Francesca F Norman1, Begoña Monge-Maillo2, Sandra Chamorro-Tojeiro2, Jose-Antonio Pérez-Molina2, Rogelio López-Vélez2. 1. National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, Ctra. de Colmenar Km 9, Madrid 28034, Spain. Electronic address: ffnorman@gmail.com. 2. National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, Ctra. de Colmenar Km 9, Madrid 28034, Spain.
Abstract
BACKGROUND: Brucellosis is one of the main neglected zoonotic diseases. Several factors may contribute to the epidemiology of brucellosis. Imported cases, mainly in travellers but also in recently arrived immigrants, and cases associated with imported products, appear to be infrequently reported. METHODS: Cases of brucellosis diagnosed at a referral unit for imported diseases in Europe were described and a review of the literature on imported cases and cases associated with contaminated imported products was performed. RESULTS: Most imported cases were associated with traditional risk factors such as travel/consumption of unpasteurized dairy products in endemic countries. Cases associated with importation of food products or infected animals also occurred. Although a lower disease incidence of brucellosis has been reported in developed countries, a higher incidence may still occur in specific populations, as illustrated by cases in Hispanic patients in the USA and in Turkish immigrants in Germany. Imported brucellosis appears to present with similar protean manifestations and both classical and infrequent modes of acquisition are described, leading on occasions to mis-diagnoses and diagnostic delays. CONCLUSIONS: Importation of Brucella spp. especially into non-endemic areas, or areas which have achieved recent control of both animal and human brucellosis, may have public health repercussions and timely recognition is essential.
BACKGROUND:Brucellosis is one of the main neglected zoonotic diseases. Several factors may contribute to the epidemiology of brucellosis. Imported cases, mainly in travellers but also in recently arrived immigrants, and cases associated with imported products, appear to be infrequently reported. METHODS: Cases of brucellosis diagnosed at a referral unit for imported diseases in Europe were described and a review of the literature on imported cases and cases associated with contaminated imported products was performed. RESULTS: Most imported cases were associated with traditional risk factors such as travel/consumption of unpasteurized dairy products in endemic countries. Cases associated with importation of food products or infected animals also occurred. Although a lower disease incidence of brucellosis has been reported in developed countries, a higher incidence may still occur in specific populations, as illustrated by cases in Hispanic patients in the USA and in Turkish immigrants in Germany. Imported brucellosis appears to present with similar protean manifestations and both classical and infrequent modes of acquisition are described, leading on occasions to mis-diagnoses and diagnostic delays. CONCLUSIONS: Importation of Brucella spp. especially into non-endemic areas, or areas which have achieved recent control of both animal and humanbrucellosis, may have public health repercussions and timely recognition is essential.
Authors: Sabine Zange; Kim Schneider; Enrico Georgi; Holger C Scholz; Markus H Antwerpen; Mathias C Walter; Lothar Zoeller; Heiner von Buttlar; Johannes P Borde Journal: Infection Date: 2019-05-09 Impact factor: 3.553
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