Human brucellosis: recent advances and future challenges

Abstract

Bacteria of the genus Brucella cause brucellosis, one of the world's neglected zoonotic diseases. It is a disease of poverty; infections of livestock have a huge socioeconomic cost while human brucellosis starts as a debilitating acute infection that can be come chronic with many complications. The figure of 500 000 new human cases each year is regularly cited in reviews and research papers, however this is a vast under estimation; many of the most affected countries do not have the infrastructure for diagnosis and the broad spectrum of symptoms are shared with other febrile infections. Considering the importance of the disease, the international brucellosis research community is small; we cover a wide range of research interests ranging from veterinary and human medicine to molecular genetics, cell biology and immunology. Much work is centred on the deciphering how Brucella cause disease in animals and man; how they enter and survive in host cells, how they use their VirB Type IV secretion system to deliver effectors that modulate host cell biology and immune response.. This will lead to the identification of new strategies for vaccine development, targets for diagnostic and prognostic tests and the development of new therapies. However, as noted in the first few lines of this editorial, brucellosis is a disease of poverty; and it is important that, especially for disease surveillance, diagnosis, control and treatment, that we work for solutions that are relevant and applicable to the countries where the disease is really a problem. Here I will list a few points that highlight a small selection of the recent practical advances and some of the major challenges.

Treatment of Severe Refractory Thrombocytopenia in Brucellosis With Eltrombopag

“…Meantime, the patient also was given immunoglobulin (IVIg) intravenous (1g/kg/day) for 2 days and high dose methylprednisolone treatment (20 mg/kg/d for 3 days). Platelet counts which did not show any improvement,were 10×10 9 /L and 7×10 9 /L, at the beginning and end of the treatment, respectively.…”

“…Brucellosis is a febrile zoonotic disease caused by intracellular Gram-negative coccobacilli of the Brucella species [8,9]. The disease is primarily transmitted to humans through the consumption of unpasteurized dairy products or through occupational exposure to livestock [10,11].…”

Brucella: Reservoirs and Niches in Animals and Humans

“…For instance, within the niche from a host reservoir, Brucella can remain at a low replication rate for a long time, and under favorable conditions, egress to infect other cells and start new replicative cycles. In addition, Brucella infections in humans perdure in the ecosystem due to the lack of control of the infection in natural hosts [ 6 , 50 ]. Lymph nodes, spleen, lungs, and the reproductive organs, including placenta, testicular and mammary glands, are well-known target organs for Brucella infection [ 27 ].…”

“…Brucellosis remains endemic in many parts of the world, including the Middle East, Africa, Latin America, Central Asia, and several regions of the Mediterranean [ 1 , 2 , 3 , 4 ]. Brucella melitensis , Brucella abortus, and Brucella suis are the most important members of the genus because they are responsible for the human disease [ 5 , 6 ] and for significant economic losses in livestock [ 7 , 8 ], while Brucella canis , Brucella neotomae , and Brucella ovis display less or non-zoonotic potential [ 9 ]. Recently, many other species have been described in aquatic mammals (like Brucella pinnipedialis and Brucella ceti ) and other wildlife such as Brucella papionis , Brucella microti , Brucella inopinata, and Brucella vulpis [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ].…”

SERS Biosensor Based on Engineered 2D-Aperiodic Nanostructure for In-Situ Detection of Viable Brucella Bacterium in Complex Matrix

“…The control of Brucellosis is of prime importance in the endemic areas of poor countries, and the salubrity of animal source foods, in particular milk, is crucial to avoid the transmission of this disease from livestock to man [ 6 ]. The availability of simple and affordable tests to detect the pathogen presence in food of animal origin can therefore represent an important instrument to limit human outbreaks.…”