The brucellosis situation in Jordan

In Jordan, a new national study conducted by the Middle East Community Health Network (AMPHNET) in cooperation with the Ministry of Health, Ministry of Agriculture, Royal Medical Services, Princess Haya Center for biotechnology and US  Centers for Disease Control and Prevention (CDC), revealed that the incidence and prevalence of brucellosis in the governorates of Mafraq and Karak are the highest in the Kingdom. The study implemented in the areas of the Jordanian governorates of Mafraq, Karak and east of the capital, Amman, the risk factors for infection and exposure to animals are the highest.

The infection rate of the disease in the Kingdom is between 10 and 20 cases per 100,000 inhabitants, which is considered a relatively low percentage, while in some countries in the region, the infection rate is between 50 to 100 cases per 100,000 inhabitants.

Reminders on the brucellosis :

Brucellosis (sometimes also called malta fever) is an animal disease that can be transmitted to humans (zoonosis). It is caused by bacteria of the genus Brucella. Three species predominate: Brucella melitensisthe most pathogenic, invasive and widespread species in the world, B. abortus, and B. am. Other less frequent species exist, with variable pathogenicity for humans (B. the dog, B. the sheep, B. the sea, B. the unexpectedetc.).


The Brucella are found in most mammalian species, including ruminants, domestic and wild, as well as suids (pigs and wild boars) and lagomorphs (hares). Those that infect humans come mainly from domestic cattle, sheep, goats and pigs. The fact that wild animals act as a reservoir of infection complicates eradication efforts.
This bacterial zoonosis is widespread throughout the world. The annual incidence is 500,000 reported cases.

Humans can be infected in several ways:

  • by direct contact (penetration of the germ through the skin or mucous membrane favored by wounds or excoriations) with infected animals, animal carcasses, products of abortions, placentas, animal vaginal secretions, manure or by accidental contact with biological products in laboratories; this mode of contamination concerns people in direct contact with infected animals (breeders, veterinarians, inseminators, slaughterhouse or rendering staff) and much more rarely laboratory staff during veterinary or medical analyses;
  • by ingestion of contaminated food (unpasteurized milk and dairy products from contaminated animals, more rarely raw vegetables contaminated by manure or exceptionally insufficiently cooked meat and offal); it is the main mode of contamination among travelers who share the way of life of the local populations, in particular in terms of food;
  • by inhalation (of litter dust, contaminated aerosol in laboratories or slaughterhouses), the bacteria being able to survive for several months outside the animal’s body, in the external environment, in particular in cold and humid conditions .

Brucellosis is one of the most serious diseases of livestock, considering the damage caused by infection in animals. Decreased milk production, weight loss, loss of young, infertility, and lameness are some of the effects on animals.

Clinical aspects of brucellosis in humans:

The incubation period of brucellosis is variable, from one week to several months. The primary infection may be asymptomatic and the disease may not appear until several months or years later. In the symptomatic forms, the clinical signs are quite variable but usually evolve in three phases:

  • A phase of acute primary invasion: fever associated with myalgia, feeling unwell;
  • A secondary phase where isolated or multiple infectious foci are formed: osteo-articular (spondylodiscitis, arthritis of the knee, etc.), genitourinary (orchitis, epididymitis), hepatic (hepatic abscess), neurological (meningitis, meningo-encephalitis, brain abscess…), heart (endocarditis…)
  • Possibly, in particular in the event of insufficient or poorly followed treatment, a chronic phase whose expression is twofold:

Either a general symptomatology (asthenia, pain, fatigue),
Either a more focal symptomatology (chronic evolution of infectious foci).

Once the diagnosis has been confirmed, the treatment of human brucellosis is based on the administration of specific antibiotics for several weeks, and if necessary the surgical management of the infectious foci. Lethality is less than 2% even in the absence of treatment.


  • The prevention of occupational contamination is based on biosecurity and hygiene measures at work: washing hands, wearing gloves, masks and glasses, etc.
  • The control of contamination of food origin with Brucella passes either by the pasteurization or the sterilization of the milk, or by the use of raw milk coming from herds recognized officially free from brucellosis.

The traveler should avoid unpasteurized dairy products and undercooked meat, especially when traveling to countries where brucellosis is endemic.

Source : ProMED.



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