| Objective: The aims of this study were to analyze the clinical features and current treatment options of brucellosis in Jilin Province and to investigate whether the sika deer serves as a source of human infection by brucella in Jilin Province of Northeast China.Background: Brucellosis is the commonest zoonotic disease worldwide. The prevalence of brucellosis is increasing in China over the past several years. Misdiagnosis and delay in treatment often occurs owing to atypical symptoms and more compplications. Sika deer as a storage reservoir of brucella has been recongnized in the past decade, however, it remains unclear whether the sika deer serves as a source of human infection by brucella in Jilin Province of Northeast China.Materials and methods: Brucellosis was diagnosed in 118 patients during the periods from June 2007 through September 2009 in our hospital. The main epidemiologic and clinical data for those patients were collected and analyzed. The sources of infection and routes of transmission were investigated. Blood samples from these patients and 6 sika deer were obtained for Brucella antibody testing and culturing bacteria.Results: Of the 118 patients, 97 males and 21 female, the mean age at the time of diagnosis was 26 years (range 1-73). They were farmers (72.88%), veterinary (6.78%) and herdsmen (5.93%). 3 of those patients was sika deer breeders. Sources of infection for those patients were sheep (62.71%), followed by cow (17.80%), dog (3.39%), and deer (2.54%). Deliever animal baby was the most common means of transmission. Transmission of brucellosis to human occurred mostly through deliver aminal baby. Clinical symptoms were usually atypical and complications were common.All of the patients with fever, which has high fever (72.03%), refund sweat (72.03%), headache (21.19%), muscle pain (22.03%), liver enlargement (45.76%), splenomegaly (47.46%), and Lymph node enlargement (24.58%). Complications, in order of frequency, were hepatitis (64.41%), arthritis (55.93%), epididymal orchitis (8.47%), pneumonia (5.93%), meningitis (1.69%) and nephritis (0.85%).The initial combination therapies with brucellosis were Doxycycline plus Levofloxacin (50.00%), Doxycycline plus Strepmycin (12.71%), Doxycycline plus Ceftazidime (16.95%) , and others (20.34%). The highest frequency of subsequent treatment was Doxycycline plus Rifampacin(79.66%). The whole course of therapy was 6-weeks. Of the 118 patients with brucellosis, one patient received Doxycycline plus Levofloxin for treatment of relapse that caused by discontinuation of both drugs, and finally cured. 4 patients who failed after an initial treatment of Doxycycline for a short time, and eventually cured by using the combination of Doxycycline plus Rifampacin for 6 weeks.Of the 118 patients, 3 (1 man and 2 women) were sika deer breeders. They were from two families, and each family has a herd of approximately 60 sika deer. They observed several abortions in their deer before they were sick.. All 3 patients had prolonged intermittent fevers, night sweats, body aches, arthralgias, and weakness. Blood samples from these patients were negative for brucella culture, but positive for brucella antibodies in the agglutination test. In the 6 relevant sika deer (3 males and 3 females) examined, 1 presented with orchitis, 1 had right knee arthritis, and 1 showed progress body weight loss. However, all 6 sika deer were positive for brucella antibodies as determined by an agglutination test, and 1 of them was also positive for brucella bovis in the blood culture.Conclusion: Brucellosis is mainly found in rural areas of Jilin Province. Diversification of clinical symptoms and no standardized treatment should be concerned. Sika deer can be infected with Brucella bovis, and serve as a bacteria reservoir and transmit the infection to human in Northeast China.
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