Cost-benefit analysis of intervention policies for prevention and control of brucellosis in India

A scoping review on the epidemiology and public significance of Brucella abortus in Chinese dairy cattle and humans

Brucellosis, caused by Brucella spp., is a re-emerging One Health disease with increased prevalence and incidence in Chinese dairy cattle and humans, severely affecting animal productivity and public health. In dairy cattle, B. abortus is the primary causative agent although infections with other Brucella species occur occasionally. However, the epidemiological and comparative importance of B. abortus in dairy cattle and humans remains inadequately understood throughout China due to the heterogeneity in locations, quality, and study methods. This scoping review aims to describe the changing status of B. abortus infection in dairy cattle and humans, investigate the circulating Brucella species and biovars, and identify factors driving the disease transmission by retrieving publicly accessible literature from four databases. After passing the prespecified inclusion criteria, 60 original articles were included in the final synthesis. Although the reported animal-level and farm-level prevalence of brucellosis in dairy cattle was lower compared to other endemic countries (e.g. Iran and India), it has been reported to increase over the last decade. The incidence of brucellosis in humans displayed seasonal increases. The Rose Bengal Test and Serum Agglutination Test, interpreted in series, were the most used serological test to diagnose Brucella spp. in dairy cattle and humans. B. abortus biovar 3 was the predominant species (81.9%) and biovar (70.3%) in dairy cattle, and B. melitensis biovar 3 was identified as the most commonly detected strain in human brucellosis cases. These strains were mainly clustered in Inner Mongolia and Shannxi Province (75.7%), limiting the generalizability of the results to other provinces. Live cattle movement or trade was identified as the key factor driving brucellosis transmission, but its transmission pattern remains unknown within the Chinese dairy sector. These knowledge gaps require a more effective One Health approach to be bridged. A coordinated and evidence-based research program is essential to inform regional or national control strategies that are both feasible and economical in the Chinese context.

A Review on the Methodology and Use of the Pregnant Mouse Model in the Study of Brucella Reproductive Pathogenesis and Its Abortifacient Effect

Brucellosis is one of the most common and widespread bacterial zoonoses and is caused by Gram-negative bacteria belonging to the genus Brucella. These organisms are able to infect and replicate within the placenta, resulting in abortion, one of the main clinical signs of brucellosis. Although the mouse model is widely used to study Brucella virulence and, more recently, to evaluate the protection of new vaccines, there is no clear consensus on the experimental conditions (e.g., mouse strains, doses, routes of inoculation, infection/pregnancy time) and the natural host reproducibility of the pregnant mouse model for reproductive brucellosis. This lack of consensus calls for a review that integrates the major findings regarding the effect of Brucella wild-type and vaccine strains infections on mouse pregnancy. We found sufficient evidence on the utility of the pregnant mouse model to study Brucella-induced placentitis and abortion and propose suitable experimental conditions (dose, time of infection) and pregnancy outcome readouts for B. abortus and B. melitensis studies. Finally, we discuss the utility and limitations of the pregnant mouse as a predictive model for the abortifacient effect of live Brucella vaccines.

The Reasons Behind Long-Term Endemicity of Brucellosis in Low and Middle-Income Countries: Challenges and Future Perspectives

Brucellosis is a neglected worldwide zoonotic disease with more than 500,000 new human cases each year. Direct contact with infected animals and consumption of undercooked animal origin foods are the main routes of brucellosis transmission to humans. Although long endeavor has been applied to control and eliminate brucellosis from animal and human populations in developing countries especially in low- and middle-income countries (LMICs), the disease is still endemic in these regions. Many common or unique factors including raw milk consumption, unhygienic slaughter of livestock, extensive husbandry, budgetary limitations, misdiagnosis, and other conditions play a role in long-term endemicity of brucellosis in these locations. It has been shown that One Health is the only practical approach to control brucellosis; however, applying such methods is challenging in low-resource areas. In such conditions, brucellosis is continuously maintained in animals and repeatedly spread to human populations. In this article, factors playing a critical role in brucellosis endemicity, and the real conditions challenging the application of One Health approach in control of brucellosis are highlighted.

