Serotesting of Human Brucellosis on Wider Area of Bosnia and &Herzegovina Sadeta Hamzić¹*, Edina Bešlagić¹, Šukrija Zvizdić¹, Mufida Aljičević¹, Omer Bešlagić², Sandra Puvačić³
. Department of Microbiology, School of Medicine, University of Sarajevo,Čekaluša , Sarajevo, Bosnia and Herzegovina . Department of Patophysiology, School of Medicine, University of Sarajevo, Čekaluša , Sarajevo, Bosnia and Herzegovina . Institute of Epidemiology, School of Medicine, University of Sarajevo, Čekaluša , Sarajevo, Bosnia and Herzegovina
* Corresponding author
Abstract
The study involved individuals from different regions of Bosnia and Herzegovina, whose sera were tested in the Laboratory for specific diagnosis of human brucellosis in Microbiol- ogy Department of Medical Faculty of University in Sarajevo, during the period from . to . Sera were tested using Brucelloslide Test, qualitative agglutination test Rose Bengal. Using the agglutination test, we serologically confirmed a diagnosis of human brucellosis in (.) seropositive individuals, whereof (.) men and (.) women. In- dividuals with human brucellosis were the most present in the age group of - (.) and - (.). One serologically confirmed death case was registered. The most sero- positive individuals were from Zenica-Doboj Canton (.), Sarajevo Canton (.), Herzegovina-Neretva Canton (.), Central Bosnia Canton (.) and Una-Sana Can- ton (.). During our four-year study, it was serologically confirmed that human brucel- losis is present in Bosnia and Herzegovina and, through seropositive testing, we revealed the level of general exposition to Brucella spp. on wider area of Bosnia and Herzegovina.
KEY WORDS: Brucella, human brucellosis, serodiagnosis, Bosnia and Herzegovina.
BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES 2005; 5 (3): 46-49 SADETA HAMZIĆ ET AL.: SEROTESTING OF HUMAN BRUCELLOSIS ON WIDER AREA OF BOSNIA AND HERZEGOVINA
Introduction of University in Sarajevo. Blood samples were collected by venipuncture, and isolated serum samples were pre- Genus Brucella is consisted of small, immobile, Gram- served on –C until testing. Sera were tested using Bru- negative coccobaccili which are pathogenic for humans celloslide Test, qualitative agglutination test Rose Bengal. and animals. The first human cases of brucellosis were described in ., by J.A. Marston, physician with the Results British army settled in Malta (). Brucellae are intra- cellular parasites that can be transmitted to a range of Out of clinically suspect serotested individuals during animal species, including humans (). Four Brucella the four-year period mentioned above, anti-Brucella an- species, B. abortus, B. melitensis, B. suis and B. canis, tibodies were detected in tested sera in (,) indi- can cause brucellosis when transmitted to humans. viduals, while the result of agglutination test Rose Bengal General infection routes in humans are digestive tract remained negative in (,) individuals (Chart ). (consuming contaminated milk), mucosa (splashing Serotesting results for individuals clinically sus- route), skin (contact with infected animal tissues) or pected to have human brucellosis are represent- inhalation. Brucellosis is a system-affecting disease ed in Table ., for the period from . to . able to involve any of the major organ systems. Clini- During ., individuals clinically suspected to cal disease manifestations are therefore very different. have brucellosis, were serotested. Agglutination test The most frequent described symptoms include peri- was positive in (,) individuals, while the re- odical fever, cold, night sweating, headache, physical sult remained negative in (.) individuals. Dur- pains, anorexia and weakness. Additionally, infection ing ., individuals were serotested, whereof focuses can occur in liver, reticuloendothelial system, (,) individuals had a positive agglutination test, bones and joints, urogenital tract, central nervous sys- while the result remained negative in (,) in- tem, eyes, skin, lungs and heart (endocarditis) (). The dividuals. Out of individuals serotested in ., treatment of brucellosis includes a logn-term antibiotic therapy, with recurrences if the therapy is discontinued too early or if microorganisms are in particularly deep focus of infection. These recurrences usually occur in or months after the therapy discontinuation. Con- trolling and supervising brucellosis is based on limited disease spreading and possible eradication of the infec- tion in animals, pasterizing the milk and milk products, and reducing professional risk, wherever it is possible.
