Standard Tube Agglutination Test Research Articles

Potential risk of blood transfusion‐transmitted brucellosis in an endemic area of China

Brucellosis is a severe zoonotic disease that is increasingly prevalent in north China. A study evaluating Brucella infection in blood donors was conducted at Kashi central blood station, Xinjiang, China. Four serologic and two molecular methods of detection of Brucella infection were used in plasma samples from blood donations collected from Kashi in northwest China, considered a brucellosis-endemic area. Blood donor samples collected in Shenzhen, southern China, a brucellosis-nonendemic area, were tested as a negative control group. In 3896 plasma samples collected from Kashi central blood station, 135 (3.5%) plasma samples were reactive by the Rose Bengal plate test (RBPT), and 120 (3.1%) of the 135 RBPT-reactive sample were also reactive with the standard tube agglutination test (SAT), respectively. All samples of the control group of 399 blood samples from Shenzhen blood center tested negative with RBPT and SAT. Of 135 seroreactive plasma samples, 39 (1.0%) reacted with B. melitensis membrane protein extracts by enzyme-linked immunosorbent assay and 25 were reactive to either rBP26 or rOMP31 by Western blot. Thirteen plasma samples and two follow-up blood samples were identified as carrying Brucella DNA by quantitative polymerase chain reaction (PCR) and nested PCR. Overall 15 (1:300) Kashi blood donations were found positive by nucleic acid testing, confirmed specific by DNA sequencing. The data indicate a probable high rate of Brucella bacteremia, suggesting a potential risk of transfusion-transmitted brucellosis. Blood donation screening for Brucella infection may be considered in the high Brucella-endemic areas of China.

Seroprevalence study of bubaline brucellosis in Kota Division of Rajasthan using various serodiagnostic tests

The study was undertaken to investigate the seroprevalence of brucellosis in buffaloes of Sangod, Mandana, Bundi, Talera, Chhabra, Jhalrapatan and Dag regions of Kota division of Rajasthan. Blood samples (436) were collected for detection of Brucella antibody using Rose Bengal plate test (RBPT), standard tube agglutination test (STAT), heat inactivation test (HIT), 2-mercaptoethanol test (2-MET), agar gel immunodiffusion test (AGID) and avidin biotin enzyme linked immunosorobent assay (AB ELISA). Overall seroprevalence was recorded as 37.84% by AB ELISA, 35.09% by RBPT, 29.59% by STAT, 26.15% in HIT, 25.23% in 2-MET and 13.99% in AGID. AB ELISA was found as the most sensitive whereas AGID was the least sensitive test. Higher number of females (38.46%) showed seropositivity as compared to males (30.30%). The results of the study indicated (a) relative suitability of ELISA as a screening test, and (b) endemacity of infection in villages of Kota division, Rajasthan.

Serum annexin A2 levels in acute brucellosis and brucellar spondylodiscitis.

Brucellosis is a chronic granulomatous infection and may present with various clinical manifestations. Brucellar spondylodiscitis symptoms are initially subtle and nonspecific. Annexin A2 (ANXA2) is involved in various biological functions, including osteoclast formation, bone resorption, and cell growth regulation. In this study, we aimed to determine the clinical significance of serum ANXA2 levels in acute brucellosis and brucellar spondylodiscitis. This prospective study included 96 acute brucellosis patients and 51 healthy controls. Acute brucellosis was diagnosed by a 1/160 or higher titer in a standard tube agglutination (STA) test or a four-fold increase in titers between two STA tests performed two weeks apart in the presence of clinical symptoms within the last eight weeks and/or growth of Brucella spp. in appropriately prepared culture media. ANXA2 levels were determined with an enzyme-linked immunosorbent assay (ELISA). Forty (41.7%) of 96 acute brucellosis patients were male and 56 (58.3%) were female. Serum ANXA2 levels were elevated in patients compared to healthy controls (p = 0.001). Eighteen of 96 (18.7%) acute brucellosis patients had brucellar spondylodiscitis. The serum ANXA2 levels of patients with brucellar spondylodiscitis were higher than those of patients with acute disease without brucellar spondylodiscitis (p = 0.001). ANXA2, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) values were elevated in the brucellar spondylodiscitis group compared to patients without brucellar spondylodiscitis. Serum ANXA2 measurement together with ESR and CRP is thought to be indicative in the diagnosis of brucellar spondylodiscitis, a common complication of brucellosis.

