Brucella: A Bioterror Zoonotic Disease

It is Important to Monitor and Curb Brucella Outbreaks

Eating raw or unpasteurized dairy products is the most common way to get Brucellosis from animals. It can also be spread through the air. Touching the body fluids of an infected animal can also transmit the infection to humans. 

Brucellosis cannot be transmitted from person to person like a cold virus. However, it can spread quickly in the air, and many people can get infected simultaneously [5]. When aerosolized, it can also cause widespread harm as a bioterror agent. 

The Brucella species of bacteria are, in fact, a perfect storm of a bioterror threat because they are easy to grow, store, transfer, and circulate. When Brucella is aerosolized and released, it can cause serious health issues, even though the human mortality rate is low [6].

Symptoms of Brucellosis in Humans

Brucellosis, the infection caused by the Brucella bacteria, causes fever, chills, fatigue, sweats, joint pain, and headaches. The mortality rate is low. The incubation period is, on average, 2 – 4 weeks. It is essential to keep an eye out for recurrence because Brucellosis symptoms can vanish and return after a few weeks or months. Some people end up with Chronic Brucellosis that can last years. 

In animals, Brucella can cause reproductive issues leading to abortions. As a result, there is an economic loss for farmers and cattle herds, who may have to cull many infected animals. They are also at risk of getting infected if proper safety protocols for handling animals are not followed [7]. Because Brucella infections can cause widespread problems for humans and livestock and is a potential biothreat, the worlds of epidemiology and public health welcome the latest studies on this issue. 

The Latest Research On Brucella

• Brucella in Palestine
  • Aljanazreh et al. (July 2021) studied the resurgence of Brucellosis in Palestine from 2015 to 2017 after a decade without it. Even though Palestine had a Brucellosis Control Program since 1998, cases began to emerge after 2012. A similar pattern was found in their neighbor, Israel. DNA analysis found that all isolates were Brucella melitensis strains of a local origin. The authors used the GIDEON infectious diseases database to map the epidemiology of Brucella outbreaks within the country. To prevent further disease recurrence, the researchers proposed strengthening Palestinian and Israeli Brucellosis control programs. Longer-term cooperation between key stakeholders is also crucial for long-term success in preventing Brucellosis in the region [8].

• Brucella in Tunisia
  • Battikh et al. (March 2021) reported on Brucellosis’s clinical and laboratory features in Tunisia. The country saw a rise in Brucellosis cases from 2014 to 2017. It prompted this study about patients hospitalized in the Rabta university hospital in the capital city of Tunis. The authors relied on the GIDEON infectious disease database for Brucellosis incidence and prevalence data as part of the study.
  • They concluded that Brucellosis is still endemic in Tunisia. Most infected patients in the hospital seemed to have consumed raw milk or milk products. The surge in cases was due to less stringent vaccination efforts for cattle and livestock, lower border controls since 2011, illegally importing livestock, and insufficient health checks at critical facilities [9].

• Brucella in Greece
  • Katsiolis et al. (preprint, 2021) published about detecting Brucellosis in ruminant herds in Greece. The researchers emphasize the economic significance of their study apart from health concerns. Brucellosis can cause reproductive issues in animals and abortions in herds. Along with other European countries, Greece also applied control and eradication programs for sheep, goats, and cows. Since current laboratory Brucella detection methods have several challenges, the study proposes a new diagnostic tool for better reliability in detecting Brucella from samples [10].

• Brucella in Kazakhstan
  • Nicolaevna Gavrilova et al. from Kazakhstan (August 2021) studied the effect of a Lactobacillus-based probiotic to help prevent Brucella outbreaks. The researchers used information from GIDEON about how Brucella affects humans as part of their discussion on important it is to curtail the periodic epizootic outbreaks that occur in hot spots. The study concluded favor using probiotics for prophylactic and therapeutic reasons to reduce bacterial load in infected mice [11].

• Brucella in Costa Rica
  • Rosales Galeano et al. (2020) addressed the under-reporting of Brucellosis cases in Costa Rica. The authors studied cases between 2015 and 2017 for people working on dairy farms. They found seroprevalence for smooth Brucella spp. was 12.5%. Risky cultural practices were the main reasons for the prevalence.
  • These include preparing and consuming food with unpasteurized milk products, artificial insemination, and birthing calves without adequate protection. The study references data from GIDEON when discussing Brucellosis epidemiology and worldwide incidence and prevalence [12].

• Brucella study from Ethiopia
  • Rosales Galeano et al. (2019) reviewed Brucellosis’s epidemiology, diagnosis, control, and prevention. The authors discuss how Brucella was first identified, isolated, and eliminated in developed countries. The article discusses how developing countries must implement similar stringent methods of animal immunization, farm sanitation, and more [13].

• Brucella in Armenia
  • Sargsyan et al. (2019) published their acute and chronic Brucellosis observations from an 11-year audit of a tertiary hospital in Armenia. Data from the GIDEON infectious diseases database helped them understand the epidemiology of Brucellosis outbreaks in Armenia. This research was significant because brucella incidence had been almost twice as high in Armenia than in other countries. Cases in Armenia have doubled over the last three decades.
  • The authors studied patients hospitalized between the years 2006 to 2016. They found that most of them were primarily males between the ages of 20-60. Many had not sought medical help until almost two months after they developed symptoms. The authors stressed the importance of targeted educational campaigns to help lower the prevalence of this disease [14].

Please note that while this list is a curated list of some significant research, it is not comprehensive. Here are more studies for further reading: 

• Comparisons of Brucellosis between human and veterinary medicine
• First case-control study of zoonotic Brucellosis in Gafsa district, southwest Tunisia
• Molecular Assay of the Contamination of the Vaccinated Livestock Milk from West South of Iran: a Warning Report Against Brucellosis
• Accidental laboratory exposure to Brucella melitensis: the prospective post-exposure management and a detailed investigation into the nature of the exposure

Conclusion

Eliminating Brucellosis from the developing world requires collaboration, awareness-building, and education among communities that work closely with animals. Since Brucellosis often presents with flu-like symptoms, frontline clinicians in high and moderate risk regions must test for Brucellosis to account for potential cognitive biases. Public health officials worldwide must implement rigorous Brucella control programs and encourage more studies on Brucellosis to help identify and protect vulnerable populations.