Boletim epidemiológico: perfil epidemiológico dos casos de brucelose humana em Goiás entre 2018 e abril de 2023 / Epidemiological bulletin: epidemiological profile of cases of human brucellosis in Goiás between 2018 and April 2023

Boletim que tem como objetivo demosntrar qual é o perfil epidemiológico dos casos humanos de brucelose no estado de Goiás, além de fazer o comparativo dos municípios com focos da doença em animais , haja vista que se trata de uma zoonose de ampla distribuição mundial e que gera impactos econômicos e sociais. Trata-se de um estudo desenvolvido baseado no banco de dados do Sistema de Agravos e Notificação (SINAN-NET), do Gerenciador de Ambiente Laboratorial (GAL), de dados fornecidos pela agência Goiana de Defesa Agropecuária (AGRODEFESA) e da Coordenação Estadual de Zoonoses da Gerência de Vigilância Epidemiológica de Doenças Transmissíveis GVEDT/SUVISA-SES-GO da Secretaria de Estado da Saúde de Goiás (SES/GO). É um estudo de caráter quantitativo, descritivo e retrospectivo entre janeiro de 2018 e abril de 2023, com dados analisados baseados em casos notificados e confirmados de brucelose humana por município de residência

Bulletin that aims to demonstrate the epidemiological profile of human cases of brucellosis in the state of Goiás, in addition to comparing municipalities with outbreaks of the disease in animals, given that it is a zoonosis with a wide worldwide distribution and that generates economic and social impacts. This is a study developed based on the database of the Diseases and Notification System (SINAN-NET), the Laboratory Environment Manager (GAL), data provided by the Goiana Agricultural Defense agency (AGRODEFESA) and the State Coordination of Zoonoses of the Epidemiological Surveillance of Communicable Diseases Management GVEDT/SUVISA-SES-GO of the State Department of Health of Goiás (SES/GO). It is a quantitative, descriptive and retrospective study between January 2018 and April 2023, with analyzed data based on reported and confirmed cases of human brucellosis by municipality of residence

An uncommon case of brucellosis with ocular presentation / Um caso incomum de brucelose com apresentação ocular

ABSTRACT We report an unusual case of brucellosis presented with headache, diminished vision, papillitis and multiple peripapillary hemorrhages accompanied by subretinal fluid extending up to macula. Diagnosis of brucellosis was made based on positive polymerase chain reaction of cerebrospinal fluid sample for Brucella species DNA, accompanied by a raised titer of anti-brucella antibodies. Patient showed remarkable improvement on triple drug therapy in form of doxycycline, rifampicin and ceftriaxone.

RESUMO Relatamos um caso incomum de brucelose apresentada com cefaleia, visão diminuída, papilite e múltiplas hemorragias peripapilares acompanhadas por fluido sub-retinal, estendendo-se até a mácula. O diagnóstico de brucelose foi feito com base na reação em cadeia da polimerase positiva de amostra de líquido cefalorraquidiano para DNA de espécies de Brucella, acompanhada por um título elevado de anticorpos antibrucela. O paciente apresentou melhora notável com a terapia tripla com drogas na forma de doxiciclina, rifampicina e ceftriaxona.

Estudio de casos confirmados de brucelosis humana en Puebla, México / Study of confirmed cases of human brucellosis in Puebla, Mexico

INTRODUCCIÓN: La brucelosis humana es un problema zoo-sanitario global. México es uno de los principales países que se ven afectados, el diagnóstico oportuno y las pruebas serológicas confirmatorias son la base para la detección. OBJETIVO: Conocer la frecuencia de casos confirmados de brucelosis en diferentes Unidades de Medicina Familiar del Instituto Mexicano del Seguro Social en el estado de Puebla, México. PACIENTES Y MÉTODOS: Estudio transversal en pacientes de ambos sexos, adultos y pediátricos, con manifestaciones clínicas sugestivas de brucelosis; se realizaron pruebas serológicas para el diagnóstico confirmatorio. RESULTADOS: De un total de 77 pacientes, se obtuvieron 39 (50,6%) casos positivos, 21 (27,3%) casos saliendo de la infección, 9 (11,7%) negativos y 8 (10,4%) con memoria inmunológica; de los casos positivos, 32 (82,1%) eran adultos y 30 (76,9%) fueron del género femenino. CONCLUSIÓN: Del total de muestras, la mitad tuvo diagnóstico de brucelosis, las manifestaciones clínicas de los pacientes estudiados fueron inespecíficas, lo cual resalta la importancia del diagnóstico de laboratorio.

