Brucellosis: at least 1,000 infected in Bosnia

[Gert van der Hoek]

05 22 2008


Bosnians threatened by cattle disease, expert warns


SARAJEVO (AFP) ? An alarming rise in cases of Bosnians infected with the rare animal disease brucellosis requires urgent action to prevent it from spreading, an epidemiologist warned Thursday.

"The number of people who were registered with the infection this year is 395. The situation is very, very serious," Zlatko Puvacic, the chief epidemiologist of the Muslim-Croat half of Bosnia, told AFP.

At least another 1,000 people in the Muslim-Croat Federation had been infected by brucellosis but were not registered since they were yet to see a doctor, Puvacic estimated.

A precise figure on those currently infected with the animal disease was unknown.

Puvacic said health authorities "must urgently undertake measures to prevent further spreading of the disease."

He called for the establishment of quarantine facilities for infected cattle, mainly sheep, and for the proper disposal of the remains of euthanised animals.

"Otherwise the number of infected humans could be two to three times higher," said Puvacic.

He said the situation is identical in the Republika Srpska, the Serb entity that along with the Muslim-Croat Federation makes up post-war Bosnia.

The state veterinary office was unavailable for comment.

The disease is difficult to diagnose as its initial symptoms resemble flu, including weakness, fever, sweating, headache and pain in the joints.

Humans can contract it from contact with sick sheep and goats or by consuming infected meat, milk or cheese.

The disease, which Puvacic said was first introduced to Bosnia when infected cattle were donated to the country after its war, can be fatal but is not contagious among humans.

http://afp.google.com/article/ALeqM5jlldTVvw9pqtPpQYQ_bX-VyWXdgg

[Gert van der Hoek]

Re: Brucellosis: at least 1,000 infected in Bosnia

Bosnia region acts to curb brucellosis outbreak

Thu May 22, 2008

SARAJEVO, May 22 (Reuters) - Bosnia's Muslim-Croat federation has ordered measures to contain further outbreaks of the cattle disease brucellosis that might have infected more than 1,000 people this year, a top health official said on Thursday.

Brucellosis is a bacterial disease that affects sheep, goats and cattle and the main reason for outbreaks are nomadism, illegal transport and import of animals, chief epidemiologist Zlatko Puvacic said.

"The situation is critical and this is only a tip of an iceberg," Puvacic said, adding about 400 people tested positive between January and April this year, which was more than the total number infected in 2004-2006.

"There may be another 1,000 of those who do not show symptoms and have not sought medical assistance," Puvacic told Reuters on telephone.

People get the disease through contact with infected animals. It can also spread through contaminated or unpasteurised milk.

Puvacic said that within a week, all communities would have to set up quarantine zones and allocate special sites for burial of infected cattle that will be culled by health services.

Out of 72,000 sheep tested in 2008 in the Muslim-Croat federation, about six percent tested positive.

The figures for the Serb Republic, an autonomous region that makes up Bosnia along with the Muslim-Croat federation, were not available but Puvacic said the situation was similar.

"It is difficult to estimate the real number of people who have contracted brucellosis," he said. "We'll have more results in the next two weeks, after the fast diagnosis equipment is dispatched to villages where even a single case was reported."

According to Britain's Department of Environment, Food and Rural Affairs, the disease is caused by infection with the bacterium Brucella abortus. In cattle, brucellosis causes abortion or premature calving of recently infected animals.

In people, brucellosis can cause flu-like symptoms, such as fever, sweats, headaches and back pains but can also lead to infections of the central nervous system. (Reporting by Maja Zuvela; Editing by David Fogarty)

http://uk.reuters.com/article/latestCrisis/idUKL2272019820080522

[Gert van der Hoek]

Re: Brucellosis: at least 1,000 infected in Bosnia

From CDC website:


What is brucellosis?

Brucellosis is an infectious disease caused by the bacteria of the genus Brucella. These bacteria are primarily passed among animals, and they cause disease in many different vertebrates. Various Brucella species affect sheep, goats, cattle, deer, elk, pigs, dogs, and several other animals. Humans become infected by coming in contact with animals or animal products that are contaminated with these bacteria. In humans brucellosis can cause a range of symptoms that are similar to the flu and may include fever, sweats, headaches, back pains, and physical weakness. Severe infections of the central nervous systems or lining of the heart may occur. Brucellosis can also cause long-lasting or chronic symptoms that include recurrent fevers, joint pain, and fatigue.


How common is brucellosis?

Brucellosis is not very common in the United States, where100 to 200 cases occur each year. But brucellosis can be very common in countries where animal disease control programs have not reduced the amount of disease among animals.

Where is brucellosis usually found?