Seroepidemiology of human brucellosis in nomads in a rural area of Iran

ObjectiveTo survey the seroprevalence of brucellosis among nomads in Shoulabad, Lorestan province, Iran. MethodsIn this descriptive study, a total of 5 847 person took part by randomized cluster sampling and 312 of them with clinical feature of brucellosis were selected. The diagnosis of brucellosis was made with a standard tube agglutination test (STAT), Coombs test, and 2-mercaptoethanol (2ME) test, and the results with titers equal 1:80 or more were considered positive. ResultsThe seroprevalnce of anti-Brucella titer was 29.5% for STAT, 29.9% for Coombs test and 21.1% for 2ME test. Overall, 92, 93 and 66 patients had titers of 1:80 or higher in STAT, Coombs test and 2ME test, respectively. Seroprevalence was more among males (54.3%) than females (45.7%). There is statistical difference between seroprevalence of infection and age (P<0.05). Based on age group, 10–19 years age group was more affected (37%). ConclusionsThis results confirmed the necessity of conducting comprehensive and scheduled program of seroprevalence survey, particularly in nomad area, which aims at reducing the incidence of brucellosis as well as to guide planning programs by decision makers to improve community health.

Brucella Sacroiliitis in Thalassemia Major

To the Editor: A 17-y-old boy was admitted with fever, right sided hip pain and limping since 2 mo. He had been under treatment for thalassemia major since the age of 1 y with regular RBC transfusion and iron chelation. Physical examination revealed fever and limitation of right hip movement. Laboratory evaluation revealed; hemoglobin 10.2 g/dL, platelet count 807×10/L, white blood cell count 16.1×10/L. Biochemical tests were normal. C-reactive protein was 7.3 mg/dL; erythrocyte sedimentation rate was 32 mm/h. Serological tests for hepatitis A, B, C; HIV, HSV, EBV, CMV, parvovirus B19, toxoplasmosis were negative. Rheumatologic tests -ANA, rheumatoid factor, ANCAwere normal. Brucella standard tube agglutination test was positive at a titer of 1/640. Magnetic resonance imaging showed right sacroiliitis. Brucella was isolated from the blood and since sacroiliitis is a well known osteoarticular manifestation of brucellosis, a diagnosis of brucella sacroiliitis was made. The patient was given the specific antibiotic treatment with the combined regimen of streptomycin, doxycycline and rifampicin; he showed progressive improvement of symptoms to complete recovery. Brucellosis is an infectious disease which can present with varied clinical pictures. The signs and symptoms are usually not specific to the disease and it is often misdiagnosed. Osteoarticular involvement is very common and the frequency varies from 10–85 % [1, 2]. During the course of thalassemia major; various musculoskeletal abnormalities can be encountered due to marrow hyperplasia and extramedullary hematopoiesis either due to the disease or transfusion and iron chelation treatments [3, 4]. In our patient the diagnosis was delayed because patient’s complaints were thought to be related with thalassemia major and the iron chelation treatment. We present this case to highlight that brucellosis should be included in the differential diagnosis of childhood osteoarticular manifestations in endemic countries even if there is a multisystemic illness that could explain the condition.

Seroprevalence of caprine brucellosis in Karnataka

Aim: To study the seroprevalence of caprine bruellosis in Karnataka and compare the relative sensitivity and specificity among the different serological tests used. Materials and Methods: A total of 252 serum samples were collected from the goats of Karnataka and subjected to 5 different serological tests, i.e., Rose Bengal Plate Test (RBPT), Standard Tube Agglutination Test (STAT), 2-mercaptoethanol test (2MET), Indirect ELISA (I-ELISA) and Dot-ELISA to detect the Brucella antibodies. Results: Test-wise, the seroprevalence in goats was 5.15% by RBPT, 6.34% by STAT, 1.98% by 2-MET, 9.52% by I-ELISA and 7.14% by Dot-ELISA. The prevalence of brucellosis was found to be highest among goats of northeast Karnataka followed by northwest Karnataka, central Karnataka and south Karnataka. I-ELISA detected maximum number of positive samples. Conclusions: The study used five serological tests to determine the apparent seroprevalence of caprine brucellosis in Karnataka. Taking I-ELISA as reference, the tests revealed the relative sensitivity values in the following order: DotELISA>STAT>RBPT>2-MET.