BACKGROUND: Human brucellosis is a global health problem. Mexico is one of the main countries affected; timely diagnosis and serological tests are the basis for detection. AIM: To know the frequency of confirmed cases of brucellosis in different of Family Medicine Units of the Mexican Social Security Institute in the state of Puebla, Mexico. METHODS: Cross-sectional study in patients of both genders, adults and pediatrics, with clinical manifestations suggestive of brucellosis; serological tests were performed for the confirmatory diagnosis. RESULTS: Out of a total of 77 patients, 39 (50.6%) were positive, 21 (27.3%) cases coming out of infection, 9 (11.7%) were negative and 8 (10.4%) were defined with immunological memory; of positive cases, 32 (82.1%) were found in the adult group and 30 (76.9%) were female. CONCLUSION: Around half of samples were confirmed as brucellosis, the clinical manifestations of the patients studied were non-specific, which highlights the importance of laboratory diagnosis.

Risk factors and detection of brucella ovis in naturally infected rams and ewes / Fatores de risco e detecção de brucella ovis em carneiros e ovelhas naturalmente infectados

The objective of this study was to verify the occurrence of ovine brucellosis using Agar Gel Immunodiffusion (AGID) and Polymerase Chain Reaction (PCR) techniques, as well as to identify the main risk factors associated with infection in sheep flocks belonging to municipalities in the microregion from Teresina, PI, Brazil. A total of 100 urine and blood samples were collected from sheep aged 6 months or older. The urine samples were submitted to conventional PCR and the blood samples were examined by the AGID technique. Of the 100 blood samples, 17 (17%) were reactive to the AGID test. In conventional PCR of 100 urine samples, six (6%) were positive. Risk factors associated to infection by B. ovis included the rearing system (OR=0.19), feed management (OR=0.05), presence of dystotic births (OR=4.50), miscarriages (OR=3.75) and source of water offered to the animals (OR=0.19). Thus, it was concluded that it is possible to detect the occurrence of animals with ovine brucellosis since PCR is a reliable method to confirm infection. Furthermore, there are risk factors associated to infection by B. ovis in the municipalities studied.

Objetivou-se verificar a ocorrência da brucelose ovina através das técnicas de Imunodifusão em Gel de Ágar (IDGA) e Reação em Cadeia da Polimerase (PCR), bem como identificar os principais fatores de risco associados à infecção nos rebanhos ovinos pertencentes a municípios da microrregião de Teresina, PI, Brasil. Foram colhidas 100 amostras de urina e de sangue de ovinos com idade superior ou igual a seis meses. As amostras de urina foram submetidas a PCR convencional e as amostras de sangue à técnica de IDGA. Das 100 amostras de sangue 17 (17%) foram reagentes ao teste de IDGA. Já na PCR convencional das 100 amostras de urina, seis (6%) foram positivas. Ressalta-se que três animais foram positivos em ambos os testes. Como fatores associados à infecção por B. ovis, observou-se o tipo de sistema de criação (OR=0,19), o manejo alimentar (OR=0,05), presença de partos distócicos (OR=4,50), abortamentos (OR=3,75) e a fonte de água fornecida aos animais (OR=0,19). Assim, conclui-se que foi possível detectar a ocorrência de animais com brucelose ovina, uma vez que a PCR é um método confirmatório. Além disso, há fatores de risco associados à infecção por B. ovis nos municípios estudados.

Risk factors and detection of brucella ovis in naturally infected rams and ewes / Fatores de risco e detecção de brucella ovis em carneiros e ovelhas naturalmente infectados

The objective of this study was to verify the occurrence of ovine brucellosis using Agar Gel Immunodiffusion (AGID) and Polymerase Chain Reaction (PCR) techniques, as well as to identify the main risk factors associated with infection in sheep flocks belonging to municipalities in the microregion from Teresina, PI, Brazil. A total of 100 urine and blood samples were collected from sheep aged 6 months or older. The urine samples were submitted to conventional PCR and the blood samples were examined by the AGID technique. Of the 100 blood samples, 17 (17%) were reactive to the AGID test. In conventional PCR of 100 urine samples, six (6%) were positive. Risk factors associated to infection by B. ovis included the rearing system (OR=0.19), feed management (OR=0.05), presence of dystotic births (OR=4.50), miscarriages (OR=3.75) and source of water offered to the animals (OR=0.19). Thus, it was concluded that it is possible to detect the occurrence of animals with ovine brucellosis since PCR is a reliable method to confirm infection. Furthermore, there are risk factors associated to infection by B. ovis in the municipalities studied.

