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Case-control study on risk factors associated with Brucella melitensis in goat farms in Peninsular Malaysia

Bamaiyi PH, Hassan L, Khairani-Bejo S, ZainalAbidin M, Ramlan M, Krishnan N, et al.

Trop Anim Health Prod, 2014 Jun;46(5):739-45.
PMID: 24633657 DOI: 10.1007/s11250-014-0557-x

Caprine brucellosis is a bacterial zoonotic infection affecting goats especially in developing countries all over the world. In Malaysia, the risk factors associated with this infection in farms have not been studied. A case-control study was carried out in goat farms in four states of Malaysia to elucidate the risk factors associated with the infection on the farms using structured questionnaires and face-to-face interviews. Results indicate that the introduction of new animals (OR = 5.25; 90 % CI = 1.46, 18.88), younger age category of farms (OR = 5.53; 90 % CI = 1.09, 21.66), and farms with single breed of goats (OR = 8.50; 90 % CI = 1.27, 41.97) were significant risk factors for brucellosis. In order to control brucellosis or possibly eradicate it in goat farms, these factors need to be dealt with. Enforcing stringent importation protocols or complete ban of goat importation from brucellosis endemic countries will help reduce risk of introducing new infection into the country.

Matched MeSH terms: Brucellosis/veterinary*
A large exposure to Brucella melitensis in a diagnostic laboratory

Sam IC, Karunakaran R, Kamarulzaman A, Ponnampalavanar S, Syed Omar SF, Ng KP, et al.

J Hosp Infect, 2012 Apr;80(4):321-5.
PMID: 22237130 DOI: 10.1016/j.jhin.2011.12.004

Brucella species are easily transmitted by aerosols and can be acquired in the laboratory.

Matched MeSH terms: Brucellosis/prevention & control*
Brucellosis-induced autoimmune haemolytic anaemia (AIHA)

Mak WW, Adrian MM, Ahlam K

Med J Malaysia, 2019 Oct;74(5):443-344.
PMID: 31649226

Brucellosis is a rare zoonotic infection caused by small, fastidious Gram-negative coccobacilli of the genus Brucella that may be associated with haemolytic complications including thrombotic microangiopathy and haemolytic anaemia. We describe a patient with culture confirmed brucellosis who presented with malaise, high grade fever, hepatosplenomegaly and Coombs-positive autoimmune haemolytic anaemia. The patient was successfully treated with combination of doxycycline and rifampicin with no further episodes of relapses or haemolysis. Although rare, the possibility of brucellosis should always be kept in mind in patients with risk factors who present with haemolysis and endemic area.

Matched MeSH terms: Brucellosis
Fulltext Refractory adult onset Still's disease

Sulaiman W, Abdullah AC, Tan JTC, Baba S, Karim N

Cureus, 2017 Oct 25;9(10):e1802.
PMID: 29282446 DOI: 10.7759/cureus.1802

It is often a challenge and a dilemma for clinicians encountering patients with pyrexia of unknown origin. Numerous tests performed to determine the underlying cause often give inconclusive results. We present a 52-year-old man with undulating fever for more than 10 months with persistent hyperferritinaemia, and negative immunological and serological markers. Despite corticosteroids, disease modifying anti-rheumatic agents and immune-modulator therapy, he succumbed to the illness. A diagnosis of refractory Adult onset Still's disease complicated by haemophagocytic lymphohistiocytosis was made.

Matched MeSH terms: Brucellosis
Fulltext Identification of Brucella spp. isolated from human brucellosis in Malaysia using high-resolution melt (HRM) analysis

Mohamed Zahidi J, Bee Yong T, Hashim R, Mohd Noor A, Hamzah SH, Ahmad N

Diagn Microbiol Infect Dis, 2015 Apr;81(4):227-33.
PMID: 25641125 DOI: 10.1016/j.diagmicrobio.2014.12.012

Molecular approaches have been investigated to overcome difficulties in identification and differentiation of Brucella spp. using conventional phenotypic methods. In this study, high-resolution melt (HRM) analysis was used for rapid identification and differentiation of members of Brucella genus. A total of 41 Brucella spp. isolates from human brucellosis were subjected to HRM analysis using 4 sets of primers, which identified 40 isolates as Brucella melitensis and 1 as Brucella canis. The technique utilized low DNA concentration and was highly reproducible. The assay is shown to be a useful diagnostic tool, which can rapidly differentiate Brucella up to species level.

Matched MeSH terms: Brucellosis/microbiology*
Seroprevalence of brucellosis among farmers and veterinary technical staff in peninsular Malaysia

Bamaiyi PH, L. Hassan, S. Khairani-Bejo, M. Zainalabidin, M. Ramlan, A. Adzhar, et al.