Seroprevalence of brucellosis in buffaloes in North India

Brucellosis is an infectious disease characterized by abortion and infertility in several mammalian species including buffaloes, and is one of the most important zoonosis worldwide. The objective of present study was to establish the seroprevalence of brucellosis in buffaloes in North India and to know the exact causal species of Brucella organism. A total of 160 serum samples were analyzed. The seroprevalence of Brucellosis was 4.38% and 7.50% by Rose Bengal Plate Test (RBPT) and Standard Tube Agglutination Test (STAT), respectively. Seroprevalence was zero by both RBPT and STAT in organized dairy farm while in unorganized sector, 5.04 and 8.63% by RBPT and STAT, respectively. Age-wise seroprevalence was higher in 4.5 to 6 years old buffaloes than younger. Area-wise seroprevalence was higher in Satwari block of study area. On screening of 20 milk samples from serological positive and doubtful buffaloes by milk ring test, five samples were positive (25%). On isolation of from samples, only one sample yielded Brucella abortus. The results showed that younger buffaloes were less infected than adults. Prevalence of Brucellosis was higher in Satwari block of Jammu province compared to other study area. The presence of Brucellosis in bovine may pose a significant economic loss to the farmer and a public health hazard to the general population.

Seroprevalence Studies of Brucellosis at Organized and Unorganized Cattle Farms in North India

Brucellosis is a worldwide contagious and zoonotic bacterial infectious disease caused by Brucella. The aim of present study was therefore to establish the seroprevalence of brucellosis in cattle in North India and to know the exact causal species of Brucella organism. A total of 160 serum samples were analyzed. The seroprevalence of Brucellosis was 1.88 per cent and 3.13 per cent by Rose Bengal Plate Test (RBPT) and Standard Tube Agglutination Test (STAT), respectively. Seroprevalence was zero by both RBPT and STAT in organized dairy farm while in unorganized sector, 2.16 and 3.65 per cent by RBPT and STAT, respectively. Age-wise seroprevalence was higher in 4.5 to 6 years old cows than younger. Area-wise seroprevalence was higher in Satwari block of study area. On screening of 10 milk samples from serological positive and doubtful cows by milk ring test, two sample were positive (20%). On isolation of from samples, only one sample yielded Brucella abortus. The results showed that younger cattle were less infected than adults. Prevalence of Brucellosis was higher in Satwari block of Jammu province compared to other study area. The presence of Brucellosis in bovine may pose a significant economic loss to the farmer and a public health hazard to the general population.

Clinical Utility of A Quantitative Rose Bengal Slide Agglutination Test in the Diagnosis of Human Brucellosis in an Endemic Region

Brucellosis currently ranks as the most important zoonotic disease in the world. Brucellosis is difficult to diagnose because patients often have nonspecific clinical symptoms that can be attributed to a number of disease agents prevalent in the area. Thus, this has necessitated the dependency of clinicians on microbiological confirmation, very often by sero diagnostic methods. Early and accurate detection of brucellosis is important if specific antibiotic treatment is to be effective for the patients. The use of RBST as a qualitative means of diagnosis is quiet common. However, to date, there are only a handful of reports of the application of RBST as a quantitative diagnostic method in medical literature. The potential usefulness of quantitative Rose Bengal slide agglutination test (RBST) for suspected brucellosis was evaluated as a simple, inexpensive diagnostic tool to be used in clinical practice in an endemic region. 200 consecutive patients who reported to Belgaum Institute of Medical Sciences (BIMS) Hospital, Belgaum, Karnataka (India) between June 2009 and December 2011 were studied. Standard RBST, quantitative RBST, standard tube agglutination test (SAT), 2-mercaptoethanol test (2-ME), and blood cultures were carried out on all patients. The case was confirmed as positive for brucellosis if any one of the tests was positive and the data was compared to the quantitative RBST considering blood culture result as gold standard. B. melitensis was cultured in only 28% of the patients in this study. In patients with negative blood cultures, serology was used for diagnosis. The sensitivities were 88.9% (standard RBST), 92.6% (SAT), and 57.4% (2ME). The specificities were found to be 87.7% (standard RBST), 86.2% (SAT), and 95.7% (2ME). RBST titers > or = 1:8 were detected in a majority of patients (50, 74%) with bacteriologically proven brucellosis thereby guiding clinician for prompt therapy. Prozone reaction with RBST observed in 4 patients was an interesting finding and these four true cases would have been underdiagnosed and denied therapy on the basis of qualitative/standard RBST alone. The possibility of prozone in patient's serum with high RBST antibody titers can be avoided by testing several dilutions. This technique has an immense value particularly for use in resource poor settings seen in rural areas. It can deliver definitive diagnosis in < 10 minutes to the clinician, which may in turn result in the early initiation of specific treatment and could be applied thus as a bedside methodology. It is not technically demanding and easy to interpret, does not involve heavy capital outlay, or trained personnel and, thus, is potentially useful in resource poor laboratories, particularly in developing regions. In addition, quantitative RBST demonstrates sensitivity and specificity equivalent to that achievable by performing SAT. It can readily be extended to screen a vast number of blood samples particularly in areas where brucellosis is hyperendemic. Quantitative RBST and 2ME have been noted to be of great value in therapeutic monitoring. Our data suggest that RBST titers in a range of 1:8 and 1:16 can undoubtedly be considered diagnostic of brucellosis in conjunction with compatible clinical and epidemiological evidence for the patients residing in areas endemic for the disease. Quantitative RBST is, therefore, recommended for routine use in clinical microbiology laboratories as an accurate and speedy diagnostic assay.

