Human brucellosis in Maghreb: existence of a lineage related to socio-historical connections with Europe

Seroprevalence and Risk Factors of Brucellosis in Ruminants in Dhofar Province in Southern Oman

OBJECTIVE

The aim of the present work was to raise awareness of Brucella infection and emphasize the use of serological tests for screening and confirmation of the presence of the infection in different localities in the Dhofar region in the Sultanate of Oman.

METHODS

A seroprevalence of Brucella infection in naturally infected livestock was undertaken in 50 farms (a total of 434 sera, 207 goats, 84 sheep, 54 cattle, and 89 camels) from different wilayat of the Dhofar region in the southern part of Oman. Rose Bengal (RBT), complement fixation (CFT), and indirect enzyme-linked immunosorbent assay (I-ELISA) tests were used to determine the presence of Brucella antibodies. Statistical analysis (Pearson chi-square, binary logistic regression, and univariate logistic regression) was used to investigate the significance between the prevalence and the categorical risk factors individually, with two or more levels (animal species, animal condition, and or location).

RESULTS

Our results show that the overall seroprevalence based on CFT, RBT, and I-ELISA was 3% (13/424, CI: 1.8-5.1%), 4.8% (21/434, CI: 3.1-7.3%), and 8% (35/434, CI: 5.8-10.9%), respectively. The highest seroprevalence was reported in goats (13% (27/207)) and animals from East Jabal (13% (21/161)), whereas the lowest was recorded in camels (3.4% (3/89)) and animals from deserts (1.4% (1/69)). Parameters such as the positive predictive value (PPV) and the negative predictive value (NPV) showed that the sensitivity of I-ELISA and CFT based on the RBT test was 61.9% and 57.1%, respectively, whereas the specificity of I-ELISA (94.6%) was less than that of CFT (97.33%).

CONCLUSION

We concluded that three tests are confirmatory for the presence of Brucella infection.

Seroprevalence of human brucellosis in Morocco and associated risk factors

Background and Aim:

Brucellosis is a prevalent infectious zoonotic disease that affects humans, livestock, and wildlife in many parts of the world. A cross-sectional study was conducted to estimate the seroprevalence and risk factors of brucellosis among farmers and patients attending six health centers in Sidi Kacem province (northwestern Morocco).

Materials and Methods:

Blood samples (3-5 mL) were collected. Among 1283 participants, 351 were males and 932 were females and tested for Brucella antibodies using rose Bengal plate test and immunoglobulin (Ig)M/IgG enzyme-linked immunosorbent assay (ELISA) for confirmation.

Results:

The seroprevalence of brucellosis was 33.20% (426/1283) with a higher risk among males and rural residents. The univariable analysis revealed that contacting cattle, handling abortion products and manure, and consuming undercooked beef and goat meat were all risk factors for brucellosis. Furthermore, raw milk and milk derivatives were risk factors strongly linked to brucellosis.

Conclusion:

Our findings indicate a high prevalence of brucellosis associated with the consumption of raw meat, raw dairy products, milk, and close contact with infected animals. However, there are some limitations to this study, such as we did not use the ELISA test on all sera collected and individuals under the age of 18 were not included in the study. Moreover, building a database on the occurrence of brucellosis and associated epidemiological factors is critical for providing informed advice to policymakers to improve control strategies against this disease in Morocco.

Brucellosis in small ruminant: seroprevalence, risk factors, and distribution in the southeast of Algeria

The impact of brucellosis on public health and economy is unquestionable in developing countries such as the case of Algeria. This study aimed to provide further understanding of epidemiological status of brucellosis in small ruminant flocks in the southeast of Algeria. Therefore, a cross-sectional study was conducted among small ruminant flocks (n = 51) in El Oued district using simple random sampling strategy. The serum samples collected from 612 sheep and goats (sheep = 280, goats = 332) were screened for Brucella antibodies using the Rose Bengal test (RBT) and the indirect enzyme-linked immunosorbent assay (iELISA) in parallel on all the serum samples. The seropositive serum samples of both tests were confirmed with the complement fixation test (CFT). A structured questionnaire regarding animal, herd, and farm management was prepared and completed in parallel to sampling. Association between variables and Brucella spp. seropositivity status of herds was assessed by univariate and multivariate analysis using simple and binary logistic regression. Estimated true herd prevalence was 27.95% (95% CI, 17.18-42.01), and true individual prevalence was 3.98% (95% CI, 2.51-6.03). Seropositive herds were detected in bordering areas and regions with the highest livestock density. Occurrence of abortions in herds (p = 0.03) increased at least five times (5) the odds of being seropositive (OR, 6.25; 95% CI, 1.20-32.46). Poultry presence in farms revealed to be a protective factor (p = 0.01) (OR, 0.11; 95% CI, 0.02-0.61). The high-level seroprevalence quantified in this study in small ruminant flocks reflects the persistent animal infection endemicity and the high risk of human exposure.