Spatiotemporal dynamics and influencing factors of human brucellosis in Mainland China from 2005-2021

BACKGROUND

Brucellosis poses a significant public health concern. This study explores the spatial and temporal dynamic evolution of human brucellosis in China and analyses the spatial heterogeneity of the influencing factors related to the incidence of human brucellosis at the provincial level.

METHODS

The Join-point model, centre of gravity migration model and spatial autocorrelation analysis were employed to evaluate potential changes in the spatial and temporal distribution of human brucellosis in mainland China from 2005 to 2021. Ordinary Least Squares (OLS), Geographically Weighted Regression (GWR), and Multi-scale Geographically Weighted Regression (MGWR) models were constructed to analyze the spatial and temporal correlation between the incidence rate of human brucellosis and meteorological and social factors.

RESULTS

From 2005 to 2021, human brucellosis in China showed a consistent upward trend. The incidence rate rose more rapidly in South, Central, and Southwest China, leading to a shift in the center of gravity from the North to the Southwest, as illustrated in the migration trajectory diagram. Strong spatial aggregation was observed. The MGWR model outperformed others. Spatio-temporal plots indicated that lower mean annual temperatures and increased beef, mutton, and milk production significantly correlated with higher brucellosis incidence. Cities like Guangxi and Guangdong were more affected by low temperatures, while Xinjiang and Tibet were influenced more by beef and milk production. Inner Mongolia and Heilongjiang were more affected by mutton production. Importantly, an increase in regional GDP and health expenditure exerted a notable protective effect against human brucellosis incidence.

CONCLUSIONS

Human brucellosis remains a pervasive challenge. Meteorological and social factors significantly influence its incidence in a spatiotemporally specific manner. Tailored prevention strategies should be region-specific, providing valuable insights for effective brucellosis control measures.

Brucellae as resilient intracellular pathogens: epidemiology, host-pathogen interaction, recent genomics and proteomics approaches, and future perspectives

Brucellosis is considered one of the most hazardous zoonotic diseases all over the world. It causes formidable economic losses in developed and developing countries. Despite the significant attempts to get rid of Brucella pathogens in many parts of the world, the disease continues to spread widely. Recently, many attempts proved to be effective for the prevention and control of highly contagious bovine brucellosis, which could be followed by others to achieve a prosperous future without rampant Brucella pathogens. In this study, the updated view for worldwide Brucella distribution, possible predisposing factors for emerging Brucella pathogens, immune response and different types of Brucella vaccines, genomics and proteomics approaches incorporated recently in the field of brucellosis, and future perspectives for prevention and control of bovine brucellosis have been discussed comprehensively. So, the current study will be used as a guide for researchers in planning their future work, which will pave the way for a new world without these highly contagious pathogens that have been infecting and threatening the health of humans and terrestrial animals.

Approaches for disease prioritization and decision-making in animal health, 2000-2021: a structured scoping review

This scoping review identifies and describes the methods used to prioritize diseases for resource allocation across disease control, surveillance, and research and the methods used generally in decision-making on animal health policy. Three electronic databases (Medline/PubMed, Embase, and CAB Abstracts) were searched for articles from 2000 to 2021. Searches identified 6, 395 articles after de-duplication, with an additional 64 articles added manually. A total of 6, 460 articles were imported to online document review management software (sysrev.com) for screening. Based on inclusion and exclusion criteria, 532 articles passed the first screening, and after a second round of screening, 336 articles were recommended for full review. A total of 40 articles were removed after data extraction. Another 11 articles were added, having been obtained from cross-citations of already identified articles, providing a total of 307 articles to be considered in the scoping review. The results show that the main methods used for disease prioritization were based on economic analysis, multi-criteria evaluation, risk assessment, simple ranking, spatial risk mapping, and simulation modeling. Disease prioritization was performed to aid in decision-making related to various categories: (1) disease control, prevention, or eradication strategies, (2) general organizational strategy, (3) identification of high-risk areas or populations, (4) assessment of risk of disease introduction or occurrence, (5) disease surveillance, and (6) research priority setting. Of the articles included in data extraction, 50.5% had a national focus, 12.3% were local, 11.9% were regional, 6.5% were sub-national, and 3.9% were global. In 15.2% of the articles, the geographic focus was not specified. The scoping review revealed the lack of comprehensive, integrated, and mutually compatible approaches to disease prioritization and decision support tools for animal health. We recommend that future studies should focus on creating comprehensive and harmonized frameworks describing methods for disease prioritization and decision-making tools in animal health.

