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Background  Lack of clear risk factor identification is the main reason for the persistence of brucellosis infection in the Chinese population, and there has been little assessment of the factors contributing to  Brucella  contamination of raw whole milk. The purpose of this study was to identify risk factors affecting  Brucella  contamination of raw milk, and to evaluate effective measures for disease reduction in order to determine preventive strategies.    Methods and Findings  A nationwide survey was conducted and samples were obtained from 5211 cows corresponding to 25 sampling locations throughout 15 provinces in China. The prevalence of  Brucella  in the raw milk samples averaged 1.07% over the 15 Chinese provinces, while the prevalence of positive areas within these regions ranged from 0.23–3.84% among the nine provinces with positive samples. The survey examined factors that supposedly influence  Brucella  contamination of raw whole milk, such as management style, herd size, abortion rate, hygiene and disease control practices. A binary logistic regression analysis was carried out to determine the association between risk factors for  Brucella  and contamination of milk samples. Furthermore, a relative effect decomposition study was conducted to determine effective strategies for reducing the risk of  Brucella  contamination of raw whole milk. Our data indicate that disease prevention and control measures, abortion rate, and animal polyculture are the most important risk factors. Meanwhile, culling after quarantine was identified as an effective protective measure in the current Chinese dairy situation.    Conclusions  These results indicate that, although there is a low risk of contamination of milk with  Brucella  nationwide in China, there are individual regions where contamination is a significant problem. Controlling three factors–culling after quarantine, maintaining a low abortion rate, and avoiding mixing groups of cattle and small ruminants–could effectively reduce the risk of  Brucella  contamination of raw whole milk.

Identification and Effect Decomposition of Risk Factors for Brucella Contamination of Raw Whole Milk in China