Membrane vesicles derived from Streptococcus suis serotype 2 induce cell pyroptosis in endothelial cells via the NLRP3/Caspase-1/GSDMD pathway

Streptococcus suis serotype 2(S.suis 2)is a zoonotic pathogen that clinically causes severe swine and human infections(such as meningitis,endocarditis,and septicemia).In order to cause widespread diseases in different organs,S.suis 2 must colonize the host,break the blood barrier,and cause exaggerated inflammation.In the last few years,most studies have focused on a single virulence factor and its influences on the host.Membrane vesicles(MVs)can be actively secreted into the extracellular environment contributing to bacteria-host interactions.Gram-negative bacteria-derived outer membrane vesicles(OMVs)were recently shown to activate host Caspase-11-mediated non-canonical inflammasome pathway via deliverance of OMV-bound lipopolysaccharide(LPS),causing host cell pyroptosis.However,little is known about the effect of the MVs from S.suis 2(Gram-positive bacteria without LPS)on cell pyroptosis.Thus,we investigated the molecular mechanism by which S.suis 2 MVs participate in endothelial cell pyroptosis.In this study,we used proteomics,electron scanning microscopy,fluorescence microscope,Western blotting,and bioassays,to investigate the MVs secreted by S.suis 2.First,we demonstrated that S.suis 2 secreted MVs with an average diameter of 72.04 nm,and 200 proteins in MVs were identified.Then,we showed that MVs were transported to cells via mainly dynamin-dependent endocytosis.The S.suis 2 MVs activated NLRP3/Caspase-1/GSDMD canonical inflammasome signaling pathway,resulting in cell pyroptosis,but it did not activate the Caspase-4/-5 pathway.More importantly,endothelial cells produce large amounts of reactive oxygen species(ROS)and lost their mitochondrial membrane potential under induction by S.suis 2 MVs.The results in this study suggest for the first time that MVs from S.suis 2 were internalized by endothelial cells via mainly dynamin-dependent endocytosis and might promote NLRP3/Caspase-1/GSDMD pathway by mitochondrial damage,which produced mtDNA and ROS under induction,leading to the pyroptosis of endothelial cells.

Dihydroartemisinin ameliorates innate inflammatory response induced by Streptococcus suis-derived muramidase-released protein via inactivation of TLR4-dependent NF-kB signaling

Muramidase-released protein(MRP)is now being recognized as a critical indicator of the virulence and pathogenicity of Streptococcus suis(S.suis).However,the identification of viable therapeutics for S.suis infection was hindered by the absence of an explicit mechanism for MRP-actuated inflammation.Dihydroartemisinin(DhA)is an artemisinin derivative with potential anti-inflammatory activity.The modulatory effect of DhA on the inflammatory response mediated by the virulence factor MRP remains obscure.This research aimed to identify the signaling mechanism by which MRP triggers the innate immune response in mouse spleen and cultured macrophages.With the candidate mechanism in mind,we investigated DhA for its ability to dampen the pro-inflammatory response induced by MRP.The innate immune response in mice was drastically triggered by MRP,manifesting as splenic and systemic inflammation with splenomegaly,immune cell infiltration,and an elevation in pro-inflammatory cytokines.A crucial role for Toll-like receptor 4(TLR4)in coordinating the MRP-mediated inflammatory response via nuclear factor-kappa B(NF-kB)activation was revealed by TLR4 blockade.In addition,NFkB-dependent transducer and activator of transcription 3(STAT3)and mitogen-activated protein kinases(MAPKs)activation was required for the inflammatory signal transduction engendered by MRP.Intriguingly,we observed an alleviation effect of DhA on the MRP-induced immune response,which referred to the suppression of TLR4-mediated actuation of NF-kB-STAT3/MAPK cascades.The inflammatory response elicited by MRP is relevant to TLR4-dependent NF-kB activation,followed by an increase in the activity of STAT3 or MAPKs.DhA mitigates the inflammation process induced by MRP via blocking the TLR4 cascade,highlighting the therapeutic potential of DhA in targeting S.suis infection diseases.