Investigation of a human brucellosis outbreak in Douz, Tunisia, 2018

OBJECTIVES

In 2017, the incidence of human brucellosis in Tunisia was 9.8 per 100,000 population. In the Douz district, 2 cases were reported in March 2018. Prior to that date, the last indigenous cases to be reported in Douz had been in 2015. This study aimed to identify the source of this new contamination and recommend control interventions.

METHODS

This case-control study included residents of Douz who presented with clinical symptoms of brucellosis and had a subsequent Wright test antibody titer ≥ 1/160. The controls were neighbors of the infected cases who had a negative Rose Bengal test. Univariate and multivariate analyses were performed to estimate the odds ratios of risk factors. Goats belonging to the cases and controls were actively screened.

RESULTS

Twenty-five infected cases and 52 uninfected controls were enrolled. All infected cases had consumed goat milk and 92% had purchased it from the same breeder. Consumption of goat milk from this breeder (adjusted odds ratio [aOR], 30.78; 95% confidence interval [CI], 6.47 to 235.91) and overall consumption of raw goat milk (aOR, 14.84; 95% CI, 2.04 to 310.44) were independent risk factors for brucellosis. The breeder had 18 goats, 5 of which were smuggled from a neighboring country. Three of those goats were diagnosed with brucellosis.

CONCLUSIONS

Consumption of raw milk from smuggled sick goats was the main risk factor in this outbreak. The sick goats were slaughtered and an education campaign was conducted. Vaccination, control of cross-border animal movements, and control of goat milk sales must be strengthened to prevent the spread of brucellosis in southwestern Tunisia.

Animal and human brucellosis in Algeria: a review

Tawla n Malṭa d aṭṭan ittenṭaḍen ɣer umdan i d-xeddment tbaktiriyin n tewsit Brucella spp. D aṭṭan amaḍlan u tella deg tmura n wagrakal am Lezzayer anda mazal txeddem axessar deg lmal. Ad d-nawi dagi tasɣunt tamatut ɣef tawla n Malṭa di Lezzayer, anda i tt-id-ufan yakan ɣer umdan seg 1895 u deg wass-nni mazal-itt d ugur ameqqran i yimeẓla n tdawsa. Tella tezqaft deg tejṛutin n yimdanen deg temnaḍt ɣer tayeḍ, tamnaḍt yennul ugar d tamnaḍt uzawaɣ i yesɛan weḥd-s aktamur alemmas (tajṛut/100 000 imezdaɣ) n 65.87 teḍfer-itt-id s 9.89 deg temnaḍt Agafa-Asamar ɣef wakken i d-iwekked uɣlif n tdawsa. Aktamur n tejṛutin n tawla n Malṭa n yizgaren iɛedda s uḍfar deg 5% ar 0,76% deg tlemmast n yiseggasen n 90 d 2014 s usileɣ imfeccec anda seld ṣa yiseggasen n wahil n takza d usnefren akked ucraḍ s tgezzayt REV-1 i d-ihegga uɣlif n tdawsa mazal yegguma ad isenger aṭṭan-agi. Ilaq daɣen ad negzu dakken anerni n umḍan n tejṛutin timaynutin n yimdanen i ittujerden kifkif-it akked tejṛutin ɣer tɣeṭṭen i yellan d aɛwin n temsalmit meqqren i umdan di Lezzayer.

