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Imported brucellosis: A case series and literature review
Francesca F Norman1, Begoña Monge-Maillo1, Sandra Chamorro-Tojeiro1
1National 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.
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.
Insights
Imported brucellosis cases, often linked to travel or contaminated products, pose public health risks. Timely recognition is crucial for preventing disease spread in non-endemic regions.
Area of Science:
- Zoonotic disease epidemiology
- Infectious disease surveillance
- Public health
Background:
- Brucellosis is a significant neglected zoonotic disease with complex epidemiological factors.
- Imported cases and those linked to products are underreported.
- Understanding transmission is key to control.
Observation:
- A European referral unit analyzed imported brucellosis cases.
- Literature review focused on imported cases and product-associated transmission.
- Brucellosis presents with diverse symptoms, sometimes leading to misdiagnosis.
Findings:
- Most imported brucellosis stems from travel or consuming unpasteurized dairy in endemic areas.
- Imported food products and animals also transmit Brucella.
- Higher incidence occurs in specific immigrant populations, despite lower overall rates in developed countries.
Implications:
- Importation of Brucella into non-endemic areas presents public health challenges.
- Early diagnosis and intervention are essential for managing imported brucellosis.
- Awareness is critical for healthcare providers in non-endemic regions.
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