The brucellosis situation in Jordan

In Jordan, a new national study conducted by the Middle East Community Health Network (AMPHNET) in collaboration with the Ministry of Health, the Ministry of Agriculture, Royal Medical Services, the Princess Haya Center for Biotechnology and US Centers for Disease Control and Prevention (CDC), revealed that the incidence and prevalence of brucellosis in Governors Mafraq and Karak is the highest in the Kingdom. The study conducted in the areas of the Jordanian governors Mafraq, Karak and east of the capital Amman, the risk factors for infection and exposure to animals are the highest.

The transmission rate of the disease in the Kingdom is between 10 and 20 cases per year. 100,000 inhabitants, which is considered to be a relatively low percentage, while the infection rate in some countries in the region is between 50 and 100 cases per. 100,000 inhabitants.

Reminders on brucellosis :

Brucellosis (sometimes also called malt fever) is an animal disease that can be transmitted to humans (zoonosis). It is caused by bacteria of the genus Brucella. Three species dominate: Brucella melitensisthe most pathogenic, invasive and widespread species in the world, B. abortus, and B. am. There are other less common species with variable pathogenicity to humans (B. canis, B. ovis, B. marimum, B. inopinataetc.).

Epidemiology

That Brucella found in most mammalian species, including ruminants, domestic animals and wild animals, as well as squirrels (pigs and wild boars) and lagomorphs (hares). Those that infect humans come mainly from domestic cattle, sheep, goats and pigs. The fact that wildlife acts as a reservoir for infection complicates the extermination effort.
This bacterial zoonosis is widespread throughout the world. The annual incidence is 500,000 reported cases.

People can be infected in several ways:

  • by direct contact (penetration of the germ through the skin or mucosa favored by wounds or cuts) with infected animals, animal carcasses, abortion products, placentas, animal vaginal secretions, manure or by accidental contact with biological products in laboratories; this type of contamination concerns persons in direct contact with infected animals (breeders, veterinarians, inseminators, slaughterhouse or destruction personnel) and, much less frequently, laboratory personnel during veterinary or medical tests;
  • by consuming contaminated food (unpasteurized milk and dairy products from contaminated animals, more rarely raw vegetables contaminated with manure or unusually inadequately cooked meat and offal); it is the main form of pollution among travelers who share the way of life of the local population, especially with regard to food;
  • by inhalation (of waste dust, contaminated aerosol in laboratories or slaughterhouses), the bacteria being able to survive for several months outside the animal’s body, in the external environment, especially in cold and humid conditions.

Brucellosis is one of the most serious animal diseases considering the causes caused by infection in animals. Decreased milk production, weight loss, loss of pups, infertility and lameness are some of the effects on animals.

Clinical aspects of human brucellosis:

The incubation period for brucellosis is variable, from one week to several months. The primary infection may be asymptomatic, and the disease may not appear until several months or years later. In the symptomatic forms, the clinical signs are quite variable, but usually develop in three stages:

  • A phase of acute primary invasion: fever associated with myalgia, malaise;
  • A secondary phase in which isolated or multiple infectious foci form: osteo-articular (spondylodiscitis, arthritis of the knee, etc.), genitourinary (orchitis, epididymitis), hepatic (liver abscess), neurological (meningitis, meningo-encephalitis, brain abscess)…) , heart (endocarditis…)
  • Possibly, especially in the case of inadequate or poorly followed treatment, a chronic phase, the expression of which is twofold:

Either a general symptomatology (asthenia, pain, fatigue),
Either a more focal symptomatology (chronic development of infectious foci).

Once the diagnosis is confirmed, the treatment of human brucellosis is based on the administration of specific antibiotics for several weeks, and if necessary surgical treatment of the infectious foci. Mortality is less than 2% even without treatment.

Prevention

  • Prevention of occupational pollution is based on biosafety and hygiene measures in the workplace: washbasins, gloves, masks and goggles, etc.
  • The control of contamination of food origin with Brucella takes place either by pasteurization or sterilization of the milk or by the use of raw milk from herds officially recognized free of brucellosis.

The traveler should avoid unpasteurized dairy products and undercooked meat, especially when traveling to countries where brucellosis is endemic.

Source: ProMED.


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