Study Shows First N.C. Case Of Feral Pig Exposure To Brucella suis Bacteria

A North Carolina State University study shows that, for the first time since testing began several years ago, feral pigs in North Carolina have tested positive for Brucella suis, an important and harmful bacteria that can be transmitted to people.

The bacteria are transmitted to humans by unsafe butchering and consumption of undercooked meat. Clinical signs of brucellosis, the disease caused by the bacteria, in people are fairly non-specific and include persistent flu-like symptoms. The bacteria can also spread in pig populations, causing abortions in affected swine.

In a study conducted to test N.C. feral pig populations for several types of bacteria and viruses, about 9 percent of feral pigs studied in Johnston County and less than 1 percent of feral pigs surveyed randomly at 13 other sites across the state showed exposure to B. suis.

Dr. Chris DePerno, associate professor of forestry and environmental resources at NC State and the corresponding author of a paper describing the research, says the results are troubling for people who hunt feral pigs for sport or food.

"Now that exposure to Brucella suis has been found in North Carolina's feral pig populations, people need to take care when hunting, butchering and cooking feral pigs," DePerno says. "That means wearing gloves when field dressing feral pigs and cooking the meat to the proper temperature."

Dr. Suzanne Kennedy-Stoskopf, an NC State research professor of wildlife infectious diseases and a co-author of the paper, says that testing positive for antibodies to B. suis. means the feral pigs have been exposed to and mounted an immune response against the bacteria. Antibodies do not eliminate B. suis. from pigs, so the animals are considered infected and capable of transmitting the bacteria to other pigs and people. She adds that control and eradication programs introduced in the late 1990s eliminated swine brucellosis from all commercial pig populations in the United States.

Kennedy-Stoskopf says that B.suis can be transmitted among pig populations when pigs ingest infected tissue or fluids. Direct contact with infected pigs or ingestion of contaminated food and water could cause currently uninfected pig populations to become infected.

"Spillover from infected feral pigs to commercial pigs is an economic and a public-health concern," Kennedy-Stoskopf says. "The biggest public-health risk is to pork processors and hunters who field dress feral pigs. Although cases of brucellosis are rare in the United States, people need to understand the clinical signs - like intermittent fevers and persistent headaches - and go to the doctor for diagnosis and treatment if they have these flu-like symptoms." Because clinical signs are so non-specific, it is important to tell your physician if you have had any exposure to feral swine carcasses and meat.

Feral pig populations are exploding across the country, DePerno says. Besides the rabbit-like reproductive proclivity of feral pigs, people are partially responsible for the population boom. There is strong evidence that humans have transported feral pigs into new areas for hunting.

"Control of feral pig populations is difficult at best," DePerno says. "Research indicates that about 70 percent of the population will need to be removed each year to keep a wild population stable. Regarding feral pigs, hunting usually removes from 8 to 50 percent of a given wild population."

Feral pigs can be destructive to the environment and can outcompete native animals. They dig, root and tear up crop lands; eat just about anything; and can spread disease to animals and people.

DePerno hopes that more research on how far feral pigs travel - and increased scrutiny of hunters who move feral pigs from place to place - will help keep feral populations from spreading.

NC State graduate student Mark Sandfoss and postdoctoral researcher Dr. Maria Palamar conducted research and co-authored the paper, which is published in the Journal of Wildlife Diseases. Researchers from the U.S. Department of Agriculture and Rollins Animal Disease Diagnostic Laboratory contributed to the research.

The study was funded by NC State's Fisheries, Wildlife and Conservation Biology Program and the Department of Forestry and Environmental Resources; the Howell Woods Environmental Learning Center; and the U.S. Department of Agriculture/APHIS/Wildlife Services National Wildlife Disease Program.

"A Serosurvey of Feral Swine (Sus scrofa) in Eastern N.C."