Animal and Human Brucellosis in Pakistan

Brucellosis is a bacterial zoonotic disease that affects many animal species and can be transmitted to humans via direct contact or via contaminated food. Although brucellosis is a serious health hazard, its public health concern has been neglected in many countries. In some developing countries, such as Pakistan, where brucellosis is endemic, this disease continues to be of importance. A literature search for the past 11 years (2011–2021) provided a comprehensive insight into brucellosis in Pakistan. In this review, particular emphasis was placed on occurrence, diagnostic tests used, and prevention, treatment, and control in the context of the “One Health” approach.

Emerging diversity and ongoing expansion of the genus Brucella

Remarkable genetic diversity and breadth of host species has been uncovered in the Brucella genus over the past decade, fundamentally changing our concept of what it means to be a Brucella. From ocean fishes and marine mammals, to pond dwelling amphibians, forest foxes, desert rodents, and cave-dwelling bats, Brucella have revealed a variety of previously unknown niches. Classical microbiological techniques have been able to help us classify many of these new strains but at times have limited our ability to see the true relationships among or within species. The closest relatives of Brucella are soil bacteria and the adaptations of Brucella spp. to live intracellularly suggest that the genus has evolved to live in vertebrate hosts. Several recently discovered species appear to have phenotypes that are intermediate between soil bacteria and core Brucella, suggesting that they may represent ancestral traits that were subsequently lost in the traditional species. Remarkably, the broad relationships among Brucella species using a variety of sequence and fragment-based approaches have been upheld when using comparative genomics with whole genomes. Nonetheless, genomes are required for fine-scale resolution of many of the relationships and for understanding the evolutionary history of the genus. We expect that the coming decades will reveal many more hosts and previously unknown diversity in a wide range of environments.

Identification, geographic distribution and risk factors of Brucella abortus and Brucella melitensis infection in cattle in Algeria

Brucellosis is an infectious disease of several terrestrial and marine animals and humans caused by bacteria of the genus Brucella. This study aimed to identify Brucella species and biovars circulating in cattle and to analyze their geographic distribution across Algeria. Two hundred ninety eight milk and lymph node samples from 161 seropositive cattle of different local and foreign breeds were collected from 97 dairy farms in 56 towns of 13 wilayas (states/ provinces) of the central, eastern, western and southern regions. The samples were cultured on selective media and the obtained isolates were identified using bacteriological and molecular tests. Eighty-five Brucella isolates (72 B. abortus and 13 B. melitensis) were recovered from 63 animals in 37 dairy farms. In total, 71 (83.5 %) B. abortus bv 3, 11 (12.9 %) B. melitensis bv 2, 2 (2.4 %) B. melitensis bv 3 and 1 (1.2 %) unidentified B. abortus biovar were detected. The identification of B. abortus biovar 3 and B. melitensis biovar 2 is a new finding for Algeria and the Maghreb, respectively. B. abortus (84.7 %) was the main etiological agent of brucellosis. B. abortus showed a scattered distribution across Algeria. The fact that 60 % of the seropositive cattle showed no clinical signs, but 36 % were culture positive is an alarming observation. These data will rise awareness for the current epidemiological situation of bovine brucellosis in Algeria. To the best of our knowledge, this is the first representative countrywide bacteriological investigation of Brucella species and biovars in cattle across Algeria, which is a developing country where resources might be limited and the working conditions might not be very friendly.

Evolutionary history and current distribution of the West Mediterranean lineage of Brucella melitensis in Italy

Ovine and caprine brucellosis, caused by Brucella melitensis, is one of the world’s most widespread zoonoses and is a major cause of economic losses in domestic ruminant production. In Italy, the disease remains endemic in several southern provinces, despite an ongoing brucellosis eradication programme. In this study, we used whole-genome sequencing to detail the genetic diversity of circulating strains, and to examine the origins of the predominant sub-lineages of B. melitensis in Italy. We reconstructed a global phylogeny of B. melitensis, strengthened by 339 new whole-genome sequences, from Italian isolates collected from 2011 to 2018 as part of a national livestock surveillance programme. All Italian strains belonged to the West Mediterranean lineage, which further divided into two major clades that diverged roughly between the 5th and 7th centuries. We observed that Sicily serves as a brucellosis burden hotspot, giving rise to several distinct sub-lineages. More than 20 putative outbreak clusters of ovine and caprine brucellosis were identified, several of which persisted over the 8 year survey period despite an aggressive brucellosis eradication campaign. While the outbreaks in Central and Northern Italy were generally associated with introductions of single clones of B. melitensis and their subsequent dissemination within neighbouring territories, we observed weak geographical segregation of genotypes in the southern regions. Biovar determination, recommended in routine analysis of all Brucella strains by the World Organisation for Animal Health (OIE), could not discriminate among the four main global clades. This demonstrates a need for updating the guidelines used for monitoring B. melitensis transmission and spread, both at the national and international level, and to include whole-genome-based typing as the principal method for identification and tracing of brucellosis outbreaks.