Prevalence of Streptococcus suis Isolated from Clinically Healthy Sows in China

Streptococcus suis is an important pathogen in pigs. Transmission of this pathogen is generally believed to occur between healthy carrier sows and their offspring, so the carrier status of S. suis in healthy sows is important for the control of S. suis infections in pigs, especially in suckling and growing pigs. In this study, the prevalence of S. suis isolated from clinically healthy sows in China was studied for the first time. A total of 1 043 tonsil samples were collected from clinically healthy sows from 10 regions in China from 2005 to 2007. Among the 421 S. suis isolates, 31 strains were identified as capsular type 2. The results showed that S. suis was widespread in swine herds in China with the carrier rates in different herds ranging from 19.5 to 93.9%. Overall, 40.4 and 3.0% of clinically healthy sows harbored S. suis and capsular type 2 in their palatine tonsils, respectively. Statistically significant differences of carrier rates of S. suis and capsular type 2 between the different farms were observed, which was independent of herd sizes and geographic distributions of different herds.

Coinfection of Streptococcus suis and Nocardia asiatica in the human central nervous system:A case report

BACKGROUND Streptococcus suis(S.suis)is an anthropozoonotic pathogen that shows clinical manifestations of meningitis,septicemia,and arthritis in infected humans.Nocardia is another type of anthropozoonotic bacteria,with clinical manifestations of skin,lung,and brain abscesses in infected humans.Few intracranial infections caused by S.suis or Nocardia have been reported.To the best of our knowledge,no study has reported a patient with simultaneous intracranial infection by S.suis and Nocardia.CASE SUMMARY A 66-year-old male presented at Liaocheng People’s Hospital(Liaocheng,Shandong Province,China)reporting dizziness with nausea and vomiting.Metagenomic next-generation sequencing(m NGS)was performed on cerebrospinal fluid for examination,and the patient was diagnosed with suppurative meningitis caused by S.suis infection.He received anti-infection treatment with penicillin sodium and ceftriaxone.The patient’s condition initially improved but then deteriorated.Further m NGS of cerebrospinal fluid revealed both S.suis and Nocardia.Imaging examination revealed a brain abscess.Furthermore,a mixed infection of S.suis and Nocardia was detected in the patient’s central nervous system.The patient was treated with antibiotics and sulfamethoxazole.He was discharged after his condition improved.CONCLUSION This case shows that the disease can be recurrent in patients with intracranial infection of a rare pathogen.The possibility of mixed infection should also be considered,especially in patients treated with immunosuppressive agents.m NGS of cerebrospinal fluid is a supplement to conventional microbial pathogen identification methods.Patients with unknown pathogen diagnosis,early extensive use of antibiotics and infection with rare pathogens can be diagnosed by the combination of conventional methods and m NGS of cerebrospinal fluid.

Prokaryotic Expression of Gene Encoding Glutamate Dehydrogenase of Streptococcus suis Serotype 2 and Preparation of Polyclonal Antibodies against Its Expressed Products

[ Objective] To obtain detection antigen for diagnosis of Streptococcus suis infection. [ Method] The complete ORF of glutamate dehy- drogenase （GDH） gene was amplified from the genomic DNA of Streptococcus suis serotype 2 strain SC22 isolated in Sichuan Province by poly- merase chain reaction （PCR）. The resulting product was cloned into the prokaryotic expression vector pET-30a, which was then transformed into E. coil BL21 （DE3）. The identified positive transformants were screened for expression induced by IPTG. The expression products were subjected to SDS-PAGE and the recombinant protein was purified by nickel ion-agarose affinity chromatography. New Zealand rabbits were immunized with the purified recombinant GDH protein to prepare polyclonal antibodies. Titers of the anti-serum were determined by indirect ELISA and Western blot assay. [ Result] The recombinant GDH protein was effectively expressed in the host bacteria, and highly pure recombinant protein was obtained by nickel ion-agarose affinity chromatography. High-titer anti-serum against the recombinant protein was obtained. As evidenced by western blot as- say, the sera could react specifically with the lysates of all detected Streptococcus suis strains. In addition, the recombinant GDH protein could re- act specifically with serum samples collected from five pigs experimentally infected by strain SC22. [ Conclusion] The expressed GDH fusion protein has some common epitopes of natural GDH and can be used as detection antigen to develop ELISA and other diagnostic methods.

