Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
Department of Bacterial Vaccines, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran.
PLoS Negl Trop Dis. 2020 May 21;14(5):e0008071. doi: 10.1371/journal.pntd.0008071. eCollection 2020 May.
Brucellosis is a bacterial endemic zoonotic disease of global significance with detrimental impacts on public health and food animal production. It is caused by Brucella spp., an expanding group of pathogens able to infect various host species. Bovines and small ruminants, which excrete the bacteria in milk and in reproductive discharges, are major sources of infection for humans and other animals. Contact with contaminated animals and consumption of unpasteurized dairy products are the main routes for human infection. In spite of the considerable progress of knowledge gained and success achieved in brucellosis control in the developed world, this disease continues to be an important burden in the Middle East (ME). Common risk factors implicated in the difficulty and complexity of brucellosis control within the region include (1) social and political instabilities; (2) insufficient resources and infrastructure for appropriate diagnosis, reporting, and implementation of control measures; (3) variation of livestock husbandry systems and their commingling with other livestock and wildlife; and (4) traditional cultural practices, including consumption of unpasteurized dairy products. Development of core interdisciplinary competencies is required for a true One Health-based endeavor against the disease. National awareness and educational programs addressing all population sectors from consumers to decision-makers seem to be the next logical, sustainable, and economically viable approach toward improving disease status in this region. In the present review, we describe the current situation of brucellosis in the ME, focusing on the major limitations and shortcomings regarding disease control. We propose a regional approach toward public awareness of brucellosis as the first step in mitigating the disease and discuss the potential benefits, and components of such a strategy, which can further be used as a model for other endemic zoonotic diseases.
布鲁氏菌病是一种具有全球重要意义的细菌性地方病，对公共卫生和食用动物生产造成严重影响。它是由布鲁氏菌属引起的，该属病原体不断扩大，能够感染各种宿主物种。牛和小反刍动物会在乳汁和生殖分泌物中排出细菌，是人类和其他动物感染的主要来源。接触受污染的动物和食用未经巴氏消毒的乳制品是人类感染的主要途径。尽管在发达国家对布鲁氏菌病的控制方面已经取得了相当大的进展和成功，但该疾病仍然是中东地区的一个重要负担。该地区控制布鲁氏菌病的困难和复杂性所涉及的常见风险因素包括：（1）社会和政治不稳定；（2）缺乏适当诊断、报告和实施控制措施的资源和基础设施；（3）牲畜养殖系统的变化及其与其他牲畜和野生动物的混合；（4）传统的文化习俗，包括食用未经巴氏消毒的乳制品。开展真正的基于“同一健康”的疾病防治工作需要发展核心跨学科能力。针对从消费者到决策者的所有人群开展国家宣传和教育计划似乎是改善该地区疾病状况的下一个合乎逻辑、可持续和经济可行的方法。在本综述中，我们描述了中东地区布鲁氏菌病的现状，重点关注疾病控制方面的主要限制和不足。我们提出了一种针对布鲁氏菌病公众意识的区域方法，作为减轻疾病的第一步，并讨论了这种策略的潜在好处和组成部分，该策略可以进一步作为其他地方病动物传染病的模型。