Retrospective benefit-cost analysis of bovine brucellosis control in the state of Mato Grosso, Brazil

From 2001, due to the launching of the National Program for the Control and Eradication of Brucellosis and Tuberculosis, Brazil began a series of studies aimed at the epidemiological characterization of bovine brucellosis in its federative units. In the state of Mato Grosso, studies conducted in 2003 and 2014 showed a reduction in the prevalence of infected herds from 41.2 % to 24 % and in the prevalence of seropositive animals from 10.2 % to 5.1 %. These results stemmed from the efficient heifer vaccination program with S19 implemented by the state. From this scenario, the present study quantified and compared the benefits and costs of bovine brucellosis control in the state through a financial analysis. When considering private and public costs, the Net Present Value (NPV) was estimated at US$ 37.5 million, the Internal Rate of Return (IRR) was calculated at 31 %, and the Benefit-Cost Ratio (BCR) was 2.3. When considering only the private costs, the NPV was US$ 51.3 million, the IRR was 46 % and the BCR was 3.43, indicating that the cattle producer in Mato Grosso had a return of US$ 3.43 for each US$ 1.00 invested. Therefore, the bovine brucellosis control actions carried out in the state of Mato Grosso between 2003 and 2014 were highly advantageous from the economic point of view. The most rational way to continue decreasing bovine brucellosis prevalences at low cost in the state is to maintain the heifer vaccination program, using the RB51 vaccine in addition to S19.

Economic analysis of bovine brucellosis control in the Rondônia state, Brazil

Bovine brucellosis, mainly caused by Brucella abortus, is a worldwide distribution anthropozoonosis that causes great economic losses. In 2001, Brazil launched the National Program for the Control and Eradication of Brucellosis and Tuberculosis (PNCEBT). Contemporaneously, a great effort to characterize the epidemiology of the disease in Brazilian states was started. In the state of Rondônia, a first epidemiological study was carried out in 2004, revealing a prevalence of 35.2% of infected herds and 6.22% of seropositive females. In 2014, after a successful heifer vaccination program with strain 19 (S19), a second study detected a reduction in the prevalence of infected herds to 12.3% and of seropositive females to 1.9%. The present study aimed to quantify and compare the costs and benefits related to the control of bovine brucellosis in the state through an accounting analysis. Vaccinating heifers and performing serological tests to move animals were computed as private costs. The expenditures of the state official veterinary service for brucellosis control were considered public cost. The considered benefits of lowering prevalence were decreased cow replacement, decreased abortions, decreased perinatal and cow mortality, and increased milk production. Considering private and public costs, the net present value (NPV) was estimated at US$ 18.3 million, the internal rate of return (IRR) was calculated at 23%, and the benefit-cost ratio (BCR) was 1.7. When considering only the private costs, the NPV was US$34.9 million, the IRR was 49%, and the BCR was 3.0, meaning that the bovine producer had a return of 3 for each unit of currency invested. The results showed that the bovine brucellosis control measures implemented in the state of Rondônia, which had as its main strategy the vaccination of heifers with S19, produced highly advantageous economic results. The state should continue with its vaccination program, stimulating the use of the RB51 vaccine in addition to S19, to achieve further reductions in prevalence at low cost.

Antibiotic persistence of intracellular Brucella abortus

Background

Human brucellosis caused by the facultative intracellular pathogen Brucella spp. is an endemic bacterial zoonosis manifesting as acute or chronic infections with high morbidity. Treatment typically involves a combination therapy of two antibiotics for several weeks to months, but despite this harsh treatment relapses occur at a rate of 5–15%. Although poor compliance and reinfection may account for a fraction of the observed relapse cases, it is apparent that the properties of the infectious agent itself may play a decisive role in this phenomenon.

