Several media reports linking infertility in men to a recent outbreak of a bacterial disease in 3,245 people in China have gone viral. This outbreak reported by the Lanzhou Health Commission on September 15 in Northwest China was caused by the leakage of the bacterium Brucella from the Lanzhou Veterinary Research Institute. The biopharmaceutical was involved in manufacturing the brucella vaccine for animals.
After reporting cases of Coronavirus, the Hantavirus, the new strain of the G4-swine flu virus, cases of Bubonic plague, and the tick virus, Brucellosis is the latest infectious disease to be reported from China in 2020.
Media outlets such as The Times of India, News 18, Asianet, DNA, The DailyO, NewsByte reported this outbreak with headlines alluding that the disease can lead to infertility in men. However, scientific evidence suggests that such occurrences are extremely rare.
The claim that Brucellosis, as the bacterial disease is called, could lead to infertility in men originated from an article in the South Morning China Post. Zhu Guoqiang, a professor at Yangzhou University's College of Veterinary Medicine told the news organisation that if the disease was not treated properly, it could lead to infertility. However, he also added that he was not aware about the amount of bacteria the infected were exposed to.
Both the World Health Organisation and the Centres for Diseases Control And Prevention have clarified that human to human transmission of this disease is rare. The apex public health research bodies do not mention infertility as an outcome of the disease.
Animals are normally vaccinated against the disease. The Lanzhou institute was manufacturing this vaccine. There are no human vaccines against brucellosis.
Brucellosis and Infertility
BOOM ran a keyword search for brucellosis and infertility in scientific research search engines Google Scholar, PubMed and Science Direct. The key research showed that Brucellosis can cause inflammation and swelling of the epididymis (tube behind the testicles) and testicles in men.
However, these diseases are treatable through antibiotic therapy. Two studies published in 2014 and 2006 showed that very few people affected by brucellosis actually developed infertility. Both the studies were conducted in Turkey.
In the study published in 2014, infection in the genitourinary tract was observed in one-tenth of the 390 patients but permanent infertility only persisted in one person. Low sperm count, absence of semen, and absence of sperm were also observed which did not lead to persistent infertility.
The 2006 study stated that infertility problems could arise in patients with brucellosis but the relationship between inflammation and infertility needs to be further studied.
Except these two papers, there is a dearth of research depicting the progression of infertility through brucellosis.
What Is Brucellosis
Brucellosis a bacterial disease caused by various Brucella species mainly infects cattle, swine, goats, sheep and dogs. Humans generally acquire the disease through direct contact with infected animals, by eating or drinking contaminated animal products or by inhaling airborne agents. Most cases are caused by ingesting unpasteurized milk or cheese from infected goats or sheep.
People who work with animals and are in contact with blood, placenta, foetuses and uterine secretions have an increased risk of contracting the disease. The WHO says human-to-human transmission of this disease also known as the Malta or Mediterranean fever is very rare.
Vaccination of cattle, goats and sheep is the best recommended way to eliminate the bacteria while several countries also cull the infected animals. Pasteurizing milk, creating protective barriers and guidelines for handling animals are other important prevention strategies.
Brucellosis is diagnosed through antibody testing. Flu-like symptoms, including fever, weakness, weight loss are common symptoms. Combined antibiotic therapy is the most optimal treatment for this disease.
Brucellosis outbreak in China
Contaminated exhaust fumes caused by the use of expired disinfectants between July 24 and August 20 in 2019 led to the Brucellosis outbreak between 2019 and 2020 . The Lanzhou Veterinary Research Institute of the Chinese Academy of Agricultural was involved in producing the brucella vaccine. As early as December 26, 2019, over 181 staff and students were infected by the bacterial leak.
Subsequently, over the months the bacterial waste gas contaminated the air as well as food after taking the form of aerosols. As of September 14, 2020, 3,245 people were confirmed as positive from the 21,847 people tested. There have been no fatalities reported, yet, as per the city's health commission. The city commission has also not shared any details about the age and sex profile of the infected.
The research institute lost all its vaccine product licenses and two of its product approvals for producing the Brucellosis vaccines in animals was revoked. In its apology letter published six months later in February 2020 , the company said it had taken strict action against the eight people responsible for not checking the expiry dates of the disinfectants and sanitizers.
Around 13 cases were reported from the northeastern province of China. These cases worked at Lanzhou University during the leak in July-August 2019.
Fake Graphic Calling The Bacterial Disease A Virus
An image circulating on social media falsely claims that this bacterial disease is another virus emerging from China. The Tatva, an independent news website, made a featured image that stated that Brucellosis is a new virus leaked from another Chinese lab. This image comes at a time when there are conspiracy theories floating about SARS-CoV-2 originating from a lab in Wuhan. View the archive here.
However, virus and bacteria are different micro-organisms affecting humans. Bacteria, that are single-celled and can survive without a host can be treated with antibiotics. Viruses, on the other hand cannot survive without a host and need therapy beyond antibiotics.