Objetivou-se verificar a ocorrência da brucelose ovina através das técnicas de Imunodifusão em Gel de Ágar (IDGA) e Reação em Cadeia da Polimerase (PCR), bem como identificar os principais fatores de risco associados à infecção nos rebanhos ovinos pertencentes a municípios da microrregião de Teresina, PI, Brasil. Foram colhidas 100 amostras de urina e de sangue de ovinos com idade superior ou igual a seis meses. As amostras de urina foram submetidas a PCR convencional e as amostras de sangue à técnica de IDGA. Das 100 amostras de sangue 17 (17%) foram reagentes ao teste de IDGA. Já na PCR convencional das 100 amostras de urina, seis (6%) foram positivas. Ressalta-se que três animais foram positivos em ambos os testes. Como fatores associados à infecção por B. ovis, observou-se o tipo de sistema de criação (OR=0,19), o manejo alimentar (OR=0,05), presença de partos distócicos (OR=4,50), abortamentos (OR=3,75) e a fonte de água fornecida aos animais (OR=0,19). Assim, conclui-se que foi possível detectar a ocorrência de animais com brucelose ovina, uma vez que a PCR é um método confirmatório. Além disso, há fatores de risco associados à infecção por B. ovis nos municípios estudados.

Serological survey of leptospirosis, brucellosis, and lentivirus in herds of small ruminants in Recôncavo Baiano, Bahia, Brazil / Inquérito sorológico de leptospirose, brucelose e lentiviroses em rebanhos de pequenos ruminantes no Recôncavo Baiano, Bahia, Brasil

A serological survey was carried out to assess the frequency of leptospirosis, small ruminants lentivirus (SRLV), and brucellosis in small ruminant herds in the Recôncavo Baiano, State of Bahia, Brazil, from February to December 2017. In four goat herds, 125 animals were tested for SRLV and leptospirosis, while in five sheep herds, 378 animals were tested for leptospirosis, brucellosis, and SRLV. Regarding leptospirosis, MAT detected 80% of goats and 15.34% of sheep seroreactive. Reactivity was most frequent to serogroups Autumnalis and Grippotyphosa in goats and sheep, respectively. Regarding SRLV, 8.8% of goats and 0.79% of sheep were reactive. Search for anti-B. ovis antibodies revealed 0.52% reactivity. In sheep, three animals showed simultaneous seroreactivity for SRLV and leptospirosis, while one animal had a serological response for brucellosis and leptospirosis. In goats, simultaneous seroreactivity for SRLV and leptospirosis was observed in only one animal. Leptospirosis was the most frequent of the three infectious diseases in investigated herds.(AU)

Foi realizado um inquérito sorológico para avaliar a frequência de ocorrência de leptospirose, lentiviroses de pequenos ruminantes (LVPR) e brucelose em rebanhos de pequenos ruminantes no Recôncavo Baiano, estado da Bahia, Brasil, no período de fevereiro a dezembro de 2017. Em quatro rebanhos de caprinos, foram testados 125 animais para LVPR e leptospirose, enquanto em cinco rebanhos de ovinos, foram testados 378 animais para leptospirose, brucelose e LVPR. Em relação à leptospirose, 80% das cabras e 15,34% das ovelhas foram sororreativas. Os sorogrupos de Leptospira spp. predominantes foram Autumnalis e Grippotyphosa para caprinos e ovinos, respectivamente. Em relação as LVPR, 8,8% dos caprinos e 0,79% dos ovinos foram reativos. Adicionalmente, a pesquisa de anticorpos Anti-B. ovis revelou 0,52% de ovinos reativos. Em ovinos, três animais apresentaram sororreatividade simultânea para LVPR e leptospirose, enquanto um animal teve resposta sorológica para brucelose e leptospirose. Em caprinos, sororreatividade simultânea para LVPR e leptospirose foi observada em apenas um animal. A leptospirose foi a doença infecciosa mais frequente nos rebanhos investigados.(AU)

Evaluación del sistema Brucellacapt® para el diagnóstico serológico de la brucelosis humana en Cuba / Evaluation of the system Brucellacapt® for serological diagnosis of human brucellosis in Cuba