Authors: Mark R. Sandfoss, Christopher DePerno, Maria B. Palamar, and Suzanne Kennedy-Stoskopf, North Carolina State University; Carl W. Betsill. USDA-APHIS-Wildlife Services; Gene Erickson, Rollins Animal Disease Diagnostic Laboratory
Published: April 2012 in Journal of Wildlife Diseases

Abstract: As feral swine (Sus scrofa) populations expand their range and the opportunity for feral swine hunting increases, there is increased potential for disease transmission that may impact humans, domestic swine, and wildlife. From September 2007 to March 2010, in 13 North Carolina counties and at Howell Woods Environmental Learning Center, we conducted a serosurvey of feral swine for Brucella suis, pseudorabies virus (PRV), and classical swine fever (CSF); also, the samples obtained at Howell Woods were tested for porcine circovirus type 2 (PCV-2). Feral swine serum was collected from trapped and hunter harvested swine. For the first time since 2004 when screening began, we detected B. suis. antibodies in 9.2% (9/98) of feral swine at Howell Woods and
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Study Debunks Common Myth That Urine Is Sterile

Researchers have determined that bacteria are present in the bladders of some healthy women, which discredits the common belief that normal urine is sterile. These findings were published in the April issue of the Journal of Clinical Microbiology by researchers at Loyola University Chicago Stritch School of Medicine (SSOM)."Docve been trained to believe that urine is germ-free," said Linda Brubaker, MD, MS, dean, SSOM. "However, these findings challenge this notion, so this research may have positive implications for how we treat patients with urinary tract conditions in the future."

This study evaluated urine specimens of women who had symptoms consistent with a urinary tract infection (UTI), but were free of known UTIs. Urine samples were collected from standard urination, through a catheter, or from a thin needle inserted into the abdomen while the women were under anesthesia for gynecologic surgery. The urine was analyzed using advanced DNA-based detection methods. These tests determined that the adult female bladder can contain certain forms of bacteria that are not identified by urine culture techniques that are typically used to diagnose UTIs.

"While urine cultures have been the gold standard to identify UTIs in the past, they have limited utility," said Alan Wolfe, PhD, co-author and professor of Microbiology and Immunology, SSOM. "They are not as effective as the DNA-based detection measures used in this study."

This study also looked at collection methods to test urine for bacteria. The results revealed that the standard method to catch urine in a cup poses problems, because bacteria from the vagina often contaminate these specimens. In contrast, urine collection using a catheter or a needle was effective and comparable between tests.

Loyola researchers now plan to determine which bacteria in the bladder are helpful and which are harmful. They also will look at how these bacteria interact with each other and with their host, and how we can use this information to help patients. This research is in line with a larger international effort that is underway to identify the core bacterial composition of a healthy human body. Researchers strive to correlate changes in the composition of bacterial communities in and on the body with certain diseases.

"Further studies are needed to determine if the bacteria found in the bladders of women in this study are relevant to urinary tract conditions," Dr. Brubaker said. "If that is the case, these studies could make it possible to identify women who are at-risk for these conditions, which may change how we manage patients."

Study Sheds Light On Obstacles To Walking Following Gynecologic Surgery

Despite the well-documented benefits of walking after surgery, some patients are reluctant to make an attempt even with the encouragement of medical staff. Loyola University Health System researchers reported these findings at the prestigious 38th Annual Scientific Meeting of the Society of Gynecologic Surgeons in Baltimore.

Loyola researchers set out to determine if a program that encourages patients to walk after surgery had a positive effect. However, the study revealed that patients who were encouraged to walk actually recorded of median of 80 steps while those who received routine care without encouragement took 87 steps. Also, 12 percent of patients in the study did not walk at all during their hospital stay.

"There are many obstacles that can prevent a patient from moving after surgery," said Maike Liebermann, MD, co-investigator, LUHS. "If a patient cannot walk, this can increase the risk of complications and prolong recovery time and length of hospital stay."

Obstacles to walking can include pain, catheters or drains, hospital gowns, IVs and lack of assistance. While further research is needed, the authors found that early discontinuation of catheters and IV fluids and improvement in pain management have the potential to increase walking and overall outcomes for patients after gynecologic surgery.

This study measured steps taken in the 24 hours prior to a patient going home from the hospital. Researchers evaluated 146 patients who underwent gynecologic surgery who either had routine care with no encouragement to walk or a goal-oriented walking program following surgery. The latter group had signs at the bedside to instruct the health-care providers to encourage the patient to take at least 500 steps prior to discharge. Steps were recorded using a pedometer.

