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@article{Dang:2011:10.1371/journal.pone.0017604,
author = {Dang, TNH and Thi, PTL and Wolbers, M and Quang, TC and Van, MHN and Vu, TNT and Thi, PTL and Hoan, PN and Thi, HCT and Xuan, SD and Song, DT and Thi, THH and Truong, H and Campbell, J and Van, VCN and Tran, CN and Van, DN and Thi, HN and Spratt, BG and Tinh, HT and Farrar, J and Schultsz, C},
doi = {10.1371/journal.pone.0017604},
journal = {PLOS One},
title = {Risk Factors of Streptococcus suis Infection in Vietnam. A Case-Control Study},
url = {http://dx.doi.org/10.1371/journal.pone.0017604},
volume = {6},
year = {2011}
}

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TY  - JOUR
AB  - Background: Streptococcus suis infection, an emerging zoonosis, is an increasing public health problem across South EastAsia and the most common cause of acute bacterial meningitis in adults in Vietnam. Little is known of the risk factorsunderlying the disease.Methods and Findings: A case-control study with appropriate hospital and matched community controls for each patientwas conducted between May 2006 and June 2009. Potential risk factors were assessed using a standardized questionnaireand investigation of throat and rectal S. suis carriage in cases, controls and their pigs, using real-time PCR and culture ofswab samples. We recruited 101 cases of S. suis meningitis, 303 hospital controls and 300 community controls. Bymultivariate analysis, risk factors identified for S. suis infection as compared to either control group included eating ‘‘highrisk’’ dishes, including such dishes as undercooked pig blood and pig intestine (OR1 = 2.22; 95%CI = [1.15–4.28] andOR2 = 4.44; 95%CI = [2.15–9.15]), occupations related to pigs (OR1 = 3.84; 95%CI = [1.32–11.11] and OR2 = 5.52; 95%CI = [1.49–20.39]), and exposures to pigs or pork in the presence of skin injuries (OR1 = 7.48; 95%CI = [1.97–28.44] and OR2 = 15.96;95%CI = [2.97–85.72]). S. suis specific DNA was detected in rectal and throat swabs of 6 patients and was cultured from 2rectal samples, but was not detected in such samples of 1522 healthy individuals or patients without S. suis infection.Conclusions: This case control study, the largest prospective epidemiological assessment of this disease, has identified themost important risk factors associated with S. suis bacterial meningitis to be eating ‘high risk’ dishes popular in parts of Asia,occupational exposure to pigs and pig products, and preparation of pork in the presence of skin lesions. These risk factorscan be addressed in public health campaigns aimed at preventing S. suis infection.
AU  - Dang,TNH
AU  - Thi,PTL
AU  - Wolbers,M
AU  - Quang,TC
AU  - Van,MHN
AU  - Vu,TNT
AU  - Thi,PTL
AU  - Hoan,PN
AU  - Thi,HCT
AU  - Xuan,SD
AU  - Song,DT
AU  - Thi,THH
AU  - Truong,H
AU  - Campbell,J
AU  - Van,VCN
AU  - Tran,CN
AU  - Van,DN
AU  - Thi,HN
AU  - Spratt,BG
AU  - Tinh,HT
AU  - Farrar,J
AU  - Schultsz,C
DO  - 10.1371/journal.pone.0017604
PY  - 2011///
SN  - 1932-6203
TI  - Risk Factors of Streptococcus suis Infection in Vietnam. A Case-Control Study
T2  - PLOS One
UR  - http://dx.doi.org/10.1371/journal.pone.0017604
UR  - http://hdl.handle.net/10044/1/30000
VL  - 6
ER  -

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