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      Epidemiology, Clinical Manifestations, and Outcomes of Streptococcus suis Infection in Humans

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          Abstract

          Infection occurs mainly in Asia; occupational and food exposures are the primary risk factors.

          Abstract

          Streptococcus suis, a bacterium that affects pigs, is a neglected pathogen that causes systemic disease in humans. We conducted a systematic review and meta-analysis to summarize global estimates of the epidemiology, clinical characteristics, and outcomes of this zoonosis. We searched main literature databases for all studies through December 2012 using the search term “streptococcus suis.” The prevalence of S. suis infection is highest in Asia; the primary risk factors are occupational exposure and eating of contaminated food. The pooled proportions of case-patients with pig-related occupations and history of eating high-risk food were 38.1% and 37.3%, respectively. The main clinical syndrome was meningitis (pooled rate 68.0%), followed by sepsis, arthritis, endocarditis, and endophthalmitis. The pooled case-fatality rate was 12.8%. Sequelae included hearing loss (39.1%) and vestibular dysfunction (22.7%). Our analysis identified gaps in the literature, particularly in assessing risk factors and sequelae of this infection.

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          Streptococcus suis: an emerging human pathogen.

          Streptococcus suis infection is acquired through exposure to contaminated pigs or pig meat. Over the past few years, the number of reported S. suis infections in humans has increased significantly, with most cases originating in Southeast Asia, where there is a high density of pigs. Increased awareness, improved diagnostics, and the occurrence of outbreaks have contributed to this increase. Meningitis and sepsis are the most common clinical manifestations of S. suis infection; hearing loss is a frequent complication. In this article, we provide an overview of the emergence and clinical manifestations of S. suis infection.
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            Streptococcus suis: an emerging zoonotic pathogen.

            Streptococcus suis is a major porcine pathogen worldwide, and can be transmitted to human beings by close contact with sick or carrier pigs. S suis causes meningitis, septicaemia, endocarditis, arthritis, and septic shock in both pigs and human beings, and mortality is high. Human infection with S suis occurs mainly among certain risk groups that have frequent exposure to pigs or pork. Outbreaks of human S suis infection are uncommon, although several outbreaks have occurred in China in recent years. In July, 2005, the largest outbreak of human S suis infection occurred in Sichuan province, China, where 204 people were infected and 38 of them died. There have been 409 cases of human S suis infection worldwide, most of which have occurred in China, Thailand, and the Netherlands, and these infections have led to 73 deaths. This review provides background information on the biology and molecular characteristics of this Gram-positive bacterium, and describes the clinical signs, pathology, epidemiology, diagnosis, and treatment of human infection with S suis.
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              Community-acquired bacterial meningitis in adults.

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                Author and article information

                Journal
                Emerg Infect Dis
                Emerging Infect. Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                July 2014
                : 20
                : 7
                : 1105-1114
                Affiliations
                [1]Oxford University Clinical Research Unit, Hanoi, Vietnam (V.T.L. Huong, P. Horby, H.F.L. Wertheim);
                [2]University of Oxford, Oxford, UK (V.T.L. Huong, P. Horby, H.F.L. Wertheim, N.T. Hoa);
                [3]Nagasaki University, Nagasaki, Japan (N. Ha, N.T. Huy, X. Zhu, K. Hirayama);
                [4]Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam (H.D.T. Nghia, N.T. Hoa, T.T. Hien, C. Schultsz);
                [5]National Institute of Hygiene and Epidemiology, Hanoi (V.D. Thiem);
                [6]Ramón y Cajal Hospital, Madrid, Spain (J. Zamora);
                [7]CIBER Epidemiologia y Salud Publica, Madrid (J. Zamora);
                [8]Pham Ngoc Thach University of Medicine, Ho Chi Minh City (H.D.T. Nghia);
                [9]University of Amsterdam, Amsterdam, the Netherlands (C. Schultsz)
                Author notes
                Address for correspondence: Kenji Hirayama, Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan; email: hiraken@ 123456nagasaki-u.ac.jp
                Article
                13-1594
                10.3201/eid2007.131594
                4073838
                24959701
                5a1738a8-27ad-440b-b9e9-6e72b7207f5a
                History
                Categories
                Synopsis
                Synopsis

                Infectious disease & Microbiology
                streptococcus suis,bacterial meningitis,systematic review,meta-analysis,zoonoses,bacteria,humans

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