Introducción: En el diagnóstico microbiológico de la brucelosis, los métodos serológicos son los más utilizados. Brucellacapt® ofrece la ventaja de detectar en cualquier momento de la enfermedad anticuerpos aglutinantes y no aglutinantes contra Brucellaspp. Objetivos: Evaluar y aplicar el sistema serológico comercial Brucellacapt® para la detección de anticuerpos contra Brucella spp. Métodos: Se realizó una investigación en servicios y sistemas de tipo observacional con un estudio de caso control anidado, en el periodo de enero de 2015 a junio de 2016, en el Laboratorio Nacional de Referencia de Espiroquetas y Brucelas. Se evaluaron 50 sueros de casos y 100 de controles por Brucellacapt®. Se aplicó Brucellacapt® en 695 sueros de casos con sospecha clínica o epidemiológica de la enfermedad, los cuales fueron confirmados por ELISA. Resultados: Brucellacapt® mostró 100 por ciento de sensibilidad, 83 por ciento de especificidad, 54,6 por ciento de reactividad y 16,4 por ciento de positividad en las muestras estudiadas. Se confirmó por ELISA la presencia de anticuerpos IgM (21, 2 por ciento), IgG (6,1 por ciento) e IgM + IgG (7,6 por ciento). Doscientas cuarenta y seis muestras y otras siete fueron reactivas y positivas respectivamente, solo por Brucellacapt®. Conclusiones: Brucellacapt® contribuyó a la detección de anticuerpos en los sueros de pacientes sospechosos de la enfermedad con valores aceptables de sensibilidad y especificidad diagnóstica. Este resultado sugiere su implementación en la red nacional de laboratorios cubanos para fortalecer el diagnóstico y la vigilancia de la brucelosis humana en Cuba(AU)

Introduction: Serological methods are the most commonly used for the microbiological diagnosis of brucellosis. Brucellacapt® has the advantage of detecting agglutinating and non-agglutinating antibodies against Brucella spp. at any point in the evolution of the disease. Objectives: Evaluate and apply the commercially available serological system Brucellacapt® for detection of antibodies against Brucella spp. Methods: A nested case-control observational study was conducted of services and systems from January 2015 to June 2016 at the Spirochaete and Brucella National Reference Laboratory. Evaluation was performed of 50 serum samples from cases and 100 from controls using Brucellacapt®. The system was also used in 695 serum samples from clinically or epidemiologically suspected cases, which were confirmed by ELISA. Results: Brucellacapt® showed 100 percent sensitivity, 83 percent specificity, 54.6 percent reactivity and 16.4 percent positivity in the samples studied. Presence of the following antibodies was confirmed by ELISA: IgM (21.2 percent), IgG (6.1 percent) and IgM + IgG (7.6 percent). Two hundred forty-six samples and another seven were reactive and positive, respectively, only by Brucellacapt®. Conclusions: Brucellacapt® contributed to antibody detection in serum samples from suspected cases, with acceptable diagnostic sensitivity and specificity values. This result suggests its implementation in the Cuban national network of laboratories to strengthen the diagnosis and surveillance of human brucellosis in Cuba(AU)

Development and standardization of a western blotting test for detection of antibodies against B. abortus / Desenvolvimento e padronização do teste Western blotting para detecção de anticorpos contra B. abortus

Brucellosis is an infectious disease caused by bacteria of the genus Brucella spp. with diagnosis based on use of serological techniques. The present study aimed to develop and standardize a western blotting (WB) test for detection of antibodies against B. abortus. Samples from two groups of cattle were analyzed: group I: 60 serum samples from true positive and true negative vaccinated animals (30 positive samples from infected animals according to rose bengal test (RBT), 2-mercaptoethanol, serum agglutination test (SAT) and complement fixation test (CFT) and 30 RBT negatives samples); group II: 383 field samples (90 positive and 293 CFT negative sera). The most reactive band in the western blotting, which properly identified and separated infected from non - infected had a molecular weight of ≤ 20kDa. The sensitivity, specificity and accuracy of the WB compared to RBT was 93%, 99%, 98%, respectively and k= 0.938. When compared to CFT, the sensitivity, specificity and accuracy of the WB was 97%, 98% and 97%, respectively and k= 0.929. The WB developed and standardized in the present study is a serological test with potential use as a confirmatory test for the diagnosis of bovine brucellosis.(AU)

