BRUCELLOSIS - A NEVER ENDING STORY

Human brucellosis is the most common zoonotic disease in the world. An estimated half a million cases occurs annually. The Middle East and Mediterranean basin countries play a major role in the evolving epidemiology of this disease. In Israel, the incidence of human brucellosis has changed dramatically throughout the years with a fluctuating "baseline" incidence as well as several outbreaks. The largest outbreak was reported in 1988 resulting in an annual incidence to a level of 11 per 100,000 for that year. Since then and due to an active animal surveillance program that included "test and slaughter policy", the disease was contained but not eliminated. This policy was interrupted due to financial considerations. Since 2012, a dramatic increase in human brucellosis has occurred mainly in the south and later also in northern localities, Jerusalem district and the eastern central part of the country.

During the past three years, disease incidence has increased by more than 300%. The fact that 95% of cases are reported in the Arab population, which constitutes almost one fifth of the total population, makes the situation more concerning. In fact, the incidence of brucellosis during 2014 was as high as 35 per 100,000 in Arab inhabitants of Israel. Moreover, examining the disease in the Arab population over the years shows that the "commonly reported" incidence of 0.5 to 4 per 100,000 is actually 2.5 to 20 per 100,000. Not surprisingly, such a high incidence serves to maintain and ensure the continuity of the never ending story of brucellosis.