1Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, Cornell University, Ithaca, NY.
2New York State Department of Health, Albany, NY.
J Am Vet Med Assoc. 2023 Mar 1;261(4):451-462. doi: 10.2460/javma.23.01.0033. Print 2023 Apr 1.
Brucellosis is a highly infectious zoonotic disease of global significance due to its adverse impact on public health, economics, and trade. Despite being one of the most prevalent zoonoses worldwide, attention given to global brucellosis control and prevention has been inadequate. Brucella species of greatest one-health relevance in the US include those infecting dogs (Brucella canis), swine (Brucella suis), and cattle and domestic bison (Brucella abortus). Although not endemic in the US, Brucella melitensis warrants awareness as it poses a risk to international travelers. While brucellosis has been eradicated from domestic livestock in the US, its detection in US companion animals (B canis) and US wildlife reservoirs (B suis and B abortus) and enzootic presence internationally pose a threat to human and animal health, warranting its spotlight on the one-health stage. The challenges of B canis diagnosis in humans and dogs is addressed in more detail in the companion Currents in One Health by Guarino et al, AJVR, April 2023. Human consumption of unpasteurized dairy products and occupational exposure of laboratory diagnosticians, veterinarians, and animal care providers are responsible for human exposures reported to the US CDC. Diagnosis and treatment of brucellosis is challenging due to the limitations of diagnostic assays and the tendency of Brucella spp to produce nonspecific, insidious clinical signs and evade antimicrobial therapy, making prevention essential. This review will focus on zoonotic considerations for Brucella spp found within the US along with their epidemiology, pathophysiology, clinical presentation, treatment, and control strategies.
布鲁氏菌病是一种具有全球重要意义的高度传染性人畜共患病，因其对公共卫生、经济和贸易造成的不利影响而受到关注。尽管布鲁氏菌病是全球最普遍的人畜共患病之一，但全球对其控制和预防的重视程度仍然不足。与美国的“One Health”最相关的布鲁氏菌物种包括感染狗（犬布鲁氏菌）、猪（猪布鲁氏菌）和牛及家养野牛（流产布鲁氏菌）的布鲁氏菌。虽然布鲁氏菌病在美国并非地方性疾病，但应意识到它对国际旅行者构成威胁，因为它存在于美国。虽然在美国已从家畜中根除了布鲁氏菌病，但在美国伴侣动物（犬布鲁氏菌）和美国野生动物（猪布鲁氏菌和流产布鲁氏菌）中检测到该菌，并在国际上普遍存在，这对人类和动物健康构成了威胁，因此值得在“One Health”舞台上引起关注。Guarino 等人在 AJVR 2023 年 4 月的“Currents in One Health”中更详细地讨论了犬布鲁氏菌病在人类和犬中的诊断挑战。人类食用未经巴氏消毒的乳制品以及实验室诊断人员、兽医和动物护理人员的职业暴露，导致向美国疾病控制与预防中心报告的人类暴露。由于诊断检测的局限性以及布鲁氏菌属产生非特异性、隐匿性临床症状和逃避抗菌治疗的倾向，导致布鲁氏菌病的诊断和治疗具有挑战性，因此预防至关重要。本综述将重点关注在美国发现的布鲁氏菌属的人畜共患考虑因素，以及它们的流行病学、病理生理学、临床表现、治疗和控制策略。