Scoping review of brucellosis in Cameroon: Where do we stand, and where are we going?

Brucellosis is a zoonotic disease known to be endemic to parts of western and sub-Saharan Africa. However, the epidemiology for humans and animals remains largely unknown in many of these countries with Cameroon being a typical example. Despite common knowledge that brucellosis affects livestock, the actual number of infected animals remains unknown. Through a scoping review, the current known status of the disease is described. The aim is to ascertain relevant and publicly accessible research and knowledge of human and animal brucellosis in the country, and to provide an overview of the factors associated with its known persistence. Seroprevalence has been estimated and published in 12 separate instances (1 human; 9 cattle; 1 human and cattle; and 1 that includes cattle, pigs, and small ruminants), between 1982 and 2020, in 9 of the country's 10 geopolitical regions. In 1983, Brucella abortus and B. melitensis were isolated in cattle, but no further bacterial isolation has been published since. The seroprevalence from 196 total humans has ranged between 5.6% and 28.1%, and between 3.0% and 30.8% for 14,044 total cattle. As there is no ongoing surveillance program, it is not currently possible to identify the specific Brucella spp. that are endemic to the country and its regions. There are sufficient agricultural systems of cattle, pigs, goats, and sheep to sustain the presence of multiple Brucella spp. Surveillance information is the cornerstone of epidemiologic decision making, and is needed to direct policy makers, public health authorities, and veterinary services to appropriate actions. A combination of serological and molecular based diagnostics for surveillance is necessary to identify, quantify, and direct the appropriate public health interventions. Cameroon has an opportunity to build public and animal health infrastructure, leading the way for central Africa in the management and future eradication of brucellosis.

MLVA-16 Genotyping of Brucella abortus and Brucella melitensis Isolates from Different Animal Species in Egypt: Geographical Relatedness and the Mediterranean Lineage

Brucellosis is a common zoonotic disease in Egypt. However, there are limited data available on the genetic diversity of brucellae circulating in Egypt and other Mediterranean areas. One hundred and nine Brucella (B.) strains were isolated from different animal species in thirteen Egyptian governorates. Multi-locus variable number tandem repeats (VNTRs) analysis (MLVA-16) was employed to determine the geographical relatedness and the genetic diversity of a panel of selected Egyptian strains (n = 69), with strains originating from Italy (n = 49), Portugal (n = 52), Greece (n = 63), and Tunisia (n = 4). Egyptian B. melitensis strains clustered into two main clusters containing 21 genotypes. Egyptian B. abortus strains clustered into three main clusters containing nine genotypes. The genotypes were irregularly distributed over time and space in the study area. Egyptian strains of B. melitensis showed MLVA-16 patterns closer to that of Italian strains. Egyptian B. abortus strains isolated from cattle share the same genotype with strains from Portugal and similar to strains from Italy with low genetic diversity. Strains with similar MLVA patterns isolated from different governorates highlight the movement of the pathogen among governorates. Hence, it may also reflect the long endemicity of brucellosis in Egypt with earlier dispersal of types and great local genetic diversity. Open markets may contribute to cross-species transmission and dissemination of the new types nationwide. The presence of West Mediterranean lineages of B. melitensis and relatedness of B. abortus strains from the studied countries is a result of the socio-historical connections among the Mediterranean countries. Transnational eradication of brucellosis in the Mediterranean basin is highly demanded.