Methodology/Principal findings

We used B. abortus carrying a dual reporter in a macrophage infection model to gain a better understanding of the efficacy of recommended therapies in cellulo. For this we used automated fluorescent microscopy as a prime read-out and developed specific CellProfiler pipelines to score infected macrophages at the population and the single cell level. Combining microscopy of constitutive and induced reporters with classical CFU determination, we quantified the protective nature of the Brucella intracellular lifestyle to various antibiotics and the ability of B. abortus to persist in cellulo despite harsh antibiotic treatments.

Conclusion/Significance

We demonstrate that treatment of infected macrophages with antibiotics at recommended concentrations fails to fully prevent growth and persistence of B. abortus in cellulo, which may be explained by a protective nature of the intracellular niche(s). Moreover, we show the presence of bona fide intracellular persisters upon antibiotic treatment, which are metabolically active and retain the full infectious potential, therefore constituting a plausible reservoir for reinfection and relapse. In conclusion, our results highlight the need to extend the spectrum of models to test new antimicrobial therapies for brucellosis to better reflect the in vivo infection environment, and to develop therapeutic approaches targeting the persister subpopulation.

Brucellosis is a zoonosis endemic to many low- and middle-income countries around the world. Therapies recommended by the WHO are comprised of at least two antibiotics for several weeks, sometimes months. Relapses are frequent despite these harsh treatments. The underlying reasons for these relapses, besides reinfection and non-compliance to treatment, are unknown. Our study shows that Brucella abortus can form so called “persisters” in rich broth but also inside macrophages. This small bacterial subpopulation survives antibiotic treatment and resumes growth after removal of the antibiotics and could therefore serve as a reservoir for relapses in human brucellosis. Furthermore, we show that the intracellular lifestyle of Brucella has protective properties against recommended antibiotics as observed for other intracellular pathogens, highlighting the necessity to develop new infection models to assess antibiotic efficacy.

Brucellosis in India: Comparing exposure amongst veterinarians, para-veterinarians and animal handlers

The exposure to Brucella species is an occupational hazard for veterinary personnel in India. In our previous study, paraveterinarians and animal handlers were found to be at higher risk of being seropositive. In the present study, we further investigate comparative exposure risk to brucellosis amongst the veterinary professionals, identify risk factors, and evaluate the perceptions and practices towards using adequate personal protective equipment (PPE) while attending high risk veterinary interventions. A cross-sectional study was conducted amongst veterinary personnel in the Punjab state of India. Logistic and negative binomial regression models were constructed to interpret the influence of categorical and numerical variables on prevalence of brucellosis and the adequacy of PPE use, respectively. Compared to veterinarians, animal handlers were less likely to consider veterinary practice in sheep and goats (odds ratio [OR] 0.3; 95% confidence interval [CI]: 0.2-0.7) or assisting in obstetric interventions (OR 0.3, 95% CI 0.1-0.8) as potential exposures. They were less aware of the signs and symptoms of the disease in humans (OR 0.05, 95% CI 0.02-0.14) and of the availability of vaccines for cattle (OR 0.07, 95% CI 0.01-0.3) than the veterinarians, and were least likely of the three groups to recommend vaccination of cattle against brucellosis to animal owners (OR 0.1, 95% CI 0.02-0.3). Compared to veterinarians, they were also less likely to consider zoonotic risk (OR 0.4, 95% CI 0.2-0.8) or better efficiency (OR 0.1, 95% CI 0.05-0.4) as enablers of PPE use during veterinary procedures. Of the three occupational groups, animal handlers were also less likely to use adequate PPE during high-risk veterinary exposures, although they were found to have handled the highest number of cases of abortion. The average use of adequate PPE during high-risk interventions in one month preceding this study was lowest for animal handlers. Veterinary personnel with a higher rate of PPE use during high-risk veterinary interventions were likely to obtain information on brucellosis from government sources (p = 0.06) and felt that PPE use enhanced their professional efficiency (Incidence rate ratio [IRR] 3.3, 95% CI 1.5-8.1) compared to those who were less likely to use adequate PPE. We recommend concerted efforts to increase awareness amongst veterinary personnel, particularly amongst animal handlers, regarding brucellosis and the importance of biosecurity measures in veterinary practice. Designing training courses on the importance of PPE use along with formulation of biosecurity guidelines at local levels could help reduce the prevalence of the disease in veterinary personnel.

