Brucellosis outbreak: Analysis of risk factors and serologic screening

Israel is one of the Mediterranean countries in which Brucellosis is endemi c. As recently there has been a Brucellosis outbreak in a Kibbutz, the aim of this study is to identify asymptomatic infected Kibbutz members, and to delineate the manner of infection in this setting. Therefore, all the asymp tomatic Kibbutz members were screened by the Rose Bengal test for Brucellos is, while both patients and healthy members were asked to fill in a questio nnaire in order to pinpoint the manner of infection, and signs and symptoms of the disease. In addition to the 14 patients with Brucellosis, 2 other K ibbutz members were also found to be infected by the screening tests. Analy sis of the data of the questionnaires from 142 healthy and 16 patients disc losed that almost all of the infected patients (15/16) worked in the cowshe d, as opposed to only 24 out of 142 (16.9%) of the healthy members. The inf ected tended to participate more in calf deliveries, and had contact with c ow's blood and placenta, compared with the healthy subjects (P<0.001), whil e there were no significant differences with respect to having cuts on hand s, or working in the cowshed without gloves. In addition, 15 out of 16 (93. 8%) infected persons also drank unpasteurized milk, as compared with only 1 7 of the 142 (12%) healthy members (P<0.001), and thus were exposed to 2 ma jor risk factors (working in the cowshed and consumption of unpasteurized m ilk). As the cows of the Kibbutz's cowshed were affected by Brucella melite nsis (which usually affects flocks of goats and sheep rather than cows), th e microbe was probably transmitted to the cowshed from neighboring flocks b y wandering dogs, and then to the infected humans.