples, and environmental swabs were collected for testing. A total of 61 recessive infectors were found with an infection rate of 43.57% (61/140). Fisher's exact test showed that there were significant differences in Brucella infection rates among different posts classifications (p=0.02), working places (p=0.007), and buildings (p＜0.0001). Case-control study showed that working in vaccine production workshop was independently associated with increased risk of infection (odds ratio (OR): 2.60; 95% confidence interval (CI): 1.31-5.19). The positive detection rate was 88.06% (59/67) for production environment and 16.67% (2/12) for external environment. The investigation indicated that close contact with biological products and aerosol were the potential transmission routes of this outbreak under the condition of insufficient personal protection and disinfection. Our study provides new epidemiological evidence for a more detailed understanding of occupational infections with live attenuated Brucella vaccine.Highlights An Outbreak of occupational Brucella infection was caused by Brucella vaccine.Contacting with biological products and aerosol were potential transmission routes.This is new evidence for the virulent characteristics of attenuated Brucella vaccine.

HIV and Mediterranean Zoonoses: A Review of the Literature

A zoonosis is an infectious disease that has jumped from a non-human animal to humans. Some zoonoses are very common in the Mediterranean area and endemic in specific regions, so they represent an important problem for public health. Human Immunodeficiency Virus (HIV) is a virus that has originated as a zoonosis and is now diffused globally, with the most significant numbers of infected people among the infectious diseases. Since the introduction of antiretroviral therapy (ART), the history for people living with HIV (PLWH) has changed drastically, and many diseases are now no different in epidemiology and prognosis as they are in not-HIV-infected people. Still, the underlying inflammatory state that is correlated with HIV and other alterations related to the infection itself can be a risk factor when infected with other bacteria, parasites or viruses. We reviewed the literature for infection by the most common Mediterranean zoonoses, such as Campylobacter, Salmonella, Brucella, Rickettsia, Borrelia, Listeria and Echinococcus, and a possible correlation with HIV. We included Monkeypox, since the outbreak of cases is becoming a concern lately. We found that HIV may be related with alterations of the microbiome, as for campylobacteriosis, and that there are some zoonoses with a significant prevalence in PLWH, as for salmonellosis.

Brucellosis in China: history, progress and challenge

Brucellosis is a neglected zoonosis. It causes acute febrile illness and a potentially debilitating chronic infection in humans, and livestock infection has substantial socioeconomic impact. Over the past two decades, improvements have been made to better understand the various aspects of human and animal brucellosis. Meanwhile, especially in the developing world, immense challenges that remain in controlling and eradicating brucellosis are novel diagnostics tools and efficacious vaccines. Here, we will focus on the remarkable issues on epidemiological survey, as well as the priority and challenge of brucellosis in China. Brucellosis will be controlled with meaningful collaboration between local and public partnerships effectively applying a One Health framework.