Spread of brucellosis in Syria

In Syria, the head of the Department of Infectious and Chronic Diseases of the As-Suwayda government in the southwestern part of the country bordering Jordan announced that an increase in the number of cases of brucellosis had been recorded in the last 2 months. . During May and June 2022, approximately 80 cases were reported out of the 215 registered cases since the beginning of this year.

One of the reasons for the spread of the disease is not boiling milk properly, especially when making cheese and dairy products.

Reminders about 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. abortionand 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 eradication 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 excisions) 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 involves people in direct contact with infected animals (breeders, veterinarians, inseminators, slaughterhouse or destruction staff) and, much less frequently, laboratory staff during veterinary or medical tests;
  • by consuming contaminated food (unpasteurized milk and dairy products from contaminated animals, less frequently raw vegetables contaminated with manure or unusually inadequately prepared 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 livestock diseases considering the damage 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 at work: 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 poorly cooked meat, especially when traveling to countries where brucellosis is endemic.

Source: ProMED.


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