A Streptococcus suis serotype 2 caused streptococcal toxic shock syndrome(STSS) in a patient

Streptococcus suis （S. suis） is a Gram-positive, facultatively anaerobic coccus that has been implicated as the cause of a wide range of clinical disease syndromes in swine and other domestic animals. S. suis has also been implicated in disease in humans, especially anaong abattoir workers, swine and pork handlers. Here we report a case of streptococcal toxic shock syndrome（STSS） caused by S. suis in a 59-year-old man. Despite of intensive treatment, the patient died of shock with multiple organ failure 14 h after admission. One bacterial isolate obtained from blood culture was identified to the species level by biochemical tests and serological tests as S. suis serotype 2. Identification was confirmed by PCR amplification of genes encoding 16sRNA of S. suis and the capsule of S. suis serotype 2（cps 23）. Genes encoding virulence factors were also detected. An investigation to identify the source of S. suis revealed that several days before admission the affected man had been handling sick pigs or their meat. Transmission may occur through breaks in the skin of feet with tinea due to that no measures for personal protection was taken. This case should highten awareness of the potential for occupational exposure and human infection with S. suis.

Characterization of a Novel Gene, srpA, Conferring Resistance to Streptogramin A, Pleuromutilins, and Lincosamides in Streptococcus suis

Antimicrobial resistance is undoubtedly one of the greatest global health threats. The emergence of multidrug-resistant(MDR) Gram-positive pathogens, such as methicillin-resistant Staphylococcus aureus(MRSA), vancomycin-resistant Enterococcus faecium(VRE), and β-lactamase-resistant Streptococcus pneumonia, has severely limited our antibiotic arsenal. Numerous ribosome-targeting antibiotics, especially pleuromutilins, oxazolidinones, and streptogramins, are viewed as promising alternatives against aggressive MDR pathogens. In this study, we identified a new adenosine triphosphate(ATP)-binding cassete(ABC)-F family determinant, srp A, in Streptococcus suis(S. suis) by means of a comparative analysis of the whole-genome sequences of tiamulin(TIA)-resistant and TIA-sensitive bacteria. Functional cloning confirmed that the deduced gene can mediate cross-resistance to pleuromutilins, lincosamides, and streptogramin A in S. suis and S. aureus. A sequence alignment revealed that Srp A shares the highest amino acid identity with Vga(E)(36%) and shows canonical characteristics of ABC-F family members.In Srp A-ribosome docked compounds, the extended loop region of Srp A approaches the valnemulinbinding pocket in the ribosome peptidyl-transferase center and competes with bound valnemulin. A detailed mutational analysis of the loop residues confirmed that this domain is crucial for Srp A activity,as substitutions or truncations of this region affect the efficiency and specificity of antibiotic resistance.Intracellular antibiotics accumulation indicated that Srp A does not act as an efflux pump, while a ribosome binding assay supported the protective effects of Srp A on the ribosome by preventing antibiotic binding as well as displacing bound drugs. These findings clarify the mechanisms underlying resistance to ribosomal antibiotics.