A brucelose é uma doença infectocontagiosa, causada por bactérias do gênero Brucella spp., com diagnóstico baseado no emprego de técnicas sorológicas. Objetivou-se neste estudo desenvolver e padronizar um teste Western blotting (WB) para detecção de anticorpos contra B. abortus. Foram analisados dois grupos de amostras bovinas: grupo I, com 60 amostras de animais verdadeiros positivos e verdadeiros negativos vacinados (30 amostras positivas de animais infectados e positivos nos testes de antígeno acidificado tamponado (AAT), 2 - mercaptoetanol (2 - ME), soroaglutinação lenta em tubos (SAT) e fixação do complemento e de 30 amostras negativas no AAT); grupo II, com 383 amostras de campo, sendo 90 soropositivas e 293 soronegativas no TFC. O resultado da análise do WB revelou peso molecular ≤20kDa como sendo a área mais reativa e característica para identificação e separação dos animais infectados dos não infectados. A sensibilidade, a especificidade e a acurácia do WB, quando este foi comparado com o AAT, foram, respectivamente, 93%, 99% e 98%, e k= 0,938. Quando comparadas com a TFC, a sensibilidade, a especificidade e a acurácia foram 97%, 98% e 97%, respectivamente, e k= 0,929. O WB padronizado neste estudo mostrou-se um teste sorológico com potencial uso como teste confirmatório no diagnóstico da brucelose bovina.(AU)

Cervical brucellar spondylitis causing incomplete limb paralysis

Abstract Brucellosis, a zoonosis with worldwide distribution, is a systemic infection caused by bacteria of the genus Brucella. Meanwhile, brucellosis often causes complications, such as osteoarticular involvement, and spondylitis is the most prevalent and important clinical form. Here, is a case of cervical brucellar spondylitis causing incomplete limb paralysis in a middle-aged male. The diagnosis was based on clinical history, and supported by Brucella serology and magnetic resonance imaging. Quadruple antibacterial treatment continued for four weeks. In this case, the epidural abscess causing spinal cord compression resolved without surgery. In addition, the patient had recovered from most of the neurologic deficits.

Neurobrucelosis evaluada por reibergrama. Presentación de un caso / Neurobrucellosis evaluated by reibergram. A case report

Introducción: La brucelosis es una enfermedad zoonótica y endémica en muchas partes del mundo. La causa principal de la infección se produce por la ingestión de leche no pasteurizada o por el contacto con animales infectados. La neurobrucelosis incluye afecciones en el sistema nervioso central y periférico. Las principales manifestaciones clínicas son la meningitis, la encefalitis, la neuritis óptica y la periférica. Objetivo: Evaluar, mediante reibergrama, la dinámica intratecal de las clases mayores de inmunoglobulinas y el estado de la barrera sangre/LCR de un paciente con neurobrucelosis. Presentación del caso: Los niveles de IgA, IgM. IgG y albúmina en suero y líquido cefalorraquídeo fueron cuantificados por inmunodifusión. Los resultados fueron colocados en el reibergrama correspondiente. El paciente mostró síntesis intratecal de las tres clases mayores de inmunoglobulinas, sin disfunción de la barrera sangre/LCR. Conclusión: El estudio neuroinmunológico del líquido cefalorraquídeo puede indicar el curso activo de la respuesta inmune intratecal contra el patógeno, donde la síntesis intratecal de inmunoglobulinas y el funcionamiento de la barrera sangre/líquido cefalorraquídeo constituyeron los principales marcadores en el diagnóstico de la neuroinflamación(AU)

Introduction: Brucellosis is a zoonotic and an endemic disease in many areas around the world. The main cause of infection is the intake of unpasteurized milk or the contact with infected animals. Neurobrucellosis includes pathologic conditions in the central and peripheral nervous systems. The main clinical manifestations are meningitis, encephalitis, optical neuritis, and peripheral neuritis. Objective: To evaluate, through reibergram, the intrathecal dynamics of the major immunoglobulin classes and the blood-CSF barrier function in one patient with neurobrucellosis. Case report: IgA, IgM, IgG and albumin levels in serum and cerebrospinal fluid were quantified by using a radial immunodiffusion technique. Results were placed in the corresponding reibergram. The patient showed evidences of intrathecal synthesis of the three major immunoglobulins without blood-CSF barrier dysfunction. Conclusion: The neuroimmunological study of cerebrospinal fluid can indicate the active course of the intrathecal immune response against this pathogen, where the intrathecal synthesis of immunoglobulins and blood-cerebrospinal fluid barrier function constitute the main markers in the diagnosis of neuroinflammation(AU)

