Streptococcus suis is an important pathogen causing economic problems in the pig industry. Moreover, it is a zoonotic agent causing severe infections to people in close contact with infected pigs or pork-derived products. Although considered sporadic in the past, human S. suis infections have been reported during the last 45 years, with two large outbreaks recorded in China. In fact, the number of reported human cases has significantly increased in recent years. In this review, we present the worldwide distribution of serotypes and sequence types (STs), as determined by multilocus sequence typing, for pigs (between 2002 and 2013) and humans (between 1968 and 2013). The methods employed for S. suis identification and typing, the current epidemiological knowledge regarding serotypes and STs and the zoonotic potential of S. suis are discussed. Increased awareness of S. suis in both human and veterinary diagnostic laboratories and further establishment of typing methods will contribute to our knowledge of this pathogen, especially in regions where complete and/or recent data is lacking. More research is required to understand differences in virulence that occur among S. suis strains and if these differences can be associated with specific serotypes or STs.

Streptococcus suis is a major swine pathogen responsible for important economic losses to the swine industry worldwide. It is also an emerging zoonotic agent of meningitis and streptococcal toxic shock-like syndrome. Since the recent recognition of the high prevalence of S. suis human disease in southeast and east Asia, the interest of the scientific community in this pathogen has significantly increased. In the last few years, as a direct consequence of these intensified research efforts, large amounts of data on putative virulence factors have appeared in the literature. Although the presence of some proposed virulence factors does not necessarily define a S. suis strain as being virulent, several cell-associated or secreted factors are clearly important for the pathogenesis of the S. suis infection. In order to cause disease, S. suis must colonize the host, breach epithelial barriers, reach and survive in the bloodstream, invade different organs, and cause exaggerated inflammation. In this review, we discuss the potential contribution of different described S. suis virulence factors at each step of the pathogenesis of the infection. Finally, we briefly discuss other described virulence factors, virulence factor candidates and virulence markers for which a precise role at specific steps of the pathogenesis of the S. suis infection has not yet been clearly established.

Infections caused by Streptococcus suis are considered a global and an economical problem in the swine industry. Moreover, S. suis is an agent of zoonosis that afflicts people in close contact with infected pigs or pork-derived products. Although sporadic cases of S. suis infections in humans (mainly meningitis) have been reported during the last 40 years, a large outbreak due to this pathogen emerged in the summer of 2005 in China. The severity of the infection in humans during the outbreak, such as a shorter incubation time, more rapid disease progression and higher rate of mortality, attracted a lot of attention from the scientific community and the general press. In fact, the number of publications on S. suis (including the number of reported human cases) has significantly increased during recent years. In this article we critically review the present knowledge on S. suis infection in humans, we discuss the hypotheses that may explain the 2005 outbreak and the repercussion of such an episode on the scientific community.

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Infections caused by Streptococcus suis are considered a global problem in the swine industry. In this animal species, S. suis is associated with septicemia, meningitis, endocarditis, arthritis and, occasionally, other infections. Moreover, it is an agent of zoonosis that afflicts people in close contact with infected pigs or pork-derived products. Although sporadic cases of S. suis infection in humans have been reported, a large outbreak due to S. suis serotype 2 emerged in the summer of 2005 in Sichuan, China. A similar outbreak was observed in another Chinese province in 1998. Symptoms reported in these two outbreaks include high fever, malaise, nausea and vomiting, followed by nervous symptoms, subcutaneous hemorrhage, septic shock and coma in severe cases. The increased severity of S. suis infections in humans, such as a shorter incubation time, more rapid disease progression and higher rate of mortality, underscores the critical need to better understand the factors associated with pathogenesis of S. suis infection. From the 35 capsular serotypes currently known, serotype 2 is considered the most virulent and frequently isolated in both swine and humans. Here, we review the epidemiological, clinical and immunopathological features of S. suis infection in humans.