Advances in pathogenesis of Streptococcus suis serotype 2

Streptococcus suis is one of the major pathogens of swine streptococcosis. Among them, the strongest virulence and highest rate of clinical isolation serotype is S. suis serotype 2（SS2）. Moreover, SS2 is also an important zoonosis pathogen, which caused severe public health issues in China. It has been reported that SS2 has several virulence factors, including muramidase released protein, extracellular factors, capsule, fibronectin-binding protein, enolase, hemolysin, small RNA, biofilm, two-component regulatory systems, STK/STP, etc., whose functions involved in adhesion, anti-phagocytosis, inflammatory pathway activation, invasion, etc. Actually, SS2 has developed a variety of ways to escape from host immune system during evolution. In particularly, capsule could resist phagocytosis through inhibiting sphingosine dependent immune cell recognition, which plays an important role in escaping host inflammation response; moreover, superoxide dismutase encoding by sod A enables SS2 escaping reactive oxygen species（ROS） in host immune cells; besides, binding complement factor h with Fhb could suppress the activation of complement alternative pathway and bactericidal effect. And SS2 could also hinder the formation of neutrophil extracellular traps（NETs） to avoid trapping by swine neutrophils, while host immune globulin could be degraded by Ig A1 hydrolase and Ig M protease. In addition, SS2 could escape host immune defense with the help of multiple transcriptional factors and micro-RNA. So far, the pathogenesis of meningitis, arthritis caused by SS2 infection, is still unclear, and the virulence regulatory mechanism of phosphorylation, micro-RNA need to be further clarified. Importantly, the study of interaction mechanism of pathogen and host contribute to further demonstration the pathogenesis of SS2.

Prevention and Treatment of Chinese Herbal Preparation Yinqiaotiangan against Pathologic Model of Streptococcus suis Serotype II in Kunming Mice

[ Objectlve] This study aimed to investigate the antimicrobial effect of Chinese herbal preparation Yinqiaotiangan against Streptococcus suis serotype II in vivo. [ Method ] The prevention and treatment tests were conducted with Kunming mice weighing about 18 -22 g. In the prevention test, Kunming mice were inocu- lated with Streptococcus suis serotype II and simultaneously taken orally 0.5, 1.0 and 2.0 g/ml Chinese herbal preparation Yinqiaotiangan respectively for continu- ous 3 d, once a day; the incidence rate, mortality rate and protective rate were detected after 7 d. In the treatment test, Kunming mice were inoculated with Strepto- coccus suis serotype II to establish the Streptococcus suis serotype II pathogenic model, and then taken orally 0.5, 1.0 and 2.0 g/ml Chinese herbal preparation Yin- qiaotiangan respectively for continuous 3 d, twice a day; the mortality rate, cure rate and effective rate were detected after 7 d. [ Result ] Results of the prevention test showed that the protective rate in experimental groups was extremely significantly higher than that in control group （P 〈0.01 ）, while the incidence rate and mortality rate were extremely significantly lower than that in control group （P 〈0.01 ）. Results of the treatment test showed that the incidence rate in experimental groups was extremely significantly lower than that in control group （P 〈0.01 ）, the cure rate in 0.5 g/ml group was extremely significantly higher than that in 1.0 g/ml group and 2.0 g/ml group （P 〈 0.01 ）, the effective rate in 0.5 g/ml group was significantly higher than that in 1.0 g/ml group and 2.0 g/ml group （ P 〈 0.05 ）, with no significant difference from the positive group （P 〉 0.05 ）. [ Conclusion ] The pathologic model of Streptococcus su/s serotype II could be effec- tively prevented and treated by oral intake of low dose of Chinese herbal preparation Yinqiaotiangan in Kunming mice.