Evaluation of dot-blot test for serological diagnosis of bovine brucellosis

Abstract The objective of this study was to standardize and validate the dot-blot test for the serological diagnosis of bovine brucellosis, compare the results with those found in the 2-mercaptoethanol (2-ME) and complement fixation test (CF), and estimate the relative sensitivity and specificity of the dot-blot compared to these tests. Fifty bovine blood serum samples were used for the test standardization, and 1315 samples were used for evaluation and comparison between the tests; the results were compared using the Kappa indicator. At the end of standardization, it was established as optimal for the antigen obtained from Brucella abortus B19 after passing through a microorganism rupture process, the blood serum samples diluted at 1:100, and the conjugate at 1:30,000. The comparison of the dot-blot results with 2-ME showed Kappa index of 0.9939, sensitivity of 99.48%, and specificity 99.91%, with CF, Kappa index of 0.8226, sensitivity 100% and specificity 95.32%. Using the combination of the test results 2-ME and CF to establish the true condition of the animal, the dot-blot showed relative sensitivity of 100%, and relative specificity of 99.91%. The evaluated test proved to be effective and reliable, besides being easy to handle and interpret the results.

Sinal de Faget como manifestação clínica de brucelose. Relato de caso / Faget's sign as a clinical manifestation of brucellosis: Case report

Relata-se o caso de uma paciente do sexo feminino, 32 anos, comerciante, com manifestações sistêmicas de brucelose, como febre diária contínua, sinal de Faget, lombalgia, cervicalgia, náuseas e cefaleia. Quando questionada, a paciente referiu consumo de leite e queijo não pasteurizados de origem bovina. Nos exames laboratoriais, foram evidenciados leucocitose, linfopenia, proteína C-reativa dentro dos parâmetros da normalidade e ausência de transaminasemia, contrapondo achados clássicos da doença. Os exames de imagem mostraram sinais característicos de sacroileíte. O tratamento foi realizado com doxiciclina 100mg via oral a cada 12 horas e estreptomicina 1g via intramuscular diária. O resultado da titulação para brucelose foi positivo. A paciente teve boa resposta ao tratamento, mantendo-se afebril e em bom estado geral até a alta hospitalar, que ocorreu após 14 dias do início da medicação, tendo sido mantido o tratamento ambulatorialmente. (AU)

A case of a 32-year-old female retailer with systemic manifestations of brucellosis, such as prolonged daily fever, Faget's sign, low back and neck pain, nausea and headache. When questioned, the patient reported consumption of unpasteurized milk and cheese of bovine origin. Laboratory tests revealed leukocytosis, lymphopenia, normal levels of C-reactive protein, and absence of transaminasemia, contrasting classic findings of the disease Imaging evaluation showed characteristic signs of sacroiliitis. The treatment was performed with doxycycline 100mg orally every 12 hours, and streptomycin 1g intramuscularly once daily. The serology for brucellosis was positive. The patient showed good response to the treatment, remaining afebrile and in good general condition until hospital discharge, which took place 14 days after starting the medication; she remained on treatment in an outpatient setting. (AU)

Serological study of brucellosis in Argentine Creole sheep / Estudio serológico de brucelosis en ovejas criollas de Argentina

Ovine cattle was introduced into America during the Spanish conquest with the second journey of Columbus to the Antilles and was disseminated throughout the region. In 1587, sheep were introduced into Argentina, later developing into the "Creole" breed. We selected 486 animals from different Argentine provinces with the aim of determining the serological status of brucellosis caused by Brucella melitensis and Brucella ovis. For the detection of antibodies against smooth Brucella spp., the Rose Bengal test (RBT) was performed as screening test while the serum agglutination test (SAT) and 2 mercapto-ethanol (2ME) were run as a confirmatory technique. Moreover, for the detection of antibodies against rough Brucella spp., we used the rapid slide agglutination test (RSAT) for screening and an indirect ELISA (IELISA) as confirmatory assay. This study showed that the total positive percentage of brucellosis due to B. ovis was 2.9%. Excluding the animals mixed with the Suffolk breed; seropositivity would be 0.6%. All animals tested negative for brucellosis caused by B. melitensis.

