brucellosis-2 lecture on epidemiology – 07-03-2012 l. makrai sziu-fvs, department of microbiology...
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BRUCELLOSIS-2
Lecture on Epidemiology – 07-03-2012
L. Makrai
SZIU-FVS, Department of Microbiology and Infectious Diseases
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OVINE EPIDIDYMITIS AND ORCHITIS CAUSED BY Brucella ovis
• Occurs in most sheep-raising regions of the world (Australia, New Zealand, North and South America, South Africa, many countries in Europe)
• Infertility, epididymitis, orchitis in rams
• Sporadic abortion in ewes (placentitis)
• Increased perinatal mortality
• B. ovis, only sheep is susceptible
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Epidemiology• Introduction into a herd: with matured, infected,
asymptomatic rams
• B. ovis is shed with urine and semen
• Lifelong infection
• Ewe: infected with semen (venereal transmission) several month – get shot of brucella
• ascending infection: epididymis, testicle, accessory genital glands: inflammation, necrosis, oedema, fibrosis, spermatokele
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B. ovis (epididymitis and orchitis)
HAJTÓS DR.
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Clinical and Pathological findings• incubation period: 5-9 weeks
• skin of scrotum is flushed
• painfull and enlarged epididymis and testicles
• abnormal gait
• unilateral or bilateral testicular atrophy with swelling and hardening of the epididymis
• decreasing quality of semen and sexual activity, reduced fertility in rams
• Chronic lesions: abscesses and necrotic foci in the testicles, uneven surface, calcification
• sporadic abortion in ewes
• increased perinatal mortality
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Diagnosis• Epidemiological situation, clinical signs• Palpation of testicles• microscopic and bacteriological examination of semen• serology: - AGID
- CFT- ELISA
PCR (urine, semen, preputial washes)
Differential diagnosis: - Histophilus somni- Actinobacillus seminis- B. melitensis
Treatment: Pointless!
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Prevention, Eradication
• Castration of infected rams!
• young, immature rams: separated rearing
• ELISA test 4-6 weeks intervals: removing
seropositive rams
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SWINE BRUCELLOSIS• Occurence
– Worldwide in swine-raising regions– It has been eradicated from domesticated pigs in the US,
Canada, European countries and Australia, but it persits in wild and feral swine population.
• Biotype 1-3: worldwide• 2: wild boars in Europe• 4: arctic regions of North America, and Russia• 5: in the former USSR (murine brucellosis)
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• Etiology:– B. suis bt. 1-2-3.
• Epidemiology:Introduction into a herd:
- with infected, asymptomatic breeding animals
- vehicles, instruments
- dog, wild boar
• Pathogenesis: like cattle,
• Infection is aquired by ingestion or by coitus• but: orchitis, vertebral osteomyelitis can be seen more
frequently
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• Clinical signs: – bacteraemia: gen. asymptomatic– sows: abortion (any gestation period),
stillbirth, neonatal mortality increase,
non-viable or poorly developed piglets,
vaginal discharge for several days
temporary sterility– boars: excreting brucellae in semen (with or without clin.
signs)• Testicular abnormalities: orchitis, sterility• Lameness, incoordination, posterior paralysis: vertebral abscess,
fractures
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• Pathology:
– Fetus: odema of fetus and fetal membranes,
small haemorrhages, maceration, mumifiction
– Sows: necrotic foci in uterine wall
– Boars: enlarged testicle, inflammatory necrotic
foci
– Lesions in bones and joints: vertebral body -
deformities
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dr. Deim Zoltán felvétele
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dr. Deim Zoltán felvétele
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dr. Deim Zoltán felvétele
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• Diagnosis:
– Isolation of B. suis
– serology: Slide agglutination, tube agglutination, CFT,
ELISA: susceptibility and specificity also low:
only for livestock diagnosis!!!
• Treatment: NO!
• Eradication: Stock exchange!
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• Maintain the disease-free status:
– Control of the import of susceptible animals
– Examination of abortion cases in diagnostic institutes
– Serological survey of breeding boars in each 6 month
– Serological examination of 10% of sows in each year
– Keeping wild boars away from swineherds
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CANINE BRUCELLOSIS
• Occurence– Worldwide (America, Asia, Africa)– Europe: sporadic, everywhere– Free: New Zealand, Australia
• Susceptibility– B. canis– B. melitensis– B. abortus– B. suis
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Epidemiology• Host spectrum
– narrow, dogs and the members of wild Canidae – zoonosis (more, than 40 cases in the literature)
• Infection• oronasal contact, through mucous membranes
(oral cavity, vagina, conjunctiva)
• infective dosis:– p.o.: 106 CFU– conjunctiva: 104 - 105 CFU
• Shedding bacteria:• bitches: vaginal discharge (during oestrus, and mating),
fetus, fetal fluid (1010 CFU/ml)6 weeks after abortion
• males: settle down in the postate and epididymissemen, urine: 103 - 106 CFU/ml
for 2 years
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Clinical signs• No characteristic clinical signs, asymptomatic
• Enlargement of lymph nodes
• Pregnant bitches:
– abortion (between 45-60. days),
– reproduction failures (decreased fertility)
– Reduced litter size
– Neonatal mortality
– Most bitches that have aborted subsequently have normal gestations.