Erythromycin Resistance of Streptococcus suis Isolates In Vivo

In order to study erythromycin resistance of Streptococcus suis under high or low concentration of selective drug pressure, Streptococcus suis strain LN was isolated from a diseased pig in 2005 and showed to be susceptible to erythromycin as determined by disc diffusion and tube dilution tests. In this study, clean level rabbits were divided into three groups of six rabbits each, including a prevention dosage group, a treatment dosage group, and a control group. After injection with S. suis strain LN, erythromycin （20 μg mL^-1） was taken orally in the prevention dosage group, erythromycin （5 mg kg^-1） was injected intramuscularly in the treatment dosage group, and no treatment was given in the control group. S. suis with intermediate resistance to erythromycin was isolated on the 5th day after infection from the prevention dosage group （5th PDG） and on the 7th day after infection from the treatment dosage group （7th TDG）. Both isolates were determined to be the constitutive macrolide-lincosamide-streptogramin B （cMLSB） resistance phenotype. The resistance gene ermB was detected in all of the isolates. The results suggested that both the 5th PDG and 7th TDG isolates had a mutation （A2372T） in the 23S rRNA gene. In addition, the 5th PDG isolates had a mutation in ribosomal protein L4 （detected as G268A） and a mutation in ribosomal protein L22 （A345C）; and the 7th TDG isolates had a C insertion at site 564. Each of these mutations is considered as a possible mechanism of erythromycin resistance in S. suis strain LN. This study demonstrated that erythromycin resistance was readily induced in S. suis at a low erythromycin dose creating selective pressure in vivo. Resistance appeared to be mediated by ribosome methylation, encoded by the ermB gene.

The Mathematical Model for Streptococcus suis Infection in Pig-Human Population with Humidity Effect

In this paper,we developed a mathematical model for Streptococcus suis,which is an epidemic by considering the moisture that affects the infection.The disease is caused by Streptococcus suis infection found in pigs which can be transmitted to humans.The patients of Streptococcus suis were generally found in adults males and the elderly who contacted pigs or who ate uncooked pork.In human cases,the infection can cause a severe illness and death.This disease has an impact to the financial losses in the swine industry.In the development of models for this disease,we have divided the population into 7 related groups which are susceptible pig compartment,infected pig compartment,quarantined pig compartment,recovered pig compartment,susceptible human compartment,infected human compartment,and recovered human compartment.After that,we use this model and a quarantine strategy to analyze the spread of the infection.In addition,the basic reproduction number R0 is determined by using the next-generation matrix which can analyze the stability of the model.The numerical simulations of the proposed model are illustrated to confirm the results from theorems.The results showed that there is an effect from moisture to the disease transmission.When the moisture increases the disease infection also increases.

Identification of Antigens Common to Streptococcus suis Serotypes 2 and 9 by Immunoproteomic Analysis

Streptococcus suis is a Gram-positive pathogen that causes serious diseases in pigs. In addition to S. suis serotype 2 （SS2）, S. suis serotype 9 （SS9） is another prevalent serotype, which is frequently isolated from the organs of diseased pigs in China. An immunoproteomic-based approach was developed to identify antigens common to SS2 and SS9 for vaccine development. Cell wall proteins extracted from SS2 strain HA9801 were screened by two-dimensional Western blot using anti-SS2 sera, anti-SS9 sera, or pre-immune sera pooled from specific pathogen free （SPF） mice. Protein spots on preparative gels were excised and identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry, which led to the identification of four shared immunogenic proteins （arginine deiminase, translation elongation factor-Ts, o-acetylserine lyase, and 1-phosphofructokinase）. The genes encoding these four proteins from SS9 strain GZ0565 were cloned and their proteins were overexpressed in Escherichia coli BL21. Western blot analysis of these recombinant proteins using the convalescent serum of an SPF mini-pig inoculated with the SS2 strain, anti-SS2 sera, and anti-SS9 sera pooled from SPF mice further confirmed the immunogenicity of these proteins. These immunogenic proteins, which are encoded by genes that are reasonably conserved among SS2 and SS9 strains, could be developed as vaccine candidates.

