Overview of animal and human brucellosis in EU: a controlled disease? Maryne JAY, Claire PONSART, Virginie MICK EU / OIE & FAO Reference Laboratory for Brucellosis ANSES Maisons-Alfort, France EURL Brucellosis 1
Brucella genus 2 Gram-negative bacteria Multispecies infectious disease host species with «preferred hosts» ~10 Brucella species Zoonosis : pathogenicity for human B. abortus bv 1-6, 9 B. melitensis B. suis bv 1-3 bv 1-5 B. ovis B. canis B. neotomae B. ceti B. pinnipedialis B. microti B. inopinata
Brucellosis, a multi-species disease Wild Ruminants, Rodents, Carnivores Swine B. abortus B. melitensis B. suis Source B Garin-Bastuji 3
Brucellosis a zoonosis of worldwide importance Animal infection Human infection Mostly fertility troubles in and Easily transmissible among susceptible species Huge excretion (abortions) Many transmission routes Survival in environment Occupational (animals, laboratory) Food-borne (unpasteurized milk/fresh cheese consumption ) >500 000 confirmed cases/year (WHO) In reality...15-25 times more! Intermittent fever, aches, arthritis Acute/chronic Localized forms Minimal mortality but, substantial residual disability if not treated promptly & effectively Consequences : Trade restriction Economic losses in livestock production Public health issue 4
Human brucellosis in EU - 2013 5
In ruminants/swine : historically endemic in Europe North: dairy - B. abortus (B. suis?) - Sedentary breeding system - Small ruminants apart - Individual identification - Industrialization - AI South: B. melitensis & B. abortus (B. suis?) - Transhumance - Species mixed - Males exchange -Identification implemented lately P r e v a l e n c e + 6
A regulated disease in EU in ruminants and swine Grant & Maintenance Council Directives 64/432/EEC, 91/68/EEC, 90/429/EEC Surveillance/control system Networks : laboratories (EURL + NRLs), vet services, veterinarians, EU agencies Health management Identification (herd/animal) Mouvement control Diagnosis Validated / standardized diagnostic tools Surveillance Abortion notification Testing strategy Control/eradication strategy Test & slaughter) Low prev. Coordination between stakeholders Suspicion investigation Monitored vaccination High prev. Qualification (status) Herd Region Country Porcine: trade living animals, semen, embryos Officially free herd - No vaccination - No outbreak - Favorable annual serological surveillance - Controlled introduction Officially free region/ms - no outbreak for 3 years - 99.8% OBF herds for 5 years - Mandatory notification of abortions - Individual identification Surveillance lightened under specific conditions 7
Bovine brucellosis in EU (status) - 2013 UK PT ES IT Regional status EFSA report 2013 8
Bovine brucellosis in EU (positive cattle herds > 0.1%) - 2013 EU Co-financed eradication programme onwards 2013 EU Co-financed eradication programme 2005-2009 EFSA report 2013 9
Bovine brucellosis in EU surveillance is required Eradication mostly achieved (except in certain areas) Lesson learned: - resources (compensation) - political commitment - good network of vet. services & labs - breeders organisation - Adapted use of control tools Premature relaxation of surveillance measures Overall very low number of infected herds Threat of reintroduction in free regions/countries Surveillance is required both clinical and serological 10
Bovine brucellosis in EU surveillance is required Belgium OBF since 2003 2 abortions Only 10% sero+ 2010 : B. abortus bv. 3 Abortion 2012 : B. abortus bv. 3 Abortion Intro Bronner et al. 2013; AFSCA data, 2010-2013 11
Bovine brucellosis in EU surveillance is required Belgium OBF since 2003 Few serological reactors No clinical signs 2010 : B. abortus bv. 3 Early detection? 2012 : B. abortus bv. 3 Gap between introduction and spread? Introduction? Importance of inoculum? Physiological status of first animal exposed? Incubation period Farm management? Diffusion Risk High number of epidemiologically linked herds Serological & clinical surveillance Bronner et al. 2013; AFSCA data, 2010-2013 12
Ovine and caprine brucellosis in EU (status) - 2013 PT ES FR IT Regional status EFSA report 2013 13
Ovine and caprine brucellosis in EU (positive cattle herds > 0.1%) - 2013 EU Co-financed eradication programmeonwards 2013 EFSA report 2013 14
Caprine & Ovine brucellosis in EU Control in progress Still some pockets with high level of infection Risk practices Farm management : males lending, shared pastures, transhumance, Unadapted measures/resources? Good knowledge of : - Epidemiological situation - Livestock sector organisation Geographical specificities Implementation of the control programme 15
Disease controlled in ruminants and wildlife? Up to recently no wild reservoir identified in EU for abortus & melitensis Few sporadic contaminations in wild ruminants Dead-end hosts Godfroid et al. 2013; Munoz et al. 2010; Ferroglio et al. 1998 Primary reservoir identified in Alpine Ibex in French Alps ~10 y after eradication of the disease in domestic animals France 2002 2003 OBF 2005 Animals 64 «départements» OBmF Humans ~15-30 confirmed cases/year mostly imported cases 16
Exemple of primary reservoir in wildlife French Alps, France 2012-2012 1 human case without risk factor Fresh raw cheese consumption Bovine brucellosis outbreak B. melitensis biovar 3 Extensive survey in domestic Protected species Alpine Ibex (Capra ibex) Transmission from wildlife to domestic Origins? animals MLVA-16?? Survey Ibex = Réservoir in wild Hunted species Red deer Roe deer Chamois? n=77 High prevalence (38%)??? All negative 2 + n=56 n=65 n=154 Mick et al., 2014 (PLoS One) Garin-Bastuji et al., 2014 (EID)
Swine brucellosis in EU Outdoor reared B. suis bv. 2 Rarely B. suis bv. 1 & 3 (Cvetnic, 2009; Godfroid and Kasböhrer, 2002) 18
Issues Swine brucellosis in EU main features Mostly B. suis biovar 2 in Europe Domestic pigs Wildlife Outdoor Indoor 70 s Spill over Reservoir No mandatory surveillance No harmonized basis monitoring Clinical diagnosis? Serological diagnosis : FPSR Infected Rate of positive reactors? Control policy? Slaughter? Porcine EU regulation: trade living animals, semen, embryos Variable prevalence in many EU countries Seroprevalence up to 50% Low pathogenecity in humans? 19
Brucella suis biovar 2 infection in atypical hosts in France Region Puy-de-Dôme Drôme Creuse Host Isolation ircumstances of discovery Bovine (cow) Gravid Uterus Annual prophylaxis (serum) RBT/CFT + Brucellin positive Ovine (ewe) Lymph Nodes Annual prophylaxis (serum) RBT/CFT + Bovine (cow) Mammary LN Udder Controlling introductions RBT/CFT + Brucellin positive NO APPARENT CLINICAL SYMPTOMS 2000 2009 2014 2004 2005 2012 Other cases in cattle described recently in Belgium and Poland Risk factors Hunter Hunter (Type 2 diabete) Immunocompromised (lymphoma) Anses data, 2012 20
Conclusion Huge improvement of the situation, but Close of after eradication Introduction Wildlife reservoir Latent infection Risks Maintenance of efficient & reactive surveillance systems Reliable diagnostic tools adapted strategy (tests associations) Improvment of the situation / increasing efforts Long-term stakeholders involvement 21
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Brucella suis biovar 2 infection in atypical hosts in France 16 M 5 3 1 6 No geographical clustering Thom sen Location of strains studied in France Wildlife reservoir: population 4 2 Fig. 3: MST of MLVA-16 genotypes of the atypical strains Underestimated infection in atypical hosts? 23