Long ignored but making a comeback: a worldwide epidemiological evolution of human brucellosis

ABSTRACT

Brucellosis is a commonly neglected zoonosis that remains a serious global public health concern. The epidemiological evolution of human brucellosis has considerably changed over the past few decades, and epidemic geography is continuously expanding. Human brucellosis is emerging and re-emerging, and is imported from areas where it is endemic due to travel, immigration, and international trade. The disease continues to be prevalent in Asia and Africa, including West Asia, Central Asia, North Africa, and East Africa, with the highest incidence in Syria, Kyrgyzstan, Mongolia, Iran, Algeria, and Kenya. Re-emerging cases are frequently recorded in places where brucellosis has been controlled, such as Bosnia, Herzegovina, Azerbaijan, and the USA. In countries with a high disease burden, disease control and eradication have been extremely difficult because of livestock farming being the only source of livelihood, unique religious beliefs regarding animals, nomadic lifestyle, and low socioeconomic levels. Interventions focused on protecting livestock keepers are needed, particularly for those assisting with goat and sheep births and the consumption of raw dairy products. Notably, in most countries with a high disease burden, each period of several years with a low incidence rate was followed by a subsequent increase in cases, highlighting the necessity of continuous investment and surveillance. In addition, advocacy for the inclusion of brucellosis as a globally mandated reported disease, strict restrictions on animal movement, mandated consumption of pasteurized milk, and health education are needed. This study will help form an evidence-based strategy for international organizations to curb the future spread of brucellosis.

KEYWORDS:

• Human brucellosis
• cases
• incidence rate
• seropositive
• epidemiological evolution

Acknowledgments

We are grateful to all authors who have previously published data on brucellosis worldwide.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

LZG and GLP performed the data collection and processed and drafted the manuscript. LZG and LZJ participated in the design of the study. MW and YM critically reviewed the manuscript. MW managed the project. All the authors have read and approved the final manuscript.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China (No. L2124006), and Research on the Development Strategy of Engineering Technology in the Medical and Health Field for the Next 20 Years (No. 90100), the National Science and Technology Major Project (No. 2017ZX10303401), and the Youth Science Foundation of the State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention (No. 2021SKLID503). The funders had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.