Brucellosis in Herat Province, Afghanistan: Epidemiological Status and Risk Factors

Background: Human brucellosis, also known as Malta fever, is an acute systemic zoonotic disease in several parts of the world. The most pathogenic Brucella specie is Brucella melitensis that occurs in the human population of all age groups and of both sexes. Objectives: The present study aimed to investigate human Brucella infection in Afghanistan. Methods: The participants in this cross-sectional study were 44 patients diagnosed with Brucella infection during eight months and confirmed using Wright test by physicians of Iran Clinic Hospital. For data analysis, a statistical model was used through SPSS. Results: The most affected patients were female housewives (40.9%) and students (18.18%). The most frequent clinical manifestations were recurrent attacks of fever (95.34%), weight loss (81.39%), loss of appetite (79.06%), musculoskeletal pain (69.76%), boredom (67.44%), and lethargy (60.46%). A total of 41 (93.18%) patients mentioned the consumption of unpasteurized milk as the source of infection. Conclusions: The study results revealed that the main route of Brucella transmission in Afghanistan is the consumption of contaminated dairy products. The highest prevalence of brucellosis was observed among the young and middle-aged populations and housewives.

Knowledge of Brucellosis, Health-Seeking Behaviour, and Risk Factors for Brucella Infection amongst Workers on Cattle Farms in Gauteng, South Africa

Brucellosis in humans is under-detected and underreported in sub-Saharan Africa. Risk factors associated with Brucella infection and health seeking behaviour in response to brucellosis-like symptoms, amongst cattle farm workers and veterinary officials in South Africa, are unknown. Farm workers and veterinary officials (N = 230) were screened for brucellosis using commercial Rose Bengal Test (RBT®), IgM Enzyme-linked Immunoassay (ELISA)®, IgG ELISA® and the BrucellaCapt® test. Knowledge of brucellosis and risk factors for exposure to Brucella were also investigated. Seroprevalence varied according to test used: 10.1% (RBT®), 20.9% (IgG ELISA®) and 6.5% (BrucellaCapt®). Only 22.2% (6/27) of veterinary officials opt to visit a clinic, doctor, or hospital in response to self-experienced brucellosis-like symptoms, compared to 74.9% (152/203) of farm workers (p < 0.001). Of the BrucellaCapt® seropositive participants, 53% (7/15) did not visit a clinic in response to brucellosis-like symptoms. Weak evidence of an association between the handling of afterbirth or placenta and infection of a short evolution (RBT®, IgM ELISA® and IgG ELISA® seropositive) was found (OR = 8.9, 95% CI: 1.0–81.1, p = 0.052), and strong evidence of an association between this outcome and the slaughter of cattle (OR = 5.3, 95% CI: 1.4–19.6, p = 0.013). There was strong evidence of a positive association between inactive/resolved infection and veterinary officials vs. farm workers exposed to seropositive herds (OR = 7.0, 95% CI: 2.4–20.2, p < 0.001), with a simultaneous negative association with the handling of afterbirth or placenta (OR = 3.9, 95% CI: 1.3–11.3, p = 0.012). Findings suggest a proportion of undetected clinical cases of brucellosis amongst workers on cattle farms in Gauteng.

Epidemiosurveillance of Brucella infection in humans, non-ruminants and wildlife from Pakistan perspective (2000-2020)

This review aimed at providing an overview of the prevalence and epidemiosurveillance of brucellosis in non-ruminants and humans in Pakistan during 2000-2020. Sero-prevalence of brucellosis has been reported in non-ruminants such as camels, equines, dogs and humans with the range of 0.5-21%, 16.23-62.6%, 9.2-63.8% and 2.0-70% respectively. Non-target species like Avian, reptiles and amphibians were also reported with the prevalence of 2.5%, 24.9% and 25% respectively. Ignorance and indifference make it endemic in ruminants and much-neglected disease in non-ruminants with less or no studies reported in canines. Vaccines are available and being used for ruminants while none is available for non-ruminants, which may serve as an important source of spreading disease in animals and humans. In Pakistan, it is considered as ignored disease in non-ruminants lacking effective policies for control and eradication. This review guides policymakers to draw guidelines regarding brucellosis control and eradication using one health approach.

Aconitate decarboxylase 1 participates in the control of pulmonary Brucella infection in mice

Brucellosis is one of the most widespread bacterial zoonoses worldwide. Here, our aim was to identify the effector mechanisms controlling the early stages of intranasal infection with Brucella in C57BL/6 mice. During the first 48 hours of infection, alveolar macrophages (AMs) are the main cells infected in the lungs. Using RNA sequencing, we identified the aconitate decarboxylase 1 gene (Acod1; also known as Immune responsive gene 1), as one of the genes most upregulated in murine AMs in response to B. melitensis infection at 24 hours post-infection. Upregulation of Acod1 was confirmed by RT-qPCR in lungs infected with B. melitensis and B. abortus. We observed that Acod1-/- C57BL/6 mice display a higher bacterial load in their lungs than wild-type (wt) mice following B. melitensis or B. abortus infection, demonstrating that Acod1 participates in the control of pulmonary Brucella infection. The ACOD1 enzyme is mostly produced in mitochondria of macrophages, and converts cis-aconitate, a metabolite in the Krebs cycle, into itaconate. Dimethyl itaconate (DMI), a chemically-modified membrane permeable form of itaconate, has a dose-dependent inhibitory effect on Brucella growth in vitro. Interestingly, structural analysis suggests the binding of itaconate into the binding site of B. abortus isocitrate lyase. DMI does not inhibit multiplication of the isocitrate lyase deletion mutant ΔaceA B. abortus in vitro. Finally, we observed that, unlike the wt strain, the ΔaceA B. abortus strain multiplies similarly in wt and Acod1-/- C57BL/6 mice. These data suggest that bacterial isocitrate lyase might be a target of itaconate in AMs.

Acute pancreatitis and low ascites-serum albumin gradient ascites caused by Brucellosis

Objective: Brucellosis is a zoonotic disease seen widely around the world. Although many aspects and treatment of this disease is well known, peritoneal involvement and ascites is not well established so far. Material and Methods: This study retrospectively enrolled 346 adult patients (aged >17 years) with acute Brucellosis attending Hepatology Clinic, Van Yuzuncu Yil University, between April 2013 and May 2016. Characteristics of those with and without ascites were analyzed using Pearson correlation coefficients and Chi-Square test in SPSS software system. Results: Of the 346 cases, 20 (5, 7%) had ascites. Those with ascites had significantly higher transaminase, cholestatic enzyme and amylase levels compared to those without ascites. Conclusions: We conclude that acute Brucella infection can lead to a unique low gradient ascites probably resulting from pancreatic leakage followed by peritoneal accumulation of serum proteins.