Comparison Between Serum Neopterin, Procalcitonin, High-sensitivity C-Reactive Protein Concentrations and Erythrocyte Sedimentation Rates of Patients with Brucellosis and Extracellular Bacterial Infections.

Objectives: The aim of this study was to evaluate neopterin (NPT), procalcitonin (PCT), erythrocyte sedimentation rates (ESR) and high-sensitivity C-reactive protein (hs-CRP) levels in brucellosis and to compare them with extracellular bacterial infections. Methods: In the study, a total of 89 patients, 50 patients (study group) with acute brucellosis and 39 patients with extracellular bacterial infections (EI group), were included. In EI group, 21 patients had upper urinary tract infection (UTI) while 18 patients had skin and soft tissue infection (SSTI). As well as the appropriate clinic, the patients with positive blood cultures for Brucella spp. or Standard Tube Agglutination test ≥1/160 were diagnosed with brucellosis. Brucellosis and EI groups were compared in terms of ESR, NPT, PCT and hs-CRP. Results: In study group mean age was 40.64±1.86 (18-66) and in EI group mean age was 51.61±2.68 (18-82). After comparison analysis; ESR (16.5±1.75 vs 40.17±4.52 mm/h, p=0.0001) and hs-CRP (40±8 vs 280±30 mg/L, p=00001) were found lower in the study group than EI group while there was no difference between groups in terms of PCT (p=0.887) and NPT (p=0.688). Additionally, PCT values were higher in patients with UTI than SSTI. Conclusion: It was seen that NPT and PCT values in brucellosis were not different from extracellular bacterial infections, whereas higher ESR and hs-CRP values could be seen in patients with extracellular bacterial infections. Also, higher PCT values could be seen in patients with urinary tract infections compared to patients with skin and soft tissue infections.

Innovative modifications to Rose Bengal plate test enhance its specificity, sensitivity and predictive value in the diagnosis of brucellosis

Current agglutination tests occasionally yield false results. Superagglutination test reduced false results, had higher sensitivity (95.88%) and negative predictive value (95.83%) than Rose Bengal plate test (RBPT), Standard Tube Agglutination test (STAT), ELISA, and Complement Fixation test and specificity (89.32%) and positive predictive value (89.42%) higher than RBPT and STAT.

A case of brucellosis displaying Parkinsonian-like tremor

We report a rare case of brucellosis with Parkinsonian-like tremor and simple partial motor seizure. This patient worked as a sheep butcher and the sheep were imported from brucellosis-endemic areas. He presented with classical manifestations of brucellosis; infection was confirmed using the Rose Bengal Plate and Standard Tube Agglutination tests. The patient also suffered from headache, partial seizures, changes of personality and static tremor of both upper limbs. After anti-infection therapy, but without the use of anti-Parkinson drugs, the patient fully recovered and remained free of Parkinsonian-like tremor. Brucellosis can present with atypical symptoms, clinicians should widen their diagnostic view of brucella infection.