El ganado ovino fue introducido en América durante el segundo viaje de Colón a las Antillas y rápidamente se diseminó por la región. En 1587 entraron a la Argentina las primeras ovejas, estas se adaptaron a las condiciones naturales y se desarrolló así la denominada «oveja criolla¼. Se seleccionaron 486 animales de diferentes provincias para conocer el estado serológico de la enfermedad producida por Brucella melitensis y Brucella ovis. Para detectar anticuerpos anti-Brucella en fase lisa se utilizó la prueba de rosa de Bengala (RBT) como tamiz y como confirmatorias seroaglutinación lenta en tubo (SAT) y 2-mercaptoetanol (2ME). En fase rugosa se realizó como tamiz la prueba rápida de aglutinación (RSAT) y ELISA indirecto como prueba confirmatoria (IELISA). Este estudio mostró un porcentaje de seropositividad de brucelosis causada por B. ovis del 2,9%. Excluyendo los animales cruzados con la raza Suffolk, la seropositividad sería del 0,6%. Todos los animales fueron negativos a brucelosis causada por B. melitensis.

Occurrence of brucellosis, leptospirosis and neosporosis in cows with retained placenta in Southwest Paraná, Brazil / Ocorrência de brucelose, leptospirose e neosporose em vacas com retenção de placenta no Sudoeste do Paraná, Brasil

The aim of this study was to measure the occurrence of brucellosis, leptospirosis and neosporosis in cows from 25 family farms milk, with semi-intensive grazing system, located in the Southwest region of Paraná, Brazil. Eighty-four cows with retained placenta, between July 2013 to July 2014, diagnosed by the presence of fetal membranes in the uterus up to 12 hours after partum, decrease of appetite and of milk production, as well increase of rectal temperature were included into the study. The animals were submitted to blood collection for evaluating the seropositivity for brucellosis, leptospirosis and neosporosis. The blood was collected at 15 to 45 days postpartum, avoiding false negative results due to immune deficiency observed in the transition period. After collection, the blood was centrifuged, the serum was packed in three aliquots, identified and subsequently frozen. Serology was performed to diagnose brucellosis (technique of buffered acidified antigen), leptospirosis (through the microscopic agglutination test - MAT) and neosporosis (indirect immunofluorescence test). Animals were considered positive when presenting titer >1:100 (leptospirosis) and 1:200 (neosporosis). No animal with placenta retention presented Brucella abortus bacteria; 39% (33/84) were reactive to one or more Leptospira serovars, 15% (13/84) were positive to Neospora caninum, and 4% (4/84) had both diagnosis, being reactive for leptospirosis and neosporosis. In conclusion, data from this experiment inspires greater attention to leptospirosis and neosporosis in dairy cattle presenting placenta retention in southwest Paraná.(AU)

Objetivou-se com esse estudo avaliar a ocorrência de brucelose, leptospirose e neosporose em fêmeas bovinas de 25 propriedades leiteiras de agricultura familiar, mantidas em sistema de pastejo semi-intensivo, localizadas na Região Sudoeste do Paraná, Brasil. Para tanto, incluiu-se nesse estudo, 84 vacas diagnosticadas com retenção de placenta (RP) pela presença parcial ou total dos anexos fetais no útero após 12 horas do parto, diminuição do apetite e da produção de leite, como também aumento da temperatura retal. Os animais foram submetidos à coleta de sangue 15 a 45 dias pós-parto, a fim de evitar resultado falso negativo devido à imunodeficiência observada no período de transição. Após coleta, o sangue foi centrifugado, o soro aliquotado em três amostras, identificado e congelado. Para o diagnóstico sorológico de Brucelose utilizou-se o exame sorológico do antígeno acidificado tamponado, de leptospirose a técnica de soroaglutinação microscópica, e neosporose pela técnica de imunofluorescência indireta. Os animais foram diagnosticados positivos quando apresentaram título igual ou superior à 1:100 (leptospirose) e 1:200 (neosporose). Em nenhum dos 84 animais com RP foi detectada a presença da bactéria Brucella abortus. Desses, 39,28% (33/84) foram reativos para um ou mais sorovares de Leptospira, 15,47% (13/84) foram positivos para Neospora caninum e 4,76% (4/84) foram reativos para sorovares de Leptospira sp. e N. caninum, concomitantemente. Em conclusão, os dados deste estudo inspiram maior atenção à leptospirose e neosporose em bovinos leiteiros que apresentam retenção de placenta no sudoeste do Paraná.(AU)

Comparison of inflammatory markers between brucella and non-brucella epididymo-orchitis

