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21/1/2008 Dr. Salwa Tayel (Brucellosis) 1 Brucellosis By Dr. Salwa Tayel Associate Professor Family and Community Medicine Department King Saud University 21/1/2008 Dr. Salwa Tayel (Brucellosis) 2 3 Dr. Salwa Tayel (Brucellosis) 21/1/2008 Brucellosis (Malta fever) • Brucellosis is primarily a disease affecting animals. It can be transmitted to humans. • It is an old disease, Sir David Bruce, isolated the causative agent from a soldier in Malta in 1886 • It remains the commonest zoonotic disease worldwide. 4 Dr. Salwa Tayel (Brucellosis) 21/1/2008 Brucellosis Clinical picture • An illness characterized by – acute or gradual onset of fever, – night sweats, – undue fatigue, – anorexia, – weight loss, – headache, and – arthralgia 5 Dr. Salwa Tayel (Brucellosis) 21/1/2008 The new global map of human brucellosis 2006 6 Dr. Salwa Tayel (Brucellosis) 21/1/2008 Agent: Brucella species; bacteria Reservoir: Cattle, Sheep and Goat & camel, Swine, ……. 7 Dr. Salwa Tayel (Brucellosis) 21/1/2008 The most important routes of animal to human transmission of Brucella 8 Dr. Salwa Tayel (Brucellosis) 21/1/2008 1. Ingestion • Consumption of potentially infected unpasteurized milk, milk products, or meat. • Unpasteurized cheese, called "village cheese," from endemic areas is a particular risk for tourists. 9 Dr. Salwa Tayel (Brucellosis) 21/1/2008 2. Direct contact with infected animals, aborted fetus, the placenta and the discharge from vagina. • Accidental self inoculation of vaccines. High Risk Groups • slaughter-house workers, meat inspectors, animal handlers and veterinarians. 10 Dr. Salwa Tayel (Brucellosis) 21/1/2008 3. Inhalation of aerosols containing the bacteria – aerosol contamination of the conjunctiva • In the lab, transmission is via aerosolization High Risk Groups • Laboratory workers. 11 Dr. Salwa Tayel (Brucellosis) 21/1/2008 Transmission • In the Middle East and Africa ingestion of contaminated dairy products is an important route of infection. • In USA, Human brucellosis is primarily an occupational hazard (Lab, Vet) 12 Dr. Salwa Tayel (Brucellosis) 21/1/2008 Prevention 1. Eradication of brucellosis in animals is the key to prevention in humans. • surveillance, serologic testing, quarantine and massive immunization of animals in areas with high infection rates • legislation to control marketing and movement of animals. 13 Dr. Salwa Tayel (Brucellosis) 21/1/2008 Prevention 2. Brucellosis acquired from milk is preventable • Legislation to pasteurization of milk and dairy products. • Public health education to avoid drinking untreated milk and dairy products. 3. Health education for those occupationally at risk (Use of Safety measures). 14 Dr. Salwa Tayel (Brucellosis) 21/1/2008 Vaccination?! • A human Brucella vaccine does not exist . • For animals: all are live-attenuated. • Currently, B. abortus RB51 is used to immunize cattle • B. melitensis REV.1 is used to immunize goats and sheep. 15 Dr. Salwa Tayel (Brucellosis) 21/1/2008 Bibliotheca Alexandrina Thank you [email protected] 16 Dr. Salwa Tayel (Brucellosis) 21/1/2008 17 Dr. Salwa Tayel (Brucellosis) 21/1/2008