Screening of the family members of patients with acute Brucellosis in Southeast Iran

Unrecognized pediatric and adult family members of children with acute brucellosis

BACKGROUND AND AIM

Brucellosis is an infectious, contagious and zoonotic disease that occurs worldwide. The family members of an index case of brucellosis may be especially susceptible, due to sharing the same source of infection and similar risk factors for brucellosis. In this study, we propose to screen pediatric and adult family members of brucellosis index cases for detecting additional unrecognized infected family members.

MATERIALS AND METHODS

114 family members of 41 pediatric patients with brucellosis were evaluated. All family members completed a brief questionnaire and were tested by a standard tube agglutination test (STA).

RESULTS

The majority of family members (n=96, 84.2%) were children. Among the 114 family members, 42 (36.8%) were seropositive, and 15 (35.7%) were symptomatic. The majority of the symptomatic seropositive family members (n=12, 80%) had STA titers (≥1:640) higher than asymptomatic seropositive family members (n=9, 33%; p=0.004).

CONCLUSION

The routine screening of both pediatric and adult family members of index cases is a priority in endemic areas. Using this screening approach, unrecognized family members who are seropositive for brucellosis will be identified earlier and be able to receive prompt treatment.

Expansion of brucellosis detection in the country of Georgia by screening household members of cases and neighboring community members

Background

Brucellosis is considered as endemic zoonotic disease in the country of Georgia. However, the burden of the disease on a household level is not known. Therefore, this study sought to determine the benefits of active surveillance coupled to serological screening for the early detection of brucellosis among close contacts of brucellosis cases.

Methods

We used an active surveillance approach to estimate the rate of seropositivity among household family members and neighboring community members of brucellosis index cases. All participants were screened using the serum tube agglutination test (SAT). Blood cultures were performed, obtained isolates were identified by a bacteriological algorithm, and confirmed as Brucella spp. using real-time PCR. Further confirmation of Brucella species was done using the AMOS PCR assay.

Results

A total of 141 participants enrolled. Of these, 27 were brucellosis index cases, 86 were household family members, and 28 were neighboring community members. The serological evidence of brucellosis in the household member group was 7% and the rate at the household level was 21%. No screened community members were Brucella seropositive. Majority of brucellosis cases were caused by B. melitensis; only one index case was linked to B. abortus.

Conclusion

We found evidence of brucellosis infection among household family members of brucellosis index cases. B. melitensis was the most common species obtained. Findings of this active surveillance study highlight the importance of screening household family members of brucellosis cases and of the use of culture methods to identify Brucella species in the country of Georgia.

Clinical profile and management of brucellosis in Tehran - Iran

BACKGROUND

Brucellosis is one of the most frequent infectious diseases in many regions of Iran. The purpose of this study was to evaluate different clinical, laboratory and therapeutic aspects of this disease.

METHOD

This retrospective descriptive study was performed on patients referred to two teaching hospitals in Tehran/Iran with brucellosis diagnosis during the years 1998 - 2005. Patients' signs and symptoms, laboratory findings and clinical responses were evaluated during the study period.

RESULTS

More than half of the 415 patients enrolled in this study were female. The duration of the symptoms was reported to be less than 2 months in 83.85% of the patients prior to being examined in our centre. While sweating and fever were the most common symptoms, peripheral arthritis, sacroiliitis and splenomegaly were the most frequently reported signs. Rifampin plus cotrimoxazole was the most common regimen administered in these cases (32%) and relapse was also more frequently seen in this group of patients (13.8%), whilst doxycycline and cotrimoxazole led to the least number of relapses (2.5%).

CONCLUSIONS

Brucellosis is known to have various manifestations, so it should be considered as one of the differential diagnoses of any patient referred with different organs involvement accompanied with or without fever. Relapse is one of the complications reported even following an appropriate treatment.