ABSTRACT Objectives: Brucellosis is a multi-system infectious disease that is associated with inflammation, which causes an increase in acute phase reactants. Hematological inflammatory markers of brucellosis include mean platelet volume (MPV), red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR). In this study, we aimed to evaluate the diagnostic value of hematological inflammatory markers in Brucella epididymo-orchitis (BEO), and to investigate the utility of these markers for differential diagnosis from non-Brucella epididymo-orchitis (non-BEO). Materials and Methods: We retrospectively reviewed the records of 22 BEO and 50 non-BEO patients. Hematological parameters were recorded and compared between the two groups. The main diagnostic criteria for BEO were positive clinical findings (i.e., testicular pain, tenderness and scrotal swelling), a positive Rose Bengal test result, standard tube agglutination (STA) titer ≥ 1/160, and/or a positive blood culture. Results: The most decisive factors in discriminating between BEO and non-BEO were NLR, RDW, and MPV, in decreasing order of their strength. Regardless of other factors, NLR values < 2.3 significantly increased the odds of BEO (OR=8.080, 95% CI: 1.929-33.843, p=0.004). After adjusting for other factors, RDW values >14.45% significantly increased the odds of BEO (OR=7.020, 95% CI: 1.749-28.176, p=0.006). Independent of the other factors, patients with MPV < 7.65 fL had a 6.336 times higher risk for BEO (95% CI: 1.393 - 28.822, p=0.017). Conclusion: Hematological inflammatory markers such as NLR, RDW, and MPV can aid in the differential diagnosis of BEO and non-BEO.

Periprosthetic knee infection with Brucella species - a case report

A 63-year-old female patient presented for infected total knee prosthesis by brucella spp. several years after undergoing knee replacement arthroplasty. She underwent a two-stage revision surgery and was treated wih gentamicin, rifampicin and doxycycline for a total duration of four months

Zoonosis en grupo familiar. Revisión bibliográfica a propósito de un brote Informe de casos / ZOONOSIS IN A FAMILY GROUP: LITERATURE REVIEW OF AN OUTBREAK

Brucelosis es una zoonosis de distribución mundial. Argentina notifica 300 casos anuales. Entre agosto y octubre de 2015 diagnosticamos tres casos en un grupo familiar

The aim of the present report was to describe an outbreak of Brucellosis in a family group due to its unfrequency and etiological value. The infection caused by Brucella is a disease of animals (zoonoses) , and humans are accidental hosts. The major determinant of a human risk of acquiring the disease is the contact with infected animals. The genus Brucella contains four species pathogenic for humans: B. melitensis, B. abortus, B. suis and B. canis. Brucella are intracellular bacteria and among the species pathogenic for humans, B. melitensis are the most virulent. The organisms commonly enter the body through cuts in the skin of people handing infected animals or through their blood or secretions, and also the entry can include the respiratory or gastrointestinal tracts. Brucellosis exists worldwide, and Argentina reports 300 cases annually. Between August and October 2015, we diagnosed four cases in a family group: these cases are reported in the article.

Unrecognized pediatric and adult family members of children with acute brucellosis

Abstract Background and aim Brucellosis is an infectious, contagious and zoonotic disease that occurs worldwide. The family members of an index case of brucellosis may be especially susceptible, due to sharing the same source of infection and similar risk factors for brucellosis. In this study, we propose to screen pediatric and adult family members of brucellosis index cases for detecting additional unrecognized infected family members. Materials and methods 114 family members of 41 pediatric patients with brucellosis were evaluated. All family members completed a brief questionnaire and were tested by a standard tube agglutination test (STA). Results The majority of family members (n = 96, 84.2%) were children. Among the 114 family members, 42 (36.8%) were seropositive, and 15 (35.7%) were symptomatic. The majority of the symptomatic seropositive family members (n = 12, 80%) had STA titers (≥1:640) higher than asymptomatic seropositive family members (n = 9, 33%; p = 0.004). Conclusion The routine screening of both pediatric and adult family members of index cases is a priority in endemic areas. Using this screening approach, unrecognized family members who are seropositive for brucellosis will be identified earlier and be able to receive prompt treatment.

Guidelines for the management of human brucellosis in the State of Paraná, Brazil

Abstract Human brucellosis is a re-emerging disease with the potential for bioterrorism. The number of cases in Brazil has increased; however, the ideal management has not been established. These guidelines are intended for use by clinicians and other health-care workers providing medical care for patients with suspected brucellosis in the State of Paraná. We included a brief description of the epidemiology, clinical presentation, diagnosis, prevention of exposure, prevention of disease by chemoprophylaxis, treatment of disease, monitoring of adverse effects during treatment, management of treatment failure and relapse cases.