• Males: infertility, epididymitis, orchitis, prostatitis
• Scrotal dermatitis (saliva!)
• Dogs with chronic infections are often aspermic.
• rare: discospondylitis (lameness, paresis, paralysis), uveitis
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Leland E. Carmichael és Craig E. Greene, 1998
B. canis
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Diagnosis• Examination of semen
– p.i. 5. weeks, inflammatory cells, morphological alteration of sperm
• Isolation of B. canis
– from blood: pi 2-4 weeks – for years (5.5 years)
• Serological examination
– Slide aggl., Tube Aggl., AGID, IF, ELISA
– Earliest positive result: pi. 3-12 weeks
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Fate of infected animal
Removal of infected animals from the kennel and
from breeding prgrammes.
Castration (neutering) of infected dog and treatment
with antibiotics reduces the risk of transmission.
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Treatment
• Combination of – tetracyclines (minocycline) and– aminoglycosides (streptomicin)
• For 4 weeks
or
• Extermination of infected animals!
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Prevention• serological examination:
– Breeding dogs: in each 6 month
– Introduction of a new dog into the kennel: two times in 1 month intervals
– Breeding animals 3-4 weeks before mating.
– If a dog leave the kennel: before readmission.
• Do not get dogs from a kennel, where reproductive problems occurs
• No vaccines available!
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Brucellosis of other species
• Horse (B. abortus) – arthritis, bursitis and
tendovaginitis, fistolous withers, poll-evil
• Wild ruminants (B. abortus)
• Wild boars (B. suis) – source of B. s. infection
in domestic pigs reared outdoors
• Wild hare (B. suis bt. 2.)
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„hazelnut chocolate” spleen (wild hare – Brucellosis (B. suis bt. 2))
dr. Gyuranecz M. felvétele
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Brucella suis (chocolate agar, 37°C, 72 hours)
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B. suis bt. 4. (arthritis, reindeer)
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HUMAN BRUCELLOSISOne of the most fequently seen bacterial zoonosis in the Earth. 500.000 new patient/year!
Human is susceptible: MID50
B. melitensis ++++ (101)
B. abortus +++ (103)
B. suis ++ (105)
B. canis + (106)
B. ceti +
B. pinnipedialis +
Infection:
- ingestion (po): raw -unpasteurized- milk!
and dairy products made from this,
- skin abrasions: during abortion, amniotic fluid, urine
- inhalation (lab infections)
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Incidence of human brucellosis
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Clinical signs and pathological findings
- incubation period: 5-14 days (3 months)
- undulant fever (fluctuating pyrexia), malaise,
inappetence, fatigue, muscle and joint pains
- drenching sweats (at night)
- bone and joints alterations
(sacroiliitis, spondylitis, arthritis, osteomyelitis)
- swelling of liver and spleen (33%)
- lymph node alterations (10%)
- alteration in urinary and genital tract (glomerulonephritis,
kidney abscess, orchitis, epididymitis) (10%)
- CNS signs (7%)
- endocarditis
(B. canis: can be asymptomatic, just seroconversion)
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Treatment of human brucellosis:
Should be administered early in an infection!
– rifampicin
– gentamycin
– trimethoprim-sulfamethoxazole
– doxycycline, minocycline
– ciprofloxacin
– streptomycin
Long-term treatment may be required!
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Diagnosis
• Anamnesis!
• Haemoculture
• serology (B. canis Ag!!!), no crossreaction with B. abortus Ag!!!
– Slide agglutination – Tube agglutination– ELISA
• Fals diagnosis:
– Lack of appropriate serological kit (S-R)
– Occurence of the disease is underestimated
Time after the first clinical signs
Slide agglutination titer
2 months 32
3 months 16
8 months 2
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Prevention• Veterinarians: examination of abortion cases - use of gloves and other
protective clothing
• Education of owners about the danger of rearing of brucella infected animals
• Consumption of Raw milk should be avoided!
• Laboratory: safety rules must comply!
• The rules of common sense must be observed if we live together with animals!