Analysis of the Epidemiological, Clinical Characteristics, Treatment and Prognosis of Human Brucellosis During 2014-2018 in Huludao, China

Purpose: To describe the incidence trend, demographic and clinical characteristics, treatment and prognosis, epidemiological history and risk factors of human brucellosis in Huludao, China. Patients and Methods: A total of 1887 brucellosis patients were reported in Huludao, China from January, 2014 to December, 2018 and the case questionnaires from 1149 patients were collected from Huludao Municipal Center for Disease Control and Prevention. Demographic characteristics of the patients and the information relating to the patients' clinical manifestations, diagnosis, treatment and prognosis were collected and analyzed. Results: The number of annually reported brucellosis patients has dropped from 711 to 187 during the study period, with the incidence decreased from 27.31/100,000 in 2014 to 7.15/100,000 in 2018. A total of 1149 individual data were collected, with a mean age of 49.59 +/- 13.14 years and 75.7% were male. Patients aged more than 60 years were more likely to have arthralgia/myalgia than the other age groups, and patients who had an enlarged spleen in male were more than female (P<0.05). There were more acute brucellosis cases, less sub-acute and chronic brucellosis cases in the ethnic minority (83.6%, 5.5% and 11.0%, respectively) than that in the Han nationality (64.7%, 22.2% and 13.0%, respectively, P<0.05). For antibiotic therapy, "Doxycycline plus rifampicin or streptomycin" was the most commonly used drug combination. Sheep/goat was the main contacted animal and feeding/grazing was the most frequent transmission route; no personal protective measures were the major risk factor. Conclusion: The incidence of human brucellosis is still high in Huludao, China, and this is mostly associated with contacting with domestic animals and barely taking protective measures. The most common clinical manifestations of brucellosis patients in Huludao were fatigue, hyperhidrosis, fever, and arthralgia/myalgia, the most common route of exposure was feeding and grazing, and the major species of livestock was sheep/goat. The most commonly adopted treatment option was antibiotic therapy, and most patients responded well to treatment. The integrality and accuracy of the notifiable epidemiological case questionnaire needs to be improved in order to provide more factual and objective information for both the physicians and policy-makers.