Survey of Brucellainfection and malaria among Abattoir workers in Kampala and Mbarara Districts, Uganda

BackgroundBrucellosis is among the most widespread zoonotic infections estimated at 14% in Uganda. A cross-sectional study was conducted to estimate the sero-prevalence, risk factors of Brucella infection and malaria among abattoir workers.MethodsA survey was conducted among 232 abattoir workers in main abattoirs of Kampala and Mbarara districts in February 2007. A pre-tested questionnaire captured socio-demographic and occupational data. Brachial vein blood was tested for Brucella using Microplate Agglutination Test (MAT) and Standard Tube Agglutination Test (STAT) with a cut off titre of 1:160, and giemsa stained blood slides for malaria. Data was analyzed in SPSS 17.0.ResultsSeven males (3%, n = 232) had malaria and dual brucella and Plasmodium falciparum malaria was found in one person. Brucella sero-positivity was 10% (95% CI 6 – 16; n = 232) with 12% (n = 161) in Kampala and 7% (n = 71) in Mbarara district. Non-use of protective gear Odds ratio (OR 3.3, 95% CI (1.25 – 50) and working in the abattoir beyond 5 years OR 2.4 95% CI (1.4 – 5.6) were associated with increased risk of Brucella infection. Age, sex, religion, keeping animals and consumption of raw milk or products were not significant.ConclusionsBrucella infection is a real risk among abattoir workers and use of full protective gear reduced risk significantly. Sensitization and public health care programs are needed to control this emerging problem.

Relapsing Brucellosis After Liver Transplantation in a Child

Brucellosis is still an important infectious disease worldwide, especially in the Mediterranean area and in developing countries (1). The treatment of brucellosis is challenging because of relatively high rates of relapse and treatment failure. Obviously, relapse occurs more frequently within the first year if the full course of treatment is not completed (2). It is hypothesized that immunocompromised patients and organ transplant recipients have an increased rate of relapse (3). The hepatotoxicity of drugs used for brucellosis therapy and the drug interactions with immunosuppressive agents are important considerations in the treatment of brucellosis in immunocompromised patients and organ transplant recipients. No guidelines exist in the literature concerning the appropriate regimen and duration of therapy for brucellosis/relapsebrucellosis in these populations. In this report, we describe a child with relapsing brucellosis after liver transplantation, who was treated with two different courses of trimethoprim sulfamethoxazole (TMP-SMZ) and rifampin. A 7-year-old girl with fulminant hepatitis due to Wilson’s disease who had undergone liver transplantation 2 years ago presented to us with a fever that had lasted for more than 2 weeks. Due to the fact that the patient lives in a rural area and had consumed unpasteurized fresh cheese, she was evaluated forbrucellosis. The standard tube agglutination test and immunocapture test were positive at a titer of 1:640. The patientdid not have a history of brucellosis or similar symptoms before transplantation and the donor (mother) had no clinical or serologic evidence of brucellosis. Therefore, we postulated that the immunosuppressive therapy (tacrolimus and mycophenolate mofetil) was the predisposing factor for this infectious disease. The patient was treated with TMP-SMZ and rifampin. After treatment, her clinical and laboratory findings improved dramatically. Tacrolimus levels decreased because of increased cytochrome P450 activity due to rifampin. To prevent acute cellular rejection, the tacrolimus dosage was tripled to maintain normal drug blood levels. TMP-SMZ and rifampin were given for 12 weeks. Brucella serology was negative 4 months after treatment. One year later, the patient was evaluated for another fever of unknown origin. Although the patient was not in contact with infected animals or contaminated milk or milk products, her standard tube agglutination test and immunocapture titers were 1:320 and 1:160, respectively. TMP-SMZ and rifampin therapy were started. The patient’s response to therapy was excellent. Despite the fourfold increase in the dose of tacrolimus, normal blood levels of the drug were not achieved. To prevent acute cellular rejection during brucellosis treatment, mycophenolate mofetil, which had been previously discontinued, was restarted. Antibiotic therapy was used for a periodof 6 months to treat the brucellosis relapse. Despite fluctuations in immunosuppressive therapy, rejection and drug-induced hepatotoxicity were not observed. Antibiotic therapy was successful with no recurrence of infection during 3 years of follow-up. In conclusion, we believe that TMP-SMZ and rifampin therapy seem to be effective and reliable for the treatment of brucellosis in children after liver transplantation and that the length of treatment should be extended compared with that given in nonimmunosuppressed individuals. Ali Islek 1 Ersin Sayar1 Aygen Yilmaz1 Filiz Günseren2 Reha Artan1 1 Department of Pediatric Gastroenterology Akdeniz University Faculty of Medicine Antalya, Turkey 2 Department of Infectious Diseases and Clinical Microbiology Akdeniz University Faculty of Medicine Antalya, Turkey