Importance of brucellosis control programs of livestock on the improvement of one health

Brucellosis not only represents an important health restraint on livestock but also causes high economic losses in many developing countries worldwide. Despite considerable efforts made for the control of brucellosis, the disease is still spreading in many regions (such as the Middle East) where it represents one of the most important health hazards impacting both animals and humans. The present review aims to investigate the efficacy of veterinary control programs regarding brucellosis, with a special focus on current prevention, control, and eradication approaches. The reasons for unsuccessful control programs such as the absence of highly effective vaccines and non-certified bulls are also debated, to understand why the prevalence of brucellosis in livestock is not decreasing in many areas despite considerable efforts taken to date. The importance of governmental and regional investment in brucellosis control remains one of the main limiting factors owing to the limited budget allocated to tackle this disease. In this context, one health concept has generated novel comprehensive approaches with multiple economic implications across the livestock industry and public health. However, the implementation of such global preventive strategies appears to be a key issue for many endemic and low-income countries. According to the collected data, epidemiological contexts including management and trade systems along with well-defined agro-ecological zones should be evaluated in brucellosis endemic countries to improve milk production and to enhance the sustainability of the livestock sector at both national and regional levels.

A policy analysis of agenda-setting of Brucellosis in Iran using a multiple-stream framework: health policy and historical implications

Background

Brucellosis, a major zoonotic disease, is highly present in Iran, especially in Lorestan province. The aim of this study was to understand the issues related to Brucellosis utilizing the multiple streams framework.

Methods

A two-step method was adopted: 1) assessment of brucellosis-related documents and 2) interviews with stakeholders. As a first step, all documents related to Brucellosis were reviewed at provincial and national levels. Policy documentation on health issues included the consultation of guidelines, rules and regulations, websites, reports, books, guides, and conferences. These documents were collected by referring to specialized centers, institutions, and organizations. In the second step, semi-structured interviews were conducted to determine the burden of disease with actors and stakeholders involved with the brucellosis program in the Lorestan province. More in detail, physicians, healthcare workers, managers, policy- and decision-makers were selected for interviews.

Results

The problem stream was characterized by: 1) high prevalence of the disease, 2) traditional livestock production, 3) unsafe animal slaughtering, 4) centers for the sale and distribution of non-authorized dairy products, 5) raw milk and 6) traditional unsafe dairy products consumption, 7) incomplete livestock vaccination, 8) lack of knowledge of Brucellosis, 9) neighboring countries with high prevalence of Brucellosis, 10) lack of livestock quarantine, and 10) nomadic immigration. The policy stream was characterized by 1) primary healthcare networks, 2) guidelines, 3) medicines, insurance, and 4) diagnostic services. Finally, the political stream was characterized by: 1) support of the University of Medical Sciences, 2) sponsorship by the Ministry of Health and Medical Education, 3) Health transformation plan, and 4) Working Group on Health and Food Security in Lorestan.

Conclusion

This study examined the brucellosis-related agenda setting: if different issues are taken into consideration, it can be perceived as a health priority.

Epidemiology of bovine brucellosis in Hisar, India: identification of risk factors and assessment of knowledge, attitudes, and practices among livestock owners

