Sofian Masoomeh, Safaeipour Leila, Aghakhani Arezoo, Sharif Mohammad Reza, Banifazl Mohammad, Sharif Alireza, Farazi Ali-Asghar, Eslamifar Ali, Didgar Farshideh, Ramezani Amitis
Tuberculosis and Pediatric Infectious Research Center, Arak University of Medical Sciences, Arak, Iran.
Arak University of Medical Sciences, Arak, Iran.
Iran J Microbiol. 2013 Sep;5(3):215-9.
Brucellosis is a zoonotic disease and it's still endemic in Iran. There are some reports regarding brucellosis infection in family members sharing same risk factors and remain unrecognized. However, few studies on the importance of family screening are available. We aimed to screen household members of index cases with acute brucellosis for detecting additional unrecognized cases in central province of Iran.
163 family members of 50 index cases were enrolled in the study. Standard Tube Agglutination Test (STA) and 2-mercaptoethanol (2ME) agglutination were checked in all samples. A case with STA titer ≥ 1:80, 2-mercaptoethanol (2ME) agglutination ≥ 40 and compatible signs and symptoms was considered positive for brucellosis.
15 (9.2%) of family members were seropositive for Brucella agglutinin and among them, 8 (53.3%) were asymptomatic and 7 (46.7%) were symptomatic. STA titer ranged from 1:80 to 1:640 in seropositive members. 4 of the 15 seropositive cases who identified by screening came from one index case with 6 family members. All symptomatic seropositive cases treated for Brucella infection and recovered without any complications in 6 months follow up.
On the basis of our data, family members of brucellosis patients are at risk of disease acquisition, and screening of household members provides an effective way for early diagnosis and prompt treatment. However cost benefit of screening should be evaluated to reach definite decision for the implementation of the screening as a nationwide program.
布鲁氏菌病是一种人畜共患病，在伊朗仍然流行。有一些关于具有相同危险因素的家庭成员感染布鲁氏菌病但未被识别的报道。然而，关于家庭筛查重要性的研究很少。我们旨在对伊朗中部省份急性布鲁氏菌病确诊病例的家庭成员进行筛查，以发现其他未被识别的病例。
本研究纳入了50例确诊病例的163名家庭成员。对所有样本进行标准试管凝集试验（STA）和2-巯基乙醇（2ME）凝集试验。STA滴度≥1:80、2-巯基乙醇（2ME）凝集试验≥40且有相符体征和症状的病例被视为布鲁氏菌病阳性。
15名（9.2%）家庭成员布鲁氏菌凝集素血清学阳性，其中8名（53.3%）无症状，7名（46.7%）有症状。血清学阳性成员的STA滴度范围为1:80至1:640。筛查出的15例血清学阳性病例中有4例来自一名有6名家庭成员的确诊病例。所有有症状的血清学阳性病例均接受了布鲁氏菌感染治疗，在6个月的随访中康复且无任何并发症。
根据我们的数据，布鲁氏菌病患者的家庭成员有感染疾病的风险，对家庭成员进行筛查为早期诊断和及时治疗提供了一种有效方法。然而，应评估筛查的成本效益，以便就是否将筛查作为一项全国性计划做出明确决定。