Patients and Methods
During the period from . to ., sera from in- dividuals from different regions of Bosnia and Herzegov- ina, clinically suspected to have brucellosis, were tested in the Laboratory for specific diagnosis of human bru- cellosis in Microbiology Department of Medical Faculty
BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES 2005; 5 (3): 46-49 SADETA HAMZIĆ ET AL.: SEROTESTING OF HUMAN BRUCELLOSIS ON WIDER AREA OF BOSNIA AND HERZEGOVINA
(,) individuals had a positive agglutination test, of cases reported in endemic areas varies between while the result remained negative in (,) indi- and per inhabitants, with serological di- viduals. During ., individuals were serotested, agnosis in minimum of human population (). whereof (,) individuals had a positive agglu- Professions traditionally related to the higher risk in- tination test, while the result remained negative in clude farmers, veterinarians, shamblers and butchers, (,) individuals. Chart . represents the rate be- as well as laboratory personnel. However, effective con- tween seropositive and negative individuals in overall trol steps in ranch industry, as well as more frequently diagnostic specimen for the period from . to . consuming unpasterized milk products, lead to the fact Out of seropositive individuals, there were (,) that brucellosis is disease most commonly caused by men and (,) infected women. The most sero- nutrition (). Significant increase in the proportion of positive individuals were confirmed in the age group food-home transmissions is the main reason for a great of - (,) and - (,). One serologically need for tests that would be fast and reliable detectors confirmed death case was registered. Out of sero- of brucellae in food and environment. Through specific positive individuals confirmed during ., of them diagnostic of the cases suspected for human brucel- (,) were from Mostar, (,) from Sarajevo, losis, as well as through seroprevalent testing, we tried (,) from Gornji Vakuf, (,) from Blagaj. Three to reveal a level of general exposition to Brucella spp. seropositive individuals in . were from Sarajevo. Immediate actions should focus on public education During ., out of seropositive individuals, of them that will help decrease the risk of brucellosis: Supervis- (,) were from Zenica, while (,) from Sarajevo. ing and controlling disease outbreaks in already deter- During ., we had seropositive individuals, where- mined seats. Defining sources and routes of disease of (,) from Zenica, (,) from Sarajevo, transmissions. Consume only boiled or pasteurized milk, (,) from Konjic, (,) from Busovača, (,) or dairy products prepared from milk treated in this way. from Visoko, (,) from Travnik and (,) from Wash hands thorougly after handling raw meat or milk. Novi Travnik, Cazin, Breza, Žepče, Olovo and Tešanj. The results of serological diagnosis of human brucello- Conclusions sis for cantons, for the period from . to ., are represented in Table . During the four-year period, we . Detecting specific anti-Brucella antibodies using recorded the highest seroprevalence of human brucel- agglutination test Rose Bengal, we serologically losis in Zenica-Doboj Canton (,), Sarajevo Canton diagnosed human brucellosis in (.) clinically (,), Herzegovina-Neretva Canton (,), Central suspect individuals. Bosnia Canton (,) and Una-Sana Canton (,). . The highest prevalence of human brucellosis was present in Zenica-Doboj Canton (.). Discussion . Agglutination test Rose Bengal can provide a useful diagnostic information. Brucellosis is a zoonosis of the world-wide impor- . A fast diagnostic of human brucellosis has important tance, especially in developing countries. According to implications of public health and laboratory security. the World Health Organization, the annual incidence
BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES 2005; 5 (3): 46-49 SADETA HAMZIĆ ET AL.: SEROTESTING OF HUMAN BRUCELLOSIS ON WIDER AREA OF BOSNIA AND HERZEGOVINA
References
() Marsten J. A. Report on fever (Malta). Great Br. Army Med. Dept. () Chomel B. B., De Bess E.E., Mangiamele D.M., Reilly K.F., Farver Rep. ; :-. T.B., Sun R.K., Barett L.R. Changing trends in the epidemiology of () Corbel M.J., Brinley – Morgan W.J. Genus Brucella. Bergey’s human Brucellosis in California from to : A shift toward manual of systematic bacteriology, ; :- food-home transmission. J. Infect. Dis, ; :-. () Young E. J., Mandell G.L., Benett J.E., Dolin R. Brucella species. () Bešlagić O. Sero-epidemiološka istraživanja bruceloze među Principles and practice of infectious diseases, ; :-. stanovnicima ugroženih područja u Federaciji Bosne i Hercegov- () World Health Organization. Brucellosis. Fact sheet N. www. ine. Diplomski rad, Medicinski fakultet Univerziteta u Sarajevu, who.int/inffs/en/fact_.html. (Online) World Health Organi- . zation, Geneva, Switzerland. .
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