Brucellosis caused by facultative intracellular bacteria, Brucella, remains a global threat to both animal and human health. In this study we aimed to identify potential risk factors of bovine brucellosis and to assess the knowledge, attitudes, and practices (KAPs) of livestock keepers in Hisar, India. A standardized questionnaire was used to collate information regarding potential risk factors of bovine brucellosis and livestock owners' KAPs. A total of 127 livestock keepers were involved. Serum samples from their animals (n = 635) were tested for the presence of antibodies against Brucella by Rose Bengal Plate Test (RBPT) and indirect enzyme-linked immunosorbent assay (iELISA). Out of these, 78 (61.4%) of the herds had at least one seropositive animal, and 302 (47.6%) of the cattle were seropositive. Univariate and multivariate analysis revealed significant associations between intensive farm type (OR = 4.6; 95% CI, 1.6-16.7; P = 0.009), hygienic disposal of aborted fetuses (OR = 0.3; 95% CI, 0.08-0.9; P = 0.04) and herd seropositivity for brucellosis. The majority, 96 (75.6%) of the respondents, were males aged 18-50, and 82 (64.6%) owned a small-backyard farm. Only 51 (40.2%) of the participants knew about brucellosis; out of them, 54.9% (28/51) could not identify clinical signs of brucellosis. Six (11.8%) participants indicated abortion as the most noticeable clinical sign, and 45.1% indicated that consumption of raw milk is associated with high risk of contracting brucellosis. A large proportion of respondents confirmed that milk from their animals was regularly consumed (86.6%) and sold (59.8%) to other people. These results suggest that bovine brucellosis is endemic in Haryana, where Brucella-contaminated milk is likely being regularly sold. Brucellosis control efforts in Haryana should include education programs to raise awareness of the disease and means to control it in cattle and to prevent zoonotic transmission.

Cost-Benefit Analysis of a Mass Vaccination Strategy to Control Brucellosis in Sheep and Goats in Northern Iraq

Brucellosis is a major economic and production-limiting disease for livestock owners and the community in Iraq. A cost–benefit analysis was conducted to evaluate the impact of an expanded annual mass vaccination programme of sheep and goats that involves all female and male sheep and goats over the age of 3 months with Rev. 1 vaccine. The proposed expanded vaccination programme was compared to the current annual vaccination program, which involved only vaccinating female sheep and goats between the ages of 3 and 6 months of age with Rev. 1. The cost-benefit analysis model was developed utilizing data collected in Dohuk Governorate, northern Iraq. The seroprevalence in small ruminants (using Rose Bengal test and ELISA in series) was predicted to decrease from 9.22% to 0.73% after 20 years of implementing the proposed annual mass vaccination program. The net present value of the mass vaccination program was estimated to be US$ 10,564,828 (95% Confidence Interval (CI): −16,203,454 to 37,049,245), the benefit–cost ratio was estimated to be 4.25 (95% CI: −2.71 to 11.22), and the internal rate of return was 91.38% (95% CI:11.71 to 190.62%). The proposed vaccination strategy was predicted to decrease the overall financial loss caused by brucellosis from 1.75 to 0.55 US$ per adult female animal. The results of this economic analysis highlight the benefit of implementing an annual mass vaccination program of small ruminants with Rev. 1 vaccine to reduce the prevalence of brucellosis in northern Iraq.

Bovine brucellosis - a comprehensive review

Brucellosis is a zoonotic disease of great animal welfare and economic implications worldwide known since ancient times. The emergence of brucellosis in new areas as well as transmission of brucellosis from wild and domestic animals is of great significance in terms of new epidemiological dimensions. Brucellosis poses a major public health threat by the consumption of non-pasteurized milk and milk products produced by unhygienic dairy farms in endemic areas. Regular and meticulous surveillance is essentially required to determine the true picture of brucellosis especially in areas with continuous high prevalence. Additionally, international migration of humans, animals and trade of animal products has created a challenge for disease spread and diagnosis in non-endemic areas. Isolation and identification remain the gold standard test, which requires expertise. The advancement in diagnostic strategies coupled with screening of newly introduced animals is warranted to control the disease. Of note, the diagnostic value of miRNAs for appropriate detection of B. abortus infection has been shown. The most widely used vaccine strains to protect against Brucella infection and related abortions in cattle are strain 19 and RB51. Moreover, it is very important to note that no vaccine, which is highly protective, safe and effective is available either for bovines or human beings. Research results encourage the use of bacteriophage lysates in treatment of bovine brucellosis. One Health approach can aid in control of this disease, both in animals and man.