Knowledge of pastoralists on livestock diseases and exposure assessment to brucellosis within rural and peri-urban areas in Kajiado, Kenya

Background: Livestock diseases impact the livelihoods of pastoralists. Brucellosis, a neglected zoonotic disease is highly prevalent in this system with an estimated 16% of livestock population in sub-Saharan Africa infected with the disease. The objective of this study was to assess knowledge of livestock diseases and the risk of exposure to brucellosis among pastoralists living in Kajiado County of Kenya. Methods: The study sites included pastoralist communities living in rural and peri-urban areas within the County. Both primary and secondary data were collected using participatory methods including pairwise ranking, proportional piling and probing and a review of the published literature. Exposure risk assessment was conducted according to the CODEX Alimentarius framework: Hazard identification, hazard characterization, exposure assessment and risk estimation. Results: According to pastoralists, livestock diseases that frequently occurred in their flocks and herds were contagious caprine pleuropneumonia, lumpy skin disease and foot and mouth disease; but zoonoses, including anthrax and brucellosis, were also mentioned during focus group discussions. Potential pathways of exposure to brucellosis and other zoonoses included consumption of unpasteurized milk, handling infected aborted materials without protective measures and consumption of raw meat and raw blood. Consumption of unpasteurized milk and handling infected aborted materials without protectives were linked with high risk of exposure to household members living in rural areas, with the risk level within the peri-urban areas ranked very low to low for most of these risk practices. Conclusions: The results call for enhanced public education targeting vulnerable groups to mitigate risks of disease spread and other impacts of brucellosis within the affected pastoralist production systems.

Brucellosis in Colombia: Current Status and Challenges in the Control of an Endemic Disease

Brucellosis is a zoonosis of nearly worldwide distribution. The disease is considered to be endemic in most of the developing countries with a substantial impact on both human and animal health as well as on the economy. The aim of this scoping review is to provide an overview of the brucellosis status in Colombia and the factors associated with its persistence, to highlight the strengths and gaps of the adopted countermeasures and to supply evidence to policy-makers on the best approaches to mitigate the disease burden. Due to the presence of brucellosis in several susceptible production livestock systems scattered throughout the country, a plan for its control, prevention and eradication was established almost 20 years ago. However, despite extensive efforts, brucellosis prevalence has fluctuated over the years without any trend of decreasing. The restricted budget allocated for brucellosis control is a limiting factor for the success of the program. For instance, the absence of indemnities for farmers results in infected animals remaining on farms which potentially increases the risk of disease spread. Likewise, disease surveillance is restricted to Brucella abortus and excludes other Brucella species of importance, such as B. melitensis and B. suis. The countermeasures are mostly focused on cattle and only a few actions are in place for the management of brucellosis in other livestock species. In humans, cases of brucellosis are annually diagnosed, although the disease remains highly underreported. High impact educational and training programs are required to address the disease in a comprehensive manner, including vulnerable groups, such as traditional smallholders and low-productivity regions, as well as other stakeholders, such as healthcare and veterinary authorities. Important financial investments based on sustained cooperation between governmental institutions, industry, and farmers are important for developing affordable and effective strategies to control the disease.

Serological and histopathological investigation of brucellosis in cattle in Medea region, Northern Algeria

AIM

This study was performed to determine the prevalence of bovine brucellosis in Medea region, Northern Algeria.

MATERIALS AND METHODS

The study was carried out on 495 non-vaccinated cattle, of which 280 (30 males and 250 females) belonged to 57 cattle farms and 215 cows were sampled at abattoirs of Medea. Sera collected from the cattle were tested using the Rose Bengal test and confirmed by histopathological analysis.

RESULTS

Serological examination revealed that 7/57 farms (12.28%) were infected, of which 7/280 (2.5%) cattle were seropositive. The prevalence in females and males was 2.4% (6/250) and 3.33% (1/30), respectively. No significant difference has been observed between females and males. Older animals (≥8 years) were infected more. The prevalence of infection was 9.1%. Seroprevalence of Brucella infection in cows that have already had abortion was higher compared with non-aborted cows (4.34% and 2.20%, respectively). In abattoirs, a total of 25 (11.62%) seropositive cows were detected, and the histopathological analysis was positive in all these cows.

CONCLUSION

The study indicates that brucellosis indeed exists in cattle in Medea and shows that the meat of slaughtered cattle tested positive for brucellosis may constitute a real risk of transmission to both butchery personnel and consumers, which requires that the meat of infected animals should be analyzed before being marketed.