Although brucellosis can be found worldwide, it is more common in countries that do not have good standardized and effective public health and domestic animal health programs. Areas currently listed as high risk are the Mediterranean Basin (Portugal, Spain, Southern France, Italy, Greece, Turkey, North Africa), South and Central America, Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. Unpasteurized cheeses, sometimes called "village cheeses," from these areas may represent a particular risk for tourists.


How is brucellosis transmitted to humans, and who is likely to become infected?

Humans are generally infected in one of three ways: eating or drinking something that is contaminated with Brucella, breathing in the organism (inhalation), or having the bacteria enter the body through skin wounds. The most common way to be infected is by eating or drinking contaminated milk products. When sheep, goats, cows, or camels are infected, their milk is contaminated with the bacteria. If the milk is not pasteurized, these bacteria can be transmitted to persons who drink the milk or eat cheeses made it. Inhalation of Brucella organisms is not a common route of infection, but it can be a significant hazard for people in certain occupations, such as those working in laboratories where the organism is cultured. Inhalation is often responsible for a significant percentage of cases in abattoir employees. Contamination of skin wounds may be a problem for persons working in slaughterhouses or meat packing plants or for veterinarians. Hunters may be infected through skin wounds or by accidentally ingesting the bacteria after cleaning deer, elk, moose, or wild pigs that they have killed.


Can brucellosis be spread from person to person?

Direct person-to-person spread of brucellosis is extremely rare. Mothers who are breast-feeding may transmit the infection to their infants. Sexual transmission has also been reported. For both sexual and breast-feeding transmission, if the infant or person at risk is treated for brucellosis, their risk of becoming infected will probably be eliminated within 3 days. Although uncommon, transmission may also occur via contaminated tissue transplantation.

Is there a way to prevent infection?

Yes. Do not consume unpasteurized milk, cheese, or ice cream while traveling. If you are not sure that the dairy product is pasteurized, don't eat it. Hunters and animal herdsman should use rubber gloves when handling viscera of animals. There is no vaccine available for humans.


How is brucellosis diagnosed?

Brucellosis is diagnosed in a laboratory by finding Brucella organisms in samples of blood or bone marrow. Also, blood tests can be done to detect antibodies against the bacteria. If this method is used, two blood samples should be collected 2 weeks apart.


Is there a treatment for brucellosis?

Yes, but treatment can be difficult. Doctors can prescribe effective antibiotics. Usually, doxycycline and rifampin are used in combination for 6 weeks to prevent reoccuring infection. Depending on the timing of treatment and severity of illness, recovery may take a few weeks to several months. Mortality is low (<2%), and is usually associated with endocarditis.

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/Brucellosis_g.htm#whatis

[Gert van der Hoek]

Re: Brucellosis: at least 1,000 infected in Bosnia

Greece:

Brucellosis scare

Authorities in Kavala, northeastern Greece, yesterday warned people to avoid consuming unpasteurized milk or dairy products after several residents of the nearby island of Thasos displayed symptoms of brucellosis, a serious bacterial disease that causes fever, joint pain and fatigue.

It was unclear yesterday how many residents had actually contracted brucellosis.

Checks were being carried out on local farm animals too.

http://www.ekathimerini.com/4dcgi/_w_articles_politics_100017_22/05/2008_96896

[Amish Country]

Re: Brucellosis: at least 1,000 infected in Bosnia

An older farm women I knew had this disease in her younger years. At the time they feared for her life. She did pull thru and recover. Pasteurization is a wonderful thing and despite the claims and raves for "raw milk and milk products" the importance of pasteurization and sanitary practices should not be minimized or overlooked.

Today I watched a women on a TV travel program extolling the virtue of the unpasteurized cheese she was nibbling on. I heard no mention made of the potential dangers of eating unpasteurized cheese, milk or milk products. Brucellosis is one of them.

There may be more risk of this in areas where there is little or no supervision or regulation of the dairy industry. Even in more developed countries, in this day and age with soaring farm production costs and thining farm profit margins I am conserned that some farmers and food processors may be tempted to let certain sanitation, maintainance and safety practices slide in the effort to cut costs, speed production and decrease labor.

Additional potential dangers of raw milk products:

http://agbiopubs.sdstate.edu/articles/ExEx14047.pdf

Information on pasturization:

http://www.fcs.msue.msu.edu/ff/pdffiles/foodsafety2.pdf

Pasteurization has been shown to decrease the incidents of many food borne diseases. Proper food handling, sanitation practices, temperature control, dating, packaging, transportation and monitoring are also required before, during and after the process.

[Gert van der Hoek]

Re: Brucellosis: at least 1,000 infected in Bosnia

Brucellosis on the rise in Bosnia and Herzegovina

28/05/2008

Although a brucellosis epidemic is raging across the Federation of Bosnia and Herzegovina, measures to prevent its spread are not in place.