The feasibility and acceptability of various bovine brucellosis control strategies in India

Bovine brucellosis is a neglected zoonotic disease prevalent in several developing countries including India. It has been successfully controlled in many developed countries by using vaccination in conjunction with extensive surveillance and test-and-cull approaches, but some of these approaches do not suit Indian culture and norms. This study was conducted to investigate the feasibility and social acceptability of various bovine brucellosis control strategies in India. Focus group discussions and key-informant interviews were conducted with veterinarians, para-veterinarians, veterinary academics, farmers and other stakeholders. Vaccination with the Brucella strain 19 vaccine was considered feasible, but the participants were concerned about the risk of self-inoculation, the inability to vaccinate pregnant and male animals, the difficulty to differentiate vaccinated from diseased animals and the challenges of maintaining the vaccine cold chain in India. As expected, the test-and-cull approach was not considered feasible as cattle are considered sacred by Hindus and their slaughter is banned in most states. Although the test-and-segregation approach appears reasonable in theory, it would have low acceptability, if implemented without providing any compensation to farmers. Negligible biosecurity was implemented by farmers: almost no biosecurity procedures were performed for visitors entering a farm, and testing of animals was rarely undertaken before introducing them to a farm. However, the participants considered that improving biosecurity would be more acceptable and feasible than both the test-and-cull and the test-and-segregation approaches. Similarly, inadequate personal protection was used by veterinary personnel for handling parturition, retention of placenta and abortion cases; this was considered as another area of possible improvement. Farmers and veterinarians expressed serious concerns about stray cattle as many of them could potentially be infected with brucellosis, and thus could spread the infection between farms. This study recommends using vaccination and biosecurity along with some ancillary strategies to control brucellosis in India. Information from the study could be used to develop an evidence-based disease control program for the disease in the country.

Assessment of Seroprevalence and the Risk Factors of Sheep Brucellosis in Basrah (Southern Iraq): A Challenge to Prospectively Control Brucellosis

Brucellosis is one of the most important foodborne infectious diseases distributed widely in low- and middle-income countries. The current study was carried out to investigate the prevalence and risk factors that influence the distribution of Brucella in sheep. A structured questionnaire was prepared and introduced to a total of 60 resident owners from five counties, and 400 sheep blood samples were randomly collected from the selected herds. The sera of isolated sheep were tested for Brucella spp. using the Rose Bengal Test (RBT). A univariable and multivariable logistic regression analysis was used to evaluate the risk factors linked to animal management and husbandry practices at the farm level. The overall prevalence estimated for brucellosis was 31% (95% confidence interval [Cl]: 26.5–35.8). The odds of seroprevalence in sheep >1 year were significantly higher than those in sheep ≤1 year (odds ratio [OR]: 2.2, 95% Cl: 1.41–3.44). The logistic regression outcomes revealed that two variables related to the management and practices at the farm level were significantly associated with the seroprevalence of brucellosis. These variables were sheep sheep grazing with other flocks (OR: 5.8, 95 Cl% Cl: 1.53–22.67) and the practice of lending ram among sheep owners (OR: 9.3, 95% Cl: 1.05–83.82). Unconfined domesticated dogs, improper handling of aborted ewes, introduction of new animals in a herd, (purchased), and lack of knowledge about brucellosis among owners were underlined to be further important factors that could influence the spread of brucellosis. This study concluded that brucellosis is an endemic disease in Basrah, and the animal vaccination control program with an integrated health education program for sheep owners are obligatory elements of the prevention measures needed to be established to minimize the risk of brucellosis in Basrah.

Socially vs. Privately Optimal Control of Livestock Diseases: A Case for Integration of Epidemiology and Economics

This paper aims to illustrate the interdependencies between key epidemiological and economic factors that influence the control of many livestock infectious diseases. The factors considered here are (i) farmer heterogeneity (i.e., differences in how farmers respond to a perceived disease risk), (ii) off-farm effects of farmers' actions to control a disease (i.e., costs and benefits borne by agents that are external to the farm), and (iii) misalignment between privately and socially optimal control efforts (i.e., privately optimal behavior not conducive to a socially optimal outcome). Endemic chronic diseases cause a wide range of adverse social and economic impacts, particularly in low-income countries. The actions taken by farmers to control livestock diseases minimize some of these impacts, and heterogeneity in those actions leads to variation in prevalence at the farm level. While some farmers respond to perceived disease risks, others free-ride on the actions of these individuals, thereby compromising the potential benefits of collective, coordinated behavior. When evaluating a plausible range of disease cost to price of control ratios and assuming that farmers choose their privately optimal control effort, we demonstrate that achievement of a socially optimal disease control target is unlikely, occurring in <25% of all price-cost combinations. To achieve a socially optimal disease control outcome (reliant on farmers' voluntary actions), control policies must consider farmer heterogeneity, off-farm effects, and the predicted uptake of control measures under the assumption of optimized behavior.

