Brucellosis prevention and control in the Mediterranean & Middle East regions _ a guidance towards approaching the targets

Abstract

OBJECTIVES: Brucellosis remains one of the major zoonotic infections creating significant multidimensional medical, public health, social and economic problems to more than 120 countries, especially the developing ones, throughout the world. Moreover, most Brucella spp. are listed as biosecurity/ bioterror pathogen by the CDC. Among the 13 identified species, B. melitensis poses the highest risk for humans in most countries. This is due to contact with sick livestock or ingestion of raw milk, cream, and soft cheese from infected sheep and goats, which constitute the main reservoir of infection. Facing this zoonosis challenge imparts major attention on national authorities to shoulder responsibility towards building successful prevention and control programs. In any country or geographical zone, the effective establishment and implementation of such programs require tackling several factors including: 1) Awareness and public health education about the disease; 2) Diagnostic capacity and facilities for adequate and reliable identification of cases, avoiding misdiagnosis and underreporting in both public and animal health sectors; 3) Vaccination strategies and programs; 4) Intersectoral and interagency coordination; 5) Intersectoral epidemiological surveillance systems; 6) Political commitment and financial support and 7) Liaison with international organizations such as FAO, WHO and WOAH (OIE), that can provide valuable technical support, expertise sharing, capacity building and funds mobilization. These factors were encountered and addressed through an important technical level's contribution led by the WHO-Mediterranean Zoonoses Control Centre during the implementation of two “Pilot Brucellosis Epidemiological Surveillance Projects in the Public Health and Animal Health Sectors in Syria and Jordan”. These endeavors revealed a dire need for making available information adapted to reality and addressing appropriate approaches for Brucella prevention and control. The present document is based on the long experience of the authors in this field and has been warranted to address the aforementioned issues and factors in a clear, concise, well cross-checked, practical and “easy-to-handle” guidance, applicable before and during brucellosis control activities. © 2019 Lebanese Order of Physicians. All rights reserved.