Human Brucellosis and Adverse Pregnancy Outcomes

Arenas-Gamboa, Ángela M.; Rossetti, C; Chaki, Sankar P.; García-González, Daniel G.; Adams, L. Garry; Ficht, Thomas A.

doi:10.1007/s40475-016-0092-0

Cited by 36 publications

(34 citation statements)

References 78 publications

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“…Symptoms in infected individuals are non-specific and can include fever, sweats, arthralgia, myalgia, and in complicated cases, miscarriage or spontaneous abortion (1,(33)(34)(35). In this study, an attempt to directly correlate confirmed human brucellosis cases with the consumption of raw milk and products was impossible, which demonstrates a gap in evidence of unavailable data reporting human brucellosis acquired from raw milk consumption.…”

Section: Discussionmentioning

confidence: 83%

Building the Evidence Base for the Prevention of Raw Milk-Acquired Brucellosis: A Systematic Review

Adetunji

Ramı́rez

Ficht

et al. 2020

Front. Public Health

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Background: The scientific evidence of the health risks associated with the consumption of raw milk has been known for a long time. However, less clear is the impact of acquiring infectious diseases from raw milk consumption in the United States (US) due to incomplete reporting of cases and the complex factors associated with the sale and consumption of raw milk. Investigations of this current study focused on human brucellosis, one of the infectious diseases commonly acquired through the consumption of raw milk and milk products, and which continues to be a public health threat worldwide.Methodology: A qualitative systematic review of the sources of opinions that contribute to the increased trend of raw milk sales and consumption in the US was conducted.Results: Interestingly, opinions about the sale of raw milk and/or the benefits arising from its consumption varied by US region, with the proportion of messages supporting raw milk consumption being highest in the Northeast compared to other US regions. Several evidence gaps and factors that possibly contribute to the increased prevalence of raw milk-acquired brucellosis were identified including inadequate monitoring of the raw milk sales process and lack of approved diagnostic methods for validating the safety of raw milk for human consumption. Conclusions:The unavailability of data specifying brucellosis cases acquired from raw milk consumption have precluded the direct association between raw milk and increased brucellosis prevalence in the United States. Nevertheless, the evidence gaps identified in this study demonstrate the need for intensified surveillance of raw-milk acquired infectious diseases including human brucellosis; establishment of safety and quality control measures for the process of selling raw milk; and design of an effective strategy for the prevention of raw milk-acquired infectious diseases including brucellosis. Overall, for the first time, this study has not only shown the gaps in evidence that require future investigations, but also, variations in the perception of raw milk consumption that may impact disease acquisition in different US regions.

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Section: Discussionmentioning

confidence: 83%

Building the Evidence Base for the Prevention of Raw Milk-Acquired Brucellosis: A Systematic Review

Adetunji

Ramı́rez

Ficht

et al. 2020

Front. Public Health

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“…This study describes pathologic changes of the non-gravid uterus, broadens the knowledge of Brucella as a pathogen of the reproductive tract, and suggests that pregnancy is not required to generate tropism. Since infertility is also described in non-pregnant women infected with Brucella spp., it is possible that inflammation of the reproductive tract is a contributing factor [33]. Intratracheal inoculation of the guinea pig offers an intriguing model for the study of the host-pathogen interaction that leads to reproductive disease in addition to providing a reliable means of generating systemic and clinical brucellosis that could be used to evaluate vaccine candidates.…”

Section: Discussionmentioning

confidence: 99%

Characterization of a novel intratracheal aerosol challenge model of Brucella melitensis in guinea pigs