Serological evidence of Brucellosis in selected gaushalas of Haryana

Brucellosis is a neglected zoonotic disease with significant economic and public health consequences to human and animal population in developing countries. The objective of the present study was to determine the serological evidences of brucellosis in cattle reared in two gaushalas of Hisar and Jind districts, Haryana. The serological tests: Rose Bengal Plate Test (RBPT), Serum Agglutination Test (SAT) and Enzyme Linked Immunosorbent Assay (ELISA) were employed for screening the animals for brucellosis. The overall seropositivity by RBPT, SAT and ELISA was 23.46%, 20.67% and 28.49% respectively. The logistic regression modalities concluded higher likelihood of brucellosis with age > 6 years followed by 3–6 year than cows with <3 years. The agreement between tests (RBPT and ELISA, SAT and ELISA and RBPT and SAT) was found to be 0.87 (95% CI: 0.857–0.882), 0.70 (95% CI: 0.684–0.718) and 0.82 (95% CI: 0.809–0.834) respectively by kappa statistic. This study concluded high infection rate in gaushala where animals were kept as closed population with more risks of brucellosis among older milching animals which poses potential public health risk through consumption of unpasteurized milk.

Evaluation of real-time PCR as an alternative for potency testing of Brucella abortus vaccines

The aim of the research was to evaluate real-time PCR (qPCR) as an alternate method for quantitative detection of Brucella abortus strain 544 (S544) in the spleen of mice for potency testing of live B. abortus strain 19 (S19) vaccine. IS711 and eryC gene-based qPCR were optimized for calculating copy number. The copy number was further correlated with live Brucella count in the spleen by standard plate count (SPC) method. The mice were immunized with S19 and challenged with S544 on 30th Day post-immunization. The spleen of mice was collected at 15th, 21st, and 30th days post challenge (DPC) for estimation of S19 and S544 load via SPC as well as qPCR. The noteworthy difference was observed between immunized and unimmunized group by both methods at all time points. The maximum correlation between SPC and qPCR method was observed at 15th DPC in both immunized and unimmunized group. Repeated experiments at 15th DPC gave the parallel significant difference between immunized and unimmunized group by both methods. Thus novel, risk-free qPCR method can be used for the indirect culture-free potency evaluation of S19 vaccine in order to preclude the cultivation of zoonotic Brucella organisms from spleen samples.

Brucellosis in India: results of a collaborative workshop to define One Health priorities

Brucellosis is an important zoonosis worldwide. In livestock, it frequently causes chronic disease with reproductive failures that contribute to production losses, and in humans, it causes an often-chronic febrile illness that is frequently underdiagnosed in many low- and middle-income countries, including India. India has one of the largest ruminant populations in the world, and brucellosis is endemic in the country in both humans and animals. In November 2017, the International Livestock Research Institute invited experts from government, national research institutes, universities, and different international organizations to a one-day meeting to set priorities towards a "One Health" control strategy for brucellosis in India. Using a risk prioritization exercise followed by discussions, the meeting agreed on the following priorities: collaboration (transboundary and transdisciplinary); collection of more epidemiological evidence in humans, cattle, and in small ruminants (which have been neglected in past research); Economic impact studies, including cost effectiveness of control programmes; livestock vaccination, including national facilities for securing vaccines for the cattle population; management of infected animals (with the ban on bovine slaughter, alternatives such as sanctuaries must be explored); laboratory capacities and diagnostics (quality must be assured and better rapid tests developed); and increased awareness, making farmers, health workers, and the general public more aware of risks of brucellosis and zoonoses in general. Overall, the meeting participants agreed that brucellosis control will be challenging in India, but with collaboration to address the priority areas listed here, it could be possible.

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.