[Family outbreak of brucellosis. The importance of epidemiological suspicion]

Rev Esp Salud Publica. 2020 Dec 2:94:e202012145.
[Article in Spanish]

Abstract

Objective: Brucellosis is the most widespread zoonosis in the world. In Spain its incidence has decreased considerably in recent years thanks to the social and health measures carried out. 40 cases of brucellosis have been reported in humans in 2018, representing a rate of 0.09 per 100,000 inhabitants. The objective of the study was to highlight the importance of epidemiological suspicion, as well as the screening of relatives for the diagnosis of the disease.

Methods: A descriptive study of a family outbreak of imported brucellosis was carried out. Five members of the same family were evaluated after the diagnosis of brucellosis in a patient in the Health Area III of Zaragoza, in May 2019. The relatives of the patient and the health center were contacted by telephone to investigate the possibility of involvement of the relatives with whom he had traveled and lived in Morocco.

Results: In a scenario with a low frequency of disease such as our country at the present time, family screening, after an initial diagnosis of imported brucellosis, allowed the detection and treatment of four members of the same family of Maghreb origin. They were infected during a trip to their place of origin in April 2019, a month in which they lived in rural areas in contact with animals (sheep, goats, cows) and consumed dairy and meat products. The appearance of presented symptoms was temporally consistent with the incubation period of the disease.

Conclusions: Emphasize the importance of active surveillance and screening in relatives of patients diagnosed with Brucellosis, since they generally share exposures to a common source.

Objetivo: La brucelosis es la zoonosis más extendida en el mundo. En España su incidencia ha disminuido considerablemente en los últimos años gracias a las medidas sociosanitarias llevadas a cabo. Se han comunicado 40 casos de brucelosis en humanos en 2018, lo que representa una tasa de 0,09 por cada 100.000 habitantes. El objetivo de este estudio fue destacar la importancia de la vigilancia activa y del cribado en familiares de pacientes diagnosticados de brucelosis.

Metodos: Se realizó un estudio descriptivo de un brote familiar de brucelosis importada. Se evaluaron cinco miembros de una misma familia tras el diagnóstico de brucelosis de un paciente en el Área III de Salud de Zaragoza, en mayo de 2019. Se contactó telefónicamente con los familiares del paciente y el centro de salud para investigar la posibilidad de afectación de los familiares con quienes había viajado y convivido en Marruecos.

Resultados: En un escenario de escasa frecuencia de enfermedad como es nuestro país en el momento actual, el cribado familiar, tras un diagnóstico inicial de brucelosis importada, permitió detectar y tratar a cuatro miembros de una misma familia de origen magrebí. Resultaron contagiados durante un viaje en abril de 2019 a su lugar de origen, un mes en el que convivieron en el ámbito rural en contacto con animales (ovejas, cabras, vacas) y consumieron productos lácteos y cárnicos. La aparición de síntomas presentados concordó temporalmente con el periodo de incubación de la enfermedad.

Conclusiones: Destaca la importancia de la vigilancia activa y del cribado en familiares de pacientes diagnosticados de brucelosis, ya que comparten, por lo general, exposiciones a una fuente común.

Keywords: Brucella mellitensis; Brucellosis; Family outbreak; Spain.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Animals
  • Brucellosis / diagnosis
  • Brucellosis / epidemiology*
  • Cattle
  • Communicable Disease Control
  • Contact Tracing
  • Disease Outbreaks*
  • Family Health
  • Female
  • Goats
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Morocco / epidemiology
  • Sheep
  • Spain / epidemiology
  • Zoonoses / diagnosis
  • Zoonoses / epidemiology*