Sains Malaysiana, 2017;46:933-943.

A study was conducted to determine the seroprevalence and risk factors associated with brucellosis in farmers, veterinary technical staff and other volunteers in Peninsular Malaysia using the One Health concept. A cross sectional study design was employed to sample a population of farmers and Veterinary technical staff on a volunteer basis. The Brucella Coombs test was used to elucidate the seroprevalence of brucellosis in the sampled population and the associated factors and predictors for brucellosis. The seroprevalence of brucellosis among farmers and non-farmers (veterinary technical staff and others) of 446 people studied was 1.35% (95% CI=0.28-2.42). Occupation, age and drinking unpasteurized milk were significant risk factors for brucellosis using multivariate logistic regression at 90% confidence level. The odds of having brucellosis increased by 7.19 times in farmers compared to non-farmers (90% CI=1.16, 44.71), it increased 7.16 times in individuals 40 years and below compared with those above 40 years old (90% CI=1.16, 44.41) and 4.45 times among those who drink unpasteurized milk compared to those who do not (90% CI= 1.03, 19.15). This study highlights the current state of human brucellosis in Malaysia among those groups that are occupationally at risk. A nationwide health education of the occupationally exposed population especially farmers may decrease the incidence of the infection and support the on-going eradication efforts of brucellosis in Malaysia.

Matched MeSH terms: Brucellosis
Comparative study of immunopathophysiological responses induced by B. melitensis and its lipopolysaccharide in mouse model infected via intranasal route of exposure

Osman AY, Saharee AA, Jesse FF, Kadir AA

Microb Pathog, 2017 Sep;110:365-374.
PMID: 28710016 DOI: 10.1016/j.micpath.2017.07.014

In this study, we developed a mouse model and characterized the effects of intranasal inoculation of virulent Brucella melitensis strain 16M and its lipopolysaccharide (LPS). The effects of the exposure were compared with respective control groups. Both Brucella melitensis-infected and LPS-infected groups showed no significant clinical presentation with minor relevance in the mortality associated with the infection. In Brucella melitensis-infected group, significant histopathological changes in comparison to the LPS infected group with increase bacterial burden in the lungs, reproductive and reticuloendothelial organs were observed. However, both infected groups showed elevated levels of pro-inflammatory cytokine expression (IL-1β and IL6) and antibody production (IgM an IgG) as early as 3 days post-infection with predominance in LPS infected group. In contrast, low levels of sex related hormonal changes was recorded in both infected groups throughout the experimental period. This is the first detailed investigation comparing the infection progression and host responses in relation to the immunopathophysiological aspects in mouse model after intranasal inoculation with B. melitensis and its lipopolysaccharide. The study revealed a significant difference between infected and control groups with overlap in clinical, pathological, and immunological responses as well as sex related hormonal changes resulting from the infections.

Matched MeSH terms: Brucellosis/immunology*; Brucellosis/microbiology*; Brucellosis/pathology*
Development of an Immunodiagnostic Test for Screening Human Brucellosis Cases Using the Whole-Cell Antigens of Brucella abortus

Bhartiya NM, Husain AA, Daginawala HF, Singh L, Kashyap RS

Malays J Med Sci, 2020 Dec;27(6):15-26.
PMID: 33447131 DOI: 10.21315/mjms2020.27.6.3

Background: Human brucellosis is an important zoonotic disease of public health and often remains neglected owing to lack of sensitive and efficient diagnostic methods. This study evaluates diagnostic utility of in-house designed enzyme-linked immunosorbent assay (ELISA) using whole-cell antigens of Brucella abortus (B. abortus) S19 against the commercially available kits.
Methods: A prospective cohort study involving different populations within the Vidarbha regions of Maharashtra, India was conducted through camps organised from May 2009 to October 2015. A total of 568 serum samples were collected from high-risk people recruited as study cohorts based on inclusion criteria, additional risk factors and clinical symptoms. Samples were evaluated by indirect ELISA using the whole-cell antigens of B. abortus. The results were compared with the commercially available IgG detection ELISA kit to ascertain the specificity and sensitivity of the developed test.
Results: Fever, body ache, joint pain, lower back pain, loss of appetite and weight loss were major symptoms associated with the disease. With the cut-off of > 0.8, the positivity of brucellosis infection was at 12.32% (70/568) compared to 9.33% (53/568) as detected by the commercial kit. The in-house developed ELISA method yielded a sensitivity of 87.5% and specificity of 99.18% as compared to the commercial kits (sensitivity -80.30% and specificity -99.6%).
Discussion: The B. abortus S19-derived whole-cell protein-based ELISA is rapid and cost-effective and can be used for screening brucellosis infection in lieu of the commercially available ELISA kits.

Matched MeSH terms: Brucellosis