"This was the first study to measure walking after surgery in gynecologic patients," said Michael Awad, MD, study co-investigator, LUHS. "It demonstrated an easy way for doctors to evaluate a patient's ability to walk and decide if the patient is ready to go home from the hospital."

For most patients, walking after surgery is a requirement before they are allowed to leave the hospital. However, there is no guideline to determine the adequate amount of walking after surgery.

The authors concluded that further research must be done to establish standards for walking after gynecologic surgery. They reported that one consideration may be to treat walking as another vital sign, so that it is reported regularly.

In IVF Preconception Study, 96 Percent Of Women Faced Multiple Lifestyle Issues And Health Risks

Ninety-six per cent of women who attended a preconception clinic before undergoing IVF had three or more lifestyle problems and risk factors, according to a study in the May issue of the Journal of Advanced Nursing.

Half of the obese women lost weight and nearly a third of the smokers decided to quit after receiving advice at the clinic. But the nurses were surprised that some women had no motivation to lead healthier lifestyles, even though they were prepared to go through IVF to get pregnant. For example 30% of the smokers refused to quit and 16% of the obese women weren't prepared to lose weight.

Researchers from the University Medical Center in Utrecht, The Netherlands, analysed the results of questionnaires completed by 101 women who had received preconception care before IVF, together with the seven nurses who advised them.

"Medical professionals are increasingly recognising that there are important links between preconception health and positive IVF outcomes, both in terms of the success of the procedure and the health of the baby" says nurse researcher Henrietta Ockhuijsen from the Department of Reproductive Medicine and Gynaecology at the Center. "Despite this, preconception care is rarely offered to couples undergoing IVF."

A total of 130 women, aged from 25 to 42 years, completed an internet-based preconception questionnaire developed by the Erasmus Medical Center in Rotterdam and 101 of those completed a further questionnaire after they had received lifestyle advice from one of the seven nurses. The obese patients and smokers were then followed up for a further year. The registered nurses ranged from 42 to 51 years-of-age and had all worked in the fertility clinic for more than five years.

Key findings of the study included: The vast majority of the 130 women who completed the lifestyle problems and risks questionnaire faced three or more risks (96%), with only 4% facing two. These lifestyle problems and risks included bacterial and parasitic infections, alcohol use, smoking, obesity and using medication without a prescription. All of the women were satisfied with the time spent with them by the nurse providing preconception advice and 96% were satisfied with the verbal information provided. The women were also asked for their views on the preconception site run by the Erasmus Medical Center. The overall written information scored a satisfaction rate of 94%, the information and advice about lifestyle problems scored 91% and 89% respectively and the strategies to improve lifestyles scored 75%. Women valued the personal contact and approach from their nurse and the time allocated for preconception advice. But women with lower risk factors felt the clinic was unnecessary and that a better selection procedure would increase the efficiency and value of the service. Half of the 30 women who were obese lost weight. They had an average BMI of 34.3, weighed an average of 101.3kg and lost an average of 6.1kg. Ten further women said they were motivated to lose weight, but declined to be followed up, and the remaining five said they didn't feel motivated to lose weight. Seven of the 23 patients counselled for smoking quit, six reduced the number of cigarettes they smoked, three wanted to quit but declined follow up and seven were not motivated to quit. The nurses were sceptical about the clinic to start with, but became more confident about the value of the programme and their role, scoring it an average of 4.3 out of ten at the start and 6.3 at the end. More than half (57%) were happy with the training they received, 86% with the coaching, 86% with the internet-based questionnaire used, 72% with the evidence-based manual and 57% with the organisation of the clinic. However only 42% were satisfied with the fact that all the women were referred to the preconception clinic, arguing that it was more important for women who were obese, smoked, lacked knowledge and had multiple lifestyle problems to attend. Less than half (42%) were satisfied with the knowledge and skills they had to counsel women with obesity. The nurses also felt awkward about talking about issues such as weight loss and smoking cessation with women who were already facing the stress of IVF."The results of our study show that preconception care was well received by the patients and that it motivated some women to lose weight and quit smoking" concludes Henrietta Ockhuijsen. "We feel that such care should be incorporate into IVF programmes and that nurses could play a key role in running special clinics, as long as they were provided with additional education and clear protocols."