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Indian Journal of Medical Microbiology, Vol. 25, No. 2, April-June, 2007, pp. 176-177 Correspondence Screening of the family members of patients with acute Brucellosis in Southeast Iran B Sharifi - Mood, M Metanat, R Alavi - Naini Research Centre for Infectious Diseases and Tropical Medicine, Zahedan University of Medical Sciences, Zahedan Correspondence Address: Research Centre for Infectious Diseases and Tropical Medicine, Zahedan University of Medical Sciences, Zahedan, Iran (email: batoolsharifi@yahoo.com) Date of Submission: 25-Nov-2006 Code Number: mb07055 Dear Editor, Brucellosis is primarily an animal disease. Exposure to infected animals and animal products causes the disease in human. [1],[2] Acute brucellosis among household members of an index case have been reported. [3] In order to determine whether active serological screening of the family members of patients with acute brucellosis will detect additional unrecognized cases, we conducted this study. From September 2005 to December 2006, a total of 378 of household members of patients with acute brucellosis (69 families) who were referred to Boo-Ali Hospital (Southeast Iran) were enrolled in this study and serologically screened for brucellosis using the standard agglutination test (SAT). Titer of 160 or more was considered positive and diagnostic Titer of more than 160 in conjunction with compatible clinical presentation was considered to be highly suggestive of acute infection. Also, titer more than 160 in conjunction with 2 mercapto ethanol test>160 in asymptomatic group, were considered to be acute infection. Out of the 69 families screened, 33 (48%) had two family members or more with serological evidence of brucellosis. Thirteen families had three family members with positive serologic tests, 10 families; four cases, seven families; two cases, two families; five cases and one family had six household members with serological evidence of brucellosis. Of the 378 family members screened, 77(20%) were seropositive and of these 47 (61%) were symptomatic . The majority (30(63.8%)) of the symptomatic family members had a high brucella titer (> 640) in comparison to three (10%) of the asymptomatic group ( P < 0.001). Acute brucellosis prevalence rate was 13.2%. Our results showed that 20% of the family members of patients with acute brucellosis had serological evidence of brucellosis and 13.2% had acute brucellosis. In Alsubaie study from Saudi Arabia, among 178 family members 40 (23%) manifested various symptoms, 138 (77%) were asymptomatic, with an overall seroprevalence rate of 34 (19%). [3] In recent study, acute brucellosis was diagnosed and treated in 18 (78%) of the symptomatic seropositive family members and in four (36%) of the asymptomatic seropositive family members and acute brucellosis prevalence rate was seen in 22 household members (12%). [3] Other study from Southern Israel evaluated 86 family members of index cases of acute brucellosis. [4] Symptomatic brucellosis was found in eight (9%) of the screened population and an additional 5 (6%) asymptomatic individuals were found to be seropositive. [4] Peru study showed that in an endemic area in Lima (Peru), in 39 families with 232 members, there was a high rate of symptomatic infection (118/232, 50.9%). [5] Symptomatic family members were more likely to be seropositive with a high titer in comparison to the asymptomatic members. This result was also seen in the present study. In conclusion, screening family members of an index case of acute brucellosis will detect additional cases and improve the treatment, because, all family members may be exposed to a common source. References
Copyright 2007 - Indian Journal of Medical Microbiology |
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