Abstract
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.
Highlights
Brucellosis is a globally important endemic zoonotic disease that is caused by gram-negative coccobacillus bacteria belonging to the genus Brucella [1, 2]
Among classical Brucella spp., B. melitensis and B. abortus are of paramount zoonotic importance worldwide, primarily infecting small ruminants and cattle, respectively [4]
We describe some of the major limitations and shortcomings confronted in the Middle East (ME), and we propose a regional approach toward public awareness of brucellosis as the first step in controlling the disease
Summary
Brucellosis is a globally important endemic zoonotic disease that is caused by gram-negative coccobacillus bacteria belonging to the genus Brucella [1, 2]. Educational, and health conditions prevailing in the region favor endemicity of the disease [8, 12] Traditional customs, such as the consumption of unpasteurized dairy products and the high popularity of pastoralism, provide a means of animal-to-human transmission [13]. The One Health concept is based on the interdependence of human health, animal health, and environmental health and focuses on the need for cooperative decision-making, planning, and action to address health problems [16] Such an approach requires encompassing necessary discipline-specific and interdisciplinary collaborative arrangements and activities [12, 14, 15] whose prerequisite infrastructures are not likely to be provided in the near future in the ME because they demand time, coordinated organization, and authorization [17], as well as economic resources that are currently unavailable. Potential benefits and components of such an approach are discussed, which can further be used as a model for other zoonotic diseases
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