An octamer of enolase from Streptococcus suis

Enolase is a conserved cytoplasmic metalloenzyme existing universally in both eukaryotic and prokaryotic cells.The enzyme can also locate on the cell surface and bind to plasminogen,via which contributing to the mucosal surface localization of the bacterial pathogens and assisting the invasion into the host cells.The functions of the eukaryotic enzymes on the cell surface expression(including T cells,B cells,neutrophils,monocytoes,neuronal cells and epithelial cells)are not known.Streptococcus suis serotype 2(S.suis 2,SS2)is an important zoonotic pathogen which has recently caused two large-scale outbreaks in southern China with severe streptococcal toxic shock syndrome(STSS)never seen before in human sufferers.We recently identified the SS2 enolase as an important protective antigen which could protect mice from fatal S.suis 2 infection.In this study,a 2.4-angstrom structure of the SS2 enolase is solved,revealing an octameric arrangement in the crystal.We further demonstrated that the enzyme exists exclusively as an octamer in solution via a sedimentation assay.These results indicate that the octamer is the biological unit of SS2 enolase at least in vitro and most likely in vivo as well.This is,to our knowledge,the first comprehensive characterization of the SS2 enolase octamer both structurally and biophysically,and the second octamer enolase structure in addition to that of Streptococcus pneumoniae.We also investigated the plasminogen binding property of the SS2 enzyme.

Comparative analysis of whole genome structure of Streptococcus suis using whole genome PCR scanning

An outbreak associated with Streptococcus suis infection in humans emerged in Sichuan province, China in 2005. The outbreak is atypical for the apparent large number of human cases, high fatality rate and geographical spread. To determine whether the bacterium has changed, we compared both human and animal isolates from the Sichuan outbreak with those collected previously within China and in other countries using whole genome PCR scanning (WGPScaning) comparative sequencing of several known virulence factor genes and multilocus sequence typing (MLST) analysis. WGPScanning analysis showed that all primer pairs yielded PCR products of the expected sizes in all four strains tested. The nucleotide sequences of all the detected virulence factor genes are identical in the four strains and MLST results showed that the four isolates studied and reference strain all belonged to the ST1 com-plex. No new genetic changes were found in the genome structure of the isolates from this Sichuan outbreak.

In vitro Transcriptome Analysis of Two Chinese Isolates of Streptococcus suis Serotype 2

The Streptococcus suis serotype 2（S. suis 2） isolates 05ZYH33 and 98HAH33 have caused severe human infections in China. Using a strand-specific RNA-seq analysis, we compared the in vitro transcriptomes of these two Chinese isolates with that of a reference strain（P1/7）. In the89 K genomic island that is specific to these Chinese isolates, a toxin–antitoxin system showed relatively high levels of transcription among the S. suis. The known virulence factors with high transcriptional activity in these two highly-pathogenic strains are mainly involved in adhesion, biofilm formation, hemolysis and the synthesis and transport of the outer membrane protein. Furthermore,our analysis of novel transcripts identified over 50 protein-coding genes with one of them encoding a toxin protein. We also predicted over 30 small RNAs（s RNAs） in each strain, and most of them are involved in riboswitches. We found that six s RNA candidates that are related to bacterial virulence, including csp A and rli38, are specific to Chinese isolates. These results provide insight into the factors responsible for the difference in virulence among the different S. suis 2 isolates.

Gluconate 5-dehydrogenase （Ga5DH） participates in Streptococcus suis cell division

Bacterial cell division is strictly regulated in the formation of equal daughter cells. This process is governed by a series of spatial and temporal regulators, and several new factors of interest to the field have recently been identified. Here, we report the requirement of gluconate 5-dehydrogenase （Ga5DH） in cell division of the zoonotic pathogen Strepto- coccus suis. GaSDH catalyzes the reversible reduction of 5-ketogluconate to D-gluconate and was localized to the site of cell division. The deletion of Ga5DH in S. suis resulted in a plump morphology with aberrant septa joining the progeny. A significant increase was also observed in cell length. These defects were determined to be the conse- quence of Ga5DH deprivation in S. suis causing FtsZ delo- calization. In addition, the interaction of FtsZ with Ga5DH in vitro was confirmed by protein interaction assays. These results indicate that GaSDH may function to prevent the formation of ectopic Z rings during S. suis cell division.

