Human brucellosis outbreak investigation - Douz, Tunisia, 2018

• Published in: Epidemiology and health 2022-05, p.e2022048
• Main Authors: Charaa, Nejib, Ghrab, Rabaa, Ben Othman, Aicha, Makhlouf, Mohamed, Ltaief, Hejer, Ben Alaya, Nissaf, Chahed, Mohamed
• Format: Article
• Language: English
• ISSN: 2092-7193

The incidence of Human brucellosis in Tunisia in 2017 was 9.8 per 100,000 population. In Douz district two cases were reported in March, 2018. The last indigenous cases were notified in 2015. The aim of this study was to identify the source of contamination and set up control interventions. A case-control study was conducted. A case was a resident of Douz who presented clinical brucellosis with a Wright test ≥ 160. A control was a neighbor of the case who had a negative Rose Bengal test. Univariate and Multivariate analysis were performed to estimate odds ratios of risk factors. Active screening was carried out in goats. A total of 25 cases and 52 controls were enrolled in the study. All cases consumed goat's milk; out of which 92% had bought it from the same breeder. Consumption of goat's milk from this breeder (aOR=30.78, 95% CI [6.47-235.91]) and consumption of raw goat's milk (aOR=14.84, 95% CI [2.04-310.44]) were independent risk factors for the occurrence of brucellosis in cases. The breeder had 18 goats, five of which were smuggled from a neighboring country. Three of them were diagnosed with brucellosis. Consumption of raw milk from smuggled sick goats was the main risk factor in this outbreak. The sick goats were slaughtered. An education campaign was conducted. Vaccination, control of animal movements across borders and control of goat's milk sales must be strengthened in order to prevent a possible spread of the disease in the south-western region of Tunisia.