African Lineage Brucella melitensis Isolates from Omani Livestock

Brucellosis is a common livestock disease in the Middle East and North Africa, but remains poorly described in the region both genetically and epidemiologically. Traditionally found in goats and sheep, Brucella melitensis is increasingly recognized as infecting camels. Most studies of brucellosis in camels to date have focused on serological surveys, providing only limited understanding of the molecular epidemiology of circulating strains. We genotyped B. melitensis isolates from Omani camels using whole genome SNP assays and VNTRs to provide context for regional brucellosis cases. We identified a lineage of B. melitensis circulating in camels as well as in goats, sheep, and cattle in Oman. This lineage is genetically distinct from most genotypes from the Arabian Peninsula and from isolates from much of the rest of the Middle East. We then developed diagnostic assays that rapidly identify strains from this lineage. In analyses of genotypes from throughout the region, Omani isolates were genetically most closely related to strains from brucellosis cases in humans and livestock in North Africa. Our findings suggest an African origin for B. melitensis in Oman that has likely occurred through the trade of infected livestock. Moreover, African lineages of B. melitensis appear to be undersampled and consequently are underrepresented in genetic databases for Brucella. As we begin to more fully understand global genomic diversity of B. melitensis, finding and characterizing these unique but widespread lineages is essential. We predict that increased sampling of humans and livestock in Africa will reveal little known diversity in this important zoonotic pathogen.

Brucellosis: A cause of meningitis not to neglect

Brucellosis is the most frequent bacteria zoonosis in the world, with more than half a million new cases each year [1]. It is also the most significant zoonos in the edge of the Mediterranean Sea [2]. This zoonosis is capable of affecting humans and cause polymorphic clinical manifestations. In Morocco, the southern regions are the main affected areas [3].

We are reporting the observation of a 17-year-old male patient, who presented a febrile meningeal syndrome for 9 months without sensitivo-motor deficit. Tuberculosis is frequently evoked in such clinical presentations because Morocco is an endemic country, brucellosis is therefore often forgotten. The results of lumbar puncture, magnetic resonance imaging (MRI) and especially serology aided to conclude to a neuro-brucellosis. The outcome was favourable with antibiotic therapy.

Species identification and molecular typing of human Brucella isolates from Kuwait

Brucellosis is a zoonotic disease of major concern in Kuwait and the Middle East. Human brucellosis can be caused by several Brucella species with varying degree of pathogenesis, and relapses are common after apparently successful therapy. The classical biochemical methods for identification of Brucella are time-consuming, cumbersome, and provide information limited to the species level only. In contrast, molecular methods are rapid and provide differentiation at intra-species level. In this study, four molecular methods [16S rRNA gene sequencing, real-time PCR, enterobacterial repetitive intergenic consensus (ERIC)-PCR and multilocus variable-number tandem-repeat analysis (MLVA)-8, MLVA-11 and MLVA-16 were evaluated for the identification and typing of 75 strains of Brucella isolated in Kuwait. 16S rRNA gene sequencing of all isolates showed 90-99% sequence identity with B. melitensis and real-time PCR with genus- and species- specific primers identified all isolates as B. melitensis. The results of ERIC-PCR suggested the existence of 75 ERIC genotypes of B. melitensis with a discriminatory index of 0.997. Cluster classification of these genotypes divided them into two clusters, A and B, diverging at ~25%. The maximum number of genotypes (n = 51) were found in cluster B5. MLVA-8 analysis identified all isolates as B. melitensis, and MLVA-8, MLVA-11 and MLVA-16 typing divided the isolates into 10, 32 and 71 MLVA types, respectively. Furthermore, the combined minimum spanning tree analysis demonstrated that, compared to MLVA types discovered all over the world, the Kuwaiti isolates were a distinct group of MLVA-11 and MLVA-16 types in the East Mediterranean Region.

Boar hunting and brucellosis caused by Brucella suis

Brucellosis remains as a significant public health concern in many areas where the infection persists in domestic hosts (i.e. goats, cattle, and domestic swine) with subsequent risk of transmission to human populations. Brucellosis caused by B. suis remains an important threat to human populations in many countries exposed to domestic and feral swine. In the U.S., swine brucellosis has been under control for many years. Meanwhile, it is a widespread infection among feral swine, particularly in the Southeastern United States; and exposure to infected animals pose a growing threat to humans. We present the case of a 31-year male hunter who six weeks after a knife injury to his hand while field dressing a wild boar, developed a febrile illness associated with hematologic abnormalities and splenic abscesses caused by Brucella suis infection.

