Brucellosis among hospital employees in Saudi Arabia

To report experience with brucellosis among expatriate hospital employees in an area of the world where brucellosis is endemic.

Review of cases from the viewpoints of direct supervisor and treating physician, including epidemiologic interviews and clinical follow-up.

Tertiary care hospital center in a developing country that increased from 125 beds to 450 beds during the period studied.

Employees with clinical findings suggesting brucellosis and in whom a positive blood culture or significantly elevated serologic test confirmed the diagnosis.

Nine hospital employees from nonendemic areas developed brucellosis. Five were from England and four from North America. Seven were bacteriology technologists, one was a nurse, and one was an obstetrician. Each had an acute febrile illness with malaise, arthralgia, or headache. Brucella titers were > or = 1:1,280. Five were bacteremic with positive Brucella cultures. All responded to anti-Brucella therapy. Three patients had relapses, but there were no complications.

Among Saudi patients, brucellosis is generally attributable to drinking infected milk or contacting infected animals. On the other hand, among expatriate hospital employees, the infection is likely due to processing Brucella cultures or dealing with infected body fluids. In 1988, the laboratory began stricter infection control measures. Since then, there has been only one case of brucellosis among the hospital employees.