Hensel

García-González

Chaki

et al. 2018

Preprint

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B. melitensis is considered the most virulent of the Brucella species, and a need exists for an improved laboratory animal model of infection that mimics natural transmission and disease. Guinea pigs are highly susceptible to infection with Brucella spp. and develop a disease syndrome that mimics natural disease after aerosol inoculation. Intratracheal inoculation is a targeted means of generating aerosols that offer advantages over aerosol chamber delivery. To establish this delivery method, female, Hartley guinea pigs were infected via intratracheal inoculation with PBS or 16M B. melitensis at low dose (101 to 103) or high dose (106 to 108) and monitored for 30 days for signs of disease. Guinea pigs in the high dose groups developed fever between 12-17 days post-inoculation. Bacteria were recovered from the spleen, liver, lymph nodes, lung, and uterus at 30-days post-inoculation and demonstrated dose dependent mean increases in colonization and pathologic changes consistent with human brucellosis. To study the kinetics of extrapulmonary dissemination, guinea pigs were inoculated with 107 CFU and euthanized at 2-hours post inoculation and at weekly intervals for 3 weeks. 5.8×105 to 4.2×106 CFU were recovered from the lung 2 hours post-inoculation indicating intratracheal inoculation is an efficient means of infecting guinea pigs. Starting at 1-week post inoculation bacteria were recovered from the aforementioned organs with time dependent mean increases in colonization. This data demonstrates that guinea pigs develop a disease syndrome that models the human manifestation of brucellosis, which makes the guinea pig a valuable model for pathogenesis studies.Author summaryBrucellosis is caused by a gram-negative, intracellular bacterial pathogen with a worldwide distribution and affects up to half a million people per year. It is a neglected zoonosis that impacts not only animal welfare, but also exert economic pressure on afflicted individuals through loss of wages and decreased productivity. In people, recurrent fever, malaise, and anorexia accompanied by enlargement of the spleen and lymph nodes are common clinical symptoms of infection. The mouse model has been used extensively to study the pathogenesis of brucellosis, but there are drawbacks to extrapolating studies in mice to develop vaccines or therapeutics for people. Mice are frequently inoculated via intraperitoneal injection, which is an artificial means of producing disease that does not mimic natural transmission or disease features, such as fever. An animal model is needed that can be infected through natural transmission routes and subsequently develop a syndrome that matches clinical disease seen in people in order to study the pathogenesis of disease and to develop vaccines and therapeutics. The guinea pig offers an improvement on the mouse model because it can be infected via aerosol inoculation and develops fever, a humoral immune response, systemic colonization, and macroscopic and microscopic lesions of disease. As such, guinea pigs could be used a more biologically relevant model for evaluation of host-pathogen interactions.

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“…Another theory was that amniotic fluid contains anti-Brucella activity [48]. However, many reports describe apparent increased rates of spontaneous abortion, intrauterine fetal death, and preterm birth in mothers with brucellosis during pregnancy [49]. Recognition and suitable treatment of infection in early course of pregnancy lead to decrease of incidence of spontaneous abortion, intrauterine fetal death, and congenital infection [44,[46][47][48][49].…”

Section: Neonatal Brucellosismentioning

confidence: 99%

“…However, many reports describe apparent increased rates of spontaneous abortion, intrauterine fetal death, and preterm birth in mothers with brucellosis during pregnancy [49]. Recognition and suitable treatment of infection in early course of pregnancy lead to decrease of incidence of spontaneous abortion, intrauterine fetal death, and congenital infection [44,[46][47][48][49]. The clinical manifestations of brucellosis in pregnancy are similar to other infected people and include arthralgia, arthritis, fever, chills, sweating, headache, malaise, nausea, vomiting, lymphadenopathy, hepatosplenomegaly, anorexia and weight loss [1][2][3][45][46][47].…”

Section: Neonatal Brucellosismentioning

confidence: 99%

“…The choice treatment for brucellosis in infected mother during pregnancy is a combination of rifampin and trimethoprim-sulfamethoxazole but trimethoprimsulfamethoxazole is contraindicated in first trimester and the last 2-4 weeks of pregnancy. During the third generation and first trimester of pregnancy, cephalosporins have been used and in the last month of pregnancy, combination of aminoglycosides (gentamycin) with rifampin is an alternative regimen [33,39,[45][46][47][48][49]].…”

Section: Neonatal Brucellosismentioning

confidence: 99%

See 1 more Smart Citation

Neonatal Brucellosis

Eghbalian¹

2020

New Insight Into Brucella Infection and Foodborne Diseases

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Brucellosis is a zoonotic infectious disease caused by the Brucella bacteria. Neonatal brucellosis is very rare and preventable and is an example of intrauterine infection, but clinical manifestations as well as transmission route are not well defined but presumed transplacental transmission. The neonate can be either infected transplacentally, or by ingestion of mother's secretions and blood during delivery, or by ingestion of breast milk. Presentation of the neonatal brucellosis including fever, arthralgia, weakness, malaise, respiratory distress, pneumonia, enlargement of liver and spleen, fever, thrombocytopenia, late neonatal hyperbilirubinemia, and septicoemia. The diagnosis of brucellosis was based on a positive blood culture (isolation Brucella of blood culture from both the mother and the neonate or only neonate) and on a high or rising titer of antibodies to the Brucella organism (positive serology only in the mother or both). The neonates with negative Brucella serology may also have Brucella infection. The mortality rate is very high, and infected neonates need early detection and timely treatment. Early detection and treatment reduce the incidence of complications. The treatment of rifampicin and trimethoprim/sulfamethoxazole is useful for neonatal brucellosis. More patients with neonatal brucellosis well respond to antibiotic therapy and must monitor by a Brucella titer of <1:40.

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Human Brucellosis and Adverse Pregnancy Outcomes

Cited by 36 publications

References 78 publications

Building the Evidence Base for the Prevention of Raw Milk-Acquired Brucellosis: A Systematic Review

Building the Evidence Base for the Prevention of Raw Milk-Acquired Brucellosis: A Systematic Review

Characterization of a novel intratracheal aerosol challenge model of Brucella melitensis in guinea pigs

Neonatal Brucellosis

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