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EC 1 th SELECTED ZOONOTIC DISEASES SYMPOSIUM May 30-31 2011 NICOSIA Brucellosis in Italy: Epidemiology, Control and Eradication Paolo Pasquali

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Presentation on theme: "EC 1 th SELECTED ZOONOTIC DISEASES SYMPOSIUM May 30-31 2011 NICOSIA Brucellosis in Italy: Epidemiology, Control and Eradication Paolo Pasquali"— Presentation transcript:

1 EC 1 th SELECTED ZOONOTIC DISEASES SYMPOSIUM May 30-31 2011 NICOSIA Brucellosis in Italy: Epidemiology, Control and Eradication Paolo Pasquali paolo.pasquali@iss.it Department of Veterinary Public Health and Food Safety, Istituto Superiore di Sanità, Rome, Italy Istituto Superiore di Sanità, Rome, Italy

2 Caprine and ovine brucellosis is usually caused by Brucella melitensis Bovine brucellosis is usually caused by Brucella abortus, less frequently by B. melitensis,

3 Clinically, the disease is characterised by one or more of the following signs: abortion, retained placenta, orchitis, epididymitis and, rarely, arthritis, with excretion of the organisms in uterine discharges and in milk

4 There is a need to control brucellosis? Why? 2/28

5 EMERGING DISEASES, 1996-2004 (WHO source) 1.CryptosporidiumNorth America 2.Lyme borreliosisNorth America 3.Brucellosis worldwide 4.E.coli O157North Europa 5.Salmonella (MDR)Northern Europe 6.EbolaAfrica 7.InfluenzaAsia 8.BSEEurope 9.SARSAsia 10.EEAfrica, America, Europe 11.Hendra/NipahSouth East Asia, Australia 3/28

6 Source: FAO 2005. Survey based on 165 veterinary public health professionals 4/28

7 Pappas G. et al., Lancet Infect Dis 2006; 6: 91–99 more than 500 000 new cases annually WHO/FAO COLLABORATING CENTRE FOR RESEARCH AND TRAINING IN VETERINARY PUBLIC HEALTH

8 Pappas G. et al., Lancet Infect Dis 2006; 6: 91–99

9 Brucellosis, indeed, is a major problem with costs related to: Human population (disease) Animals (disease and production): (direct) abortion, milking (indirect) trade limitations

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11 The disease in humans intermittent or remittent fever accompanied by malaise, anorexia and prostration, may persist for weeks or months. typically, few objective signs are apparent. The acute phase may progress to a chronic one with relapse, development of persistent localized infection or a non-specific syndrome resembling the chronic fatigue syndrome. how much the disease is acute?

12 Case study No.1

13 Majority was not simptomatic

14 Can you control the system? NO Yes Prevalence < 2% (true!) test and slaughter > 2% vaccination and/or test and slaughter which animals? when? with what? vaccination Heat treatment of milk

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16 Mass vaccination Vaccination of replacements Vaccination of replacements and test and slaughter Test and slaughter

17 Vaccination Can induce abortion Adult not pregnant Yungs after weaning (3-6 months of age)

18 1.Strain 19 PROS Strong efficacy against B.abortus High stability CONS S19 induces antibodies detectable by using standard serological test, preventing differentiation of vaccinated versus infected animals. Although highly attenuated S19 is able to induce abortion in 1-2.5% of pregnant immunised cows S19 can be shed through milk 14/28

19 2. B. melitensis Rev.1 Rev.1 vaccine is a live, smooth attenuated B. melitensis strain derived from a virulent B.melitensis isolate which became dependent on streptomycin for its growth, but lost this characteristic, although remaining streptomycin resistant, upon further subculture It stimulates protection against infection with B. melitensis in sheep and goats and also protects rams against infection with B.ovis. This vaccine is attenuated when compared with field strains but retains some virulence.

20 PROS Strong efficacy against B.melitensis and B.abortus High stability CONS REV 1 induces antibodies detectable by using standard serological test, preventing differentiation of vaccinated versus infected animals. Still able to induce abortion of pregnant immunised animals REV 1 can be shed through milk

21 3. B.abortus RB51 Rough strain devoid of the O-chain. Its roughness is very stable after multiple passages in vitro and in vivo through various species of animals

22 Strain RB51 is attenuated as indicated by studies carried out in mice, guinea pigs, goats and cattle, from all of which it is cleared in a relatively short time. Two studies carried out in sheep suggests that strain RB51 does not induce protection versus B.melitensis 18/28

23 Prevention of human brucellosis As the ultimate source of human brucellosis is direct or indirect exposure to infected animals or their products, prevention must be based on elimination of such contact.

24 SYSTEM PROBLEM BRUCELLOSIS IS A SYSTEM PROBLEM 1.Awareness of farmers and population. Risk factors are milk and lamb delivery. 2.Physicians informed and trained 3.Laboratory support to make diagnosis 4.Control 4.Control of animals (cattle and sheep) (trade and animal identification) or 5.Vaccination… or Elimination of infected animals 11/28

25 Year 2008: Sheep and goat population (herds) Total number of herds Year 2008 10.001 -20.000(2) 5.001 -10.000(8) 2.001 -5.000(8) 500 -2.000(2) RegionTotal number of herds Total117.519 Sardegna15.377 Lombardia11.641 Piemonte9.617 Sicilia9.161 Lazio8.478 Campania8.313 Calabria7.970 Toscana7.111 Basilicata6.612 Abruzzo5.735 Puglia4.013 Marche3.918 Bolzano3.602 Emilia Romagna3.391 Umbria3.017 Liguria2.553 Molise2.364 Veneto2.310 Trento1.043 Valle d'Aosta768 Friuli Venezia Giulia525

26 Year 2008: Sheep and goat population (animals) Total number of animals Year 2008 500.001 - 4.000.000(4) 200.001 - 500.000(4) 80.001 - 200.000(7) 10.000 - 80.000(5) RegionTotal number of animals Total8.634.838 Sardegna3.530.931 Sicilia946.368 Lazio818.767 Toscana525.243 Calabria463.932 Puglia411.672 Basilicata410.616 Campania303.109 Lombardia189.496 Piemonte185.062 Abruzzo183.479 Marche175.181 Umbria136.788 Emilia Romagna88.874 Bolzano69.043 Veneto58.063 Molise55.309 Trento31.059 Liguria26.088 Friuli Venezia Giulia15.439 Valle d'Aosta10.319

27 Sheep and goat herds tested in Italy

28 Percentage of infected flocks in 2009 Positive herds on controlled (%) Year 2009 2,50 - 15,00 (2) 0,20 - 2,49 (2) 0,0 -0,19 (17) Region Total RegionPercentage infected flocks Total 1,55% Prevalence decreased in Calabria, Puglia and Basilicata Sicilia 13,19% Calabria 2,81% Puglia 1,87% Campania 0,92% Basilicata 0,19% Emilia Romagna 0,08% Abruzzo 0,04% Lazio 0,03% Lombardia 0,02% Sardegna 0,01% Bolzano 0,00% Friuli Venezia Giulia 0,00% Liguria 0,00% Marche 0,00% Molise 0,00% Piemonte 0,00% Toscana 0,00% Trento 0,00% Umbria 0,00% Valle d'Aosta 0,00% Veneto 0,00%

29 VACCINATION IN SICILY YEAR 2004 - 2009

30 Take home message 1.Brucellosis is an insidious disease with high costs 2.Is very common in mediterranean Countries 3.The control strategy has to be tailored according to critical parameters (costs, epidemiology, needs, capability and so on..) 4.There is not a perfect vaccine, so far

31 Thank you


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