A study on bovine brucellosis in an organized dairy farm

Aim: To assess the status of bovine brucellosis in an organized dairy with a past history of Brucella abortions and where Brucella control measures including test and removal, calf-hood vaccination (already present adult animals were not vaccinated), use of semen obtained from a screened bull and general hygienic measures helps in the control of brucellosis in the farm have been implemented for the past four years. Materials and Methods: A total of 195 samples including 89 blood samples, 89 serum samples and 17 milk samples were collected and analysed by isolation and identification, Polymerase chain Reaction (PCR), Milk Ring Test (MRT), Rose Bengal Plate Test (RBPT), Standard Tube Agglutination Test (STAT) and Enzyme Linked Immnuno-Sorbent assay (ELISA). Results: On analysis, all the 89 blood and 17 milk samples turned out to be negative for culture and PCR. MRT and ELISA tests on all the 17 milk samples and STAT on all the 89 serum samples were also negative. The percent positives for Brucella antibodies in serum samples were 4.5 and 6.7 by RBPT and ELISA, respectively. Of the 17 vaccinated animals, 14 were negative by all the Brucella antigen and antibody diagnostic tests employed. Amongst the three vaccinated animals, one animal was positive by RBPT and I-ELISA and, two animals were positive by I-ELISA alone. On the other hand, of the 72 nonvaccinated animals, 65 were negative by all the diagnostic tests employed, three animals were positive by RBPT and 4 animals were positive by I-ELISA. Conclusion: The results of our study indicated that a combination of RBPT and I-ELISA can be successfully used for screening for brucellosis when the prevalence is low. Implementation of control measures including test and removal of the affected, calf-hood vaccination, use of semen obtained from a screened bull and general hygienic measures help in the control of brucellosis in the farm.

A review of Brucella seroprevalence among humans and animals in Bangladesh with special emphasis on epidemiology, risk factors and control opportunities

Brucellosis is a neglected bacterial zoonotic disease in many countries affecting both humans and animals. The aim of this paper is to review published reports of the seroprevalence of brucellosis in humans and animals (cattle, buffalo, sheep, goats and dogs) in Bangladesh. The prevalence studies are based primarily on the following serological tests: rose bengal plate agglutination test (RBT), plate agglutination test (PAT), tube agglutination test (TAT), mercaptoethanol agglutination test (MET), standard tube agglutination test (STAT), slow agglutination test (SAT), milk ring test (MRT), indirect enzyme-linked immunosorbant assay (I-ELISA), competitive ELISA (C-ELISA) and fluorescent polarization assay (FPA). Seroprevalences of brucellosis were found to be affected by the sensitivity and specificity of serological tests employed. Brucellosis prevalence varied based on occupations of people (2.5-18.6%) and species of animals (3.7% in cattle, 4.0% in buffalo, 3.6% in goats and 7.3% in sheep). The prevalence of brucellosis in humans was reported in livestock farmers (2.6-21.6%), milkers (18.6%), butchers (2.5%) and veterinarians (5.3-11.1%) who have direct contact with animal and its products or who consume raw milk. According to published reports brucellosis does affect people and livestock of Bangladesh. There is an immediate need for a concerted effort to control and eradicate brucellosis from domesticated animals in Bangladesh.