A Case Report of Pediatric Brucellosis in an Algerian Immigrant

An 8-year old girl presented to our facility with a 10-day history of fever, fatigue, abdominal pain and refusal to walk. She recently travelled from her native Algeria where she first developed symptoms. On evaluation, she was ill-appearing, febrile and tachycardic with hepatosplenomegaly and lymphadenopathy noted on examination. A strong musty odor was also noted from the child. Laboratory evaluation revealed pancytopenia, hyponatremia, and an elevated AST, ALT, and LDH. Malaria testing was negative, as was a PPD. On further questioning, the family reported multiple sick contacts in Algeria with similar symptoms. After discussion with Oncology and Infectious Diseases, she underwent a bone marrow biopsy that was significant for multiple non-caseating ring granulomas. She was started on combination therapy of doxycycline and for presumed brucellosis infection with improvement in her symptoms and resolution of fever. Bone marrow culture returned several days later positive for Brucella melitensis.

Molecular epidemiology of Brucella abortus isolated from cattle in Brazil, 2009-2013

The aims of the present study were to genotype Brucella abortus strains isolated from cattle in Brazil between 2009 and 2013, and to analyze their distribution to support the Programa Nacional de Controle e Erradicação de Brucelose e Tuberculose (PNCEBT) (National Brucellosis and Tuberculosis Control and Eradication Program). One hundred forty B. abortus strains isolated from cattle in Brazil between 2009 and 2013 were genotyped using a set of 18 variable number of tandem repeats (VNTR) (MLVA16+HOOF-Print 3 and 4). The multiple locus VNTR analysis (MLVA) composed by eight markers (MLVA8) revealed eight different genotypes among B. abortus strains, including five previously described and three new ones. Analysis of the MLVA16 loci revealed fifty-eight distinct genotypes, from which three were identical, thirty-eight were considered very close, and seventeen were considered distant compared to those previously described and deposited in MLVAbank. Analysis of the HOOF-Prints 3 and 4 revealed the larger number of different alleles among all VNTR assessed, exhibiting maximum resolution when associated with MLVA16 markers. This study also provides insights on the genotypes of B. abortus circulating in Brazil, which certainly contribute for the better understanding of the epidemiology and control of bovine brucellosis in the country. Moreover, our data showed a high genetic diversity among the B. abortus strains isolated between 2009 and 2013, and a close relationship among these strains and Brazilian B. abortus deposited by MLVAbank.

Brucellosis in Sub-Saharan Africa: Current challenges for management, diagnosis and control

Brucellosis is a highly contagious zoonosis caused by bacteria of the genus Brucella and affecting domestic and wild mammals. In this paper, the bacteriological and serological evidence of brucellosis in Sub-Saharan Africa (SSA) and its epidemiological characteristics are discussed. The tools available for the diagnosis and treatment of human brucellosis and for the diagnosis and control of animal brucellosis and their applicability in the context of SSA are presented and gaps identified. These gaps concern mostly the need for simpler and more affordable antimicrobial treatments against human brucellosis, the development of a B. melitensis vaccine that could circumvent the drawbacks of the currently available Rev 1 vaccine, and the investigation of serological diagnostic tests for camel brucellosis and wildlife. Strategies for the implementation of animal vaccination are also discussed.

Narrative overview of animal and human brucellosis in Morocco: intensification of livestock production as a driver for emergence?

Brucellosis is one of the most widespread zoonoses in the world caused by several species of the genus Brucella. The disease, eradicated in many developed countries, is a re-emerging neglected zoonosis endemic in several zones especially in the Mediterranean region, impacting on human health and livestock production. A One Health approach could address brucellosis control in Morocco but scarcity of reliable epidemiological data, as well as underreporting, hinders the implementation of sustainable control strategies. Surveillance and control policies implemented by the Moroccan government in domestic animals (cattle and small ruminants) in the last few decades are assessed for disease impact. This study considers the origins of animal brucellosis in Morocco and the potential for emergence of brucellosis during a shift from extensive to intensive livestock production.