By Jusuf Ramadanovic for Southeast European Times in Sarajevo -- 28/05/08


Bosnia and Herzegovina (BiH) is experiencing an epidemic of brucellosis and must keep the disease from spreading among humans and animals, warned students of the University of Sarajevo?s veterinary department in April at a round table titled "Brucellosis in BiH".

Brucellosis, also called undulant fever, or Malta fever in humans, is a highly contagious disease spread by contact with infected animals, eating raw meat or unpasteurised cheese or drinking infected milk. In humans, brucellosis can cause symptoms similar to those of flu, including fever, sweats, headaches, back pains and physical weakness. Severe infections of the central nervous system or lining of the heart may occur. According to the US Centre for Disease Control and Prevention, the mortality rate is usually less than 2% and is usually associated with endocarditis.

"Under current treatment, humans recover pretty quickly; however, doctors always emphasise that there is a possibility of relapse -- the return of the symptoms if immunity weakens or if there is new contact with the disease," explained Professor Tarik Bajrovic of the University of Sarajevo's veterinary department.

Last year, 500 people died of brucellosis in BiH. Authorities registered 104 new cases in the first three months of this year. This recent outbreak affected veterinary workers and cattle raisers most. Experts say the epidemic is out of control. The system for protection against contagious livestock diseases in the Federation of BiH (FBiH) functions poorly and is cause for alarm.

Conference attendees emphasised that authorities had declared an all-out brucellosis epidemic in some cantons of FBiH.

At a press conference following the discussion, Muamer Dervisevic, a veterinary student, said that brucellosis has been present in BiH for an extended period. He added that it spread after the 1990s conflict, primarily due to failure to regulate cattle imports and nomadic cattle raising.

In that conflict's aftermath, the prevalence of the disease, previously unknown in BiH, worsened dramatically. In early 2000, health authorities detected early cases among the owners of "donated" cattle. Since then, the disease has spread.

FBiH's chief veterinary inspector, Sulejman Hasimbegovic, is among those who say brucellosis in BiH is out of control. He says the government inadequately implemented measures to eradicate the disease. The necessary laws are not in place either. The situation, in Hasimbegovic's words, is alarming.

By contrast, in the EU, brucellosis is almost entirely eradicated. The veterinary system in BiH may be facing one of its most difficult tasks -- somehow shielding the public from diseases even though adequate protection is nonexistent.

http://www.setimes.com/cocoon/setimes/xhtml/en_GB/features/setimes/features/2008/05/28/feature-02

[tropical]

Re: Brucellosis: at least 1,000 infected in Bosnia

"primarily due to failure to regulate cattle imports and nomadic cattle raising"

[Gert van der Hoek]

Re: Brucellosis: at least 1,000 infected in Bosnia

Brucellosis is continuing to spread across Bosnia and Herzegovina and is reaching epidemic proportions, the country?s leading epidemiologist warns.

A total of 757 infections in people have been registered in 2008 just in the bigger Bosnian entity of Bosniak (Bosnian Muslim)-Croat federation, said Dr. Zlatko Puvacic, the leading federal epidemiologist, media reported on Monday.

Puvacic warned that this is almost a 100 percent increase compared to 2007. He also warned that the number of unregistered infected people is estimated to be three times higher.

Data for the other Bosnian entity, Republika Srpska, was not immediately available but brucellosis has been seen as a growing problem there as well. With more than 30 infections per 100,000 residents, Bosnia?s Federation entity has seen the greatest share of brucellosis infections than any other European country, Puvacic said.

Brucellosis is carried by domestic and wild animals and can spread to humans who work with animals or eat meat which was not properly cooked. In addition to hundreds of registered human cases, tens of thousands of cases of brucellosis has been registered among domestic animals in Bosnia over the past few years.

Bosnia is especially susceptible to this and other infectious diseases transmitted by animals because of the weak capacity of its health and veterinary services, but also because of complex administrative setup which prevents cooperation among different sectors and administrative units.

As a result, many infected humans and animals are diagnosed late. Farmers often have to wait for weeks, even months for the culling of infected domestic animals, which are then sometimes inappropriately disposed.

In humans, Brucellosis induces inconstant fevers, sweating, weakness, anaemia, headaches, depression and muscular and bodily pain but is usually not fatal. It is treatable with antibiotics although it can take weeks, even months to recover.

In October, the World Bank announced the launch of a new project aimed at improving the country?s technical and administrative capacity to fight infectious diseases, including bird flu.

http://visz.rsoe.hu/alertmap/woalert_read.php?glide=AP-20081201-19427-BIH&cat=dis&lang=eng