Improved humoral immune response in sheep against epsilon toxoid following co-adjuvantation with gel and water in oil formulation

Enterotoxaemia, a highly fatal and devastating disease of sheep and goats still continues to cause huge economic losses to small ruminant farming all over the world. Although the disease can be prevented by immunization, the present vaccines often fail to confer a high and persisting antibody titre demanding intermittent booster injections. Thus, with an aim to develop better enterotoxaemia vaccine, a novel aluminium hydroxide gel precipitated oil adjuvant epsilon toxoid vaccine (OAV) was formulated. The immunogenicity and protective efficacy of this new vaccine in comparison to presently available epsilon toxoid vaccine (TV) and aluminium hydroxide gel vaccine (AHV) was evaluated in the target species, sheep using indirect ELISA, mice neutralization test (MNT) and standard tube agglutination test (STAT). Among the vaccines tested, OAV generated maximum immune response with persistent high titre of neutralizing antibodies with protection up to 12 months following a single dose whereas; TV and AHV protected only up to 30 days and 3 months, respectively. To our knowledge, this is the first report of a vaccine which offers protection for 12 months against enterotoxaemia in sheep. Thus, the present study delineates an effective and simple approach for the prevention of extremely lethal enterotoxaemia through the use of the newly formulated OAV.

The Prevalence of Brucellosis in Adults in Northeastern Region of Turkey

Background: Brucellosis is prevalent in the Mediterranean basin, the Indian subcontinent, the Arabian peninsula, and in parts of Central Asia, Africa, Central and South America. However it continues to be one of the major health problems in developing countries, including Turkey. Objectives: The current study aimed to determine the incidence of brucellosis, which is previewed to be very common in the northeastern region of Turkey, in order to emphasize the problem. Materials and Methods: Seroprevalence of brucellosis was examined in sera of 2913 patients who referred to Igd?r State Hospital between February and December of the year 2010 by Standard Tube Agglutination Test method. Results: Results were statistically evaluated using chi-square trend analysis method. Significantly high level (1/40 dilution) of specific antibodies were detected in 525 (18 %) patient sera (P = 0.111). Conclusions: We hope that Turkey will be one of the brucellosis-free countries in near future with highlights from the current and further studies.

The pattern of autoantibodies related to false negative results of serological tests in the diagnosis of human brucellosis

For the diagnosis of human brucellosis it is essential to perform diagnostic tests because of the wide variety of clinical manifestations of the disease. Serological tests are widely used for the diagnosis of brucellosis. However, blocking substances limit the use of standard tube agglutination test. Two hundred and forty two (242) serum samples were collected from healthy persons and persons in high-risk occupation. For each sample, the rose Bengal, IgM ELISA, IgG ELISA, serum tube agglutination test (SAT) and anti-nuclear antibody (ANA) tests were performed. Three sera in which rose Bengal or ELISA and ANA tests yielded positive results were having lower level of SAT titer. By an in vitroexperiment, efficacies of ANA nucleolar pattern to the false-negative reaction in the SAT were supported. Key words: Human, brucella, serology, autoimmunity, test performance.

Brucella infections in high-risk population and in patients hospitalized for fever: A serological study at Kolar, Karnataka

Background: Brucellosis, one of the world's major zoonoses, is endemic in many parts of India. It is an occupational hazard for veterinary employees, butchers, dairy personnel, and laboratory workers. There is no information available on human brucellosis from Kolar region of southern India. Methods and Materials: Serum samples from 154 adults, at high risk for brucellosis and residing in and around Kolar, Karnataka, India, were screened for antibodies to brucella by the Rose Bengal plate agglutination test and immunoglobulin (Ig)G Enzyme-linked immunosorbent assay (ELISA). Sera detected to be positive by these screening tests were further tested by standard tube agglutination test (SAT), SAT with 2 Mercaptoethanol, and IgM ELISA. In addition, serum samples from 100 hospitalized patients with prolonged fever were also subjected to the above tests to detect acute brucella infections among patients. Results: Among the 154 individuals at high-risk screened, brucella antibodies were detected in 15 (9.74%) of the subjects. The seropositivity rate was 30.76% among veterinarians, 14.28 among cattle businessmen, 9.67% among butchers, and 3.79% among animal owners. Seropositivity was associated with drawing blood and exposure to animals during parturition. Symptoms such as myalgia, low back ache, and joint pains were significantly more among seropositives. When the results of all the tests were taken together, 33.3% seropositives could be classified as past brucella infections and 66.6% as possible chronic brucella infections. Among the 100 hospitalized patients with prolonged fever acute brucellosis was diagnosed in one patient. Conclusion: Brucellosis is an important zoonosis in Kolar region. Among individuals at high risk many have serological profile of possible chronic brucellosis; such individuals may need treatment and follow-up.