Isolation and Identification of a High-pathogenicity Strepto- coccus suis Serotype 7 Strain

In order to diagnose the diseased pigs in a certain large pig farm in Binzhou City, Shandong Province, the dead piglets with joint swelling were subjected to necroscopy, and the pathogenic bacterium was isolated and identified. One Gram-positive Streptococcus was isolated. The strain was subjected to characteristic culture, microscopic examination and molecular biological identification, and resistance detection, animal regression experiment and mouse pathogenicity test were carried out. The results showed that the isolate was identified to be Streptococcus suis serotype 7, which was resistant to multiple drugs; and the pathogenicity test showed that the strain had high pathogenicity to pigs, resulting in neurosis on partial pigs, and the strain had no pathogenicity to Kunming and BALB/c mice but certain pathogenicity to CD1 mice.

Diagnosis and Treatment of Swine Streptococcicosis

[ Objective] This paper aimed to sum up the clinical symptoms, pathological changes, diagnosis and control method of swine streptococ- cicosis. [Method] III and dead pigs were dissected and organs such as liver, kidney, spleen and lung were aseptically took to inoculate in sheep blood agar, respectively, with bacteria isolated and purified to Gram staining and microscopy. [ Result] It was positive in Gram staining and hemoly- sis ting was formed on the sheep blood agar; the bacteria could ferment sucrose, sorbital, glucose, mannose, lactose and hydrolyze sodium hippu- rate. [ Conclusion] Through drug sensitive test, it indicated that swine streptococcus suis was highly sensitive to cephalosporin, ciprofloxacin and penicillin, and showed resistance to kanamycin, oxytetracycline, streptomycin and gentamicin.

Cultural drivers and health-seeking behaviours that impact on the transmission of pig-associated zoonoses in Lao People’s Democratic Republic

Pig rearing is an important income source in the Lao People’s Democratic Republic(PDR),with many smallholder farmers using traditional free-range pig production systems.Despite the potentially significant health risks posed by pig production regarding pig-associated zoonoses,information on the sociocultural drivers of these zoonoses is significantly lacking.This review summarises the existing sociocultural knowledge on eight pig-associated zoonoses suspected to be endemic in Southeast Asia:brucellosis,Q fever(Coxiella burnetii),trichinellosis,hepatitis E virus,leptospirosis,Japanese encephalitis,Streptococcus suis and Taenia solium taeniasis-cysticercosis.It summarises current knowledge on these diseases grouped according to their clinical manifestations in humans to highlight the propensity for underreporting.A literature search was conducted across multiple databases for publications from 1990 to the present day related to the eight pig-associated zoonoses and the risk and impact connected with them,with Lao PDR as a case study.Many of these pig-associated zoonoses have similar presentations and are often diagnosed as clinical syndromes.Misdiagnosis and underreporting are,therefore,substantial and emphasise the need for more robust diagnostics and appropriate surveillance systems.While some reports exist in other countries in the region,information is significantly lacking in Lao PDR with existing information coming mainly from the capital,Vientiane.The disease burden imposed by these zoonoses is not only characterised by morbidity and mortality,but directly impacts on livelihoods through income reduction and production losses,and indirectly through treatment costs and lost work opportunities.Other factors crucial to understanding and controlling these diseases are the influence of ethnicity and culture on food-consumption practices,pig rearing and slaughter practices,hygiene and sanitation,health-seeking behaviours and,therefore,risk factors for disease transmission.Published information on the knowledge,attitudes and beliefs of people regarding pig zoonoses and their risk factors is also extremely limited in Lao PDR and the broader Southeast Asian region.The need for more transdisciplinary research,using a One Health approach,in order to understand the underlining social determinants of health and their impacts on health-seeking behaviours,disease transmission and,ultimately,disease reporting,cannot be more emphasized.