Human brucellosis in a nonendemic country : a report from Germany, 2002 and 2003

• Published in: European journal of clinical microbiology & infectious diseases Vol. 24; no. 7; pp. 450 - 456
• Main Authors: AL DAHOUK, S, NÖCKLER, K, HENSEL, A, TOMASO, H, SCHOLZ, H. C, HAGEN, R. M, NEUBAUER, H
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-07-2005; Springer Nature B.V
• Subjects: Adolescent; Adult; Age Factors; Aged; Bacteria; Bacterial diseases; Biological and medical sciences; Brucella melitensis; Brucella suis; Brucellosis; Brucellosis - diagnosis; Brucellosis - epidemiology; Brucellosis - physiopathology; Child; Communicable Diseases, Emerging; Diseases of striated muscles. Neuromuscular diseases; Diseases of the osteoarticular system; Diseases of the spine; Female; Germany - epidemiology; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Miscellaneous; Neurology; Retrospective Studies; Europe; Germany; Microbiology; Arthralgia; Diseases of the osteoarticular system; Cardiovascular disease; Spine disease; Pain; Brucellaceae; Heart disease; Endocardial disease; Bacteria; Brucella melitensis; Human; Nervous system diseases; Myalgia; Fever; Meningoencephalitis; Infection; Polymerase chain reaction; Spondylitis; Striated muscle disease; Central nervous system disease; Endocarditis; Bacteriosis; Brucellosis; Molecular biology
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-005-1349-z

Human brucellosis has become a rare disease in Germany since the eradication of bovine and ovine/caprine brucellosis in this country. Therefore, most physicians are unfamiliar with the illnesses clinical presentation, diagnostic tools, and therapeutic strategies. This retrospective study was carried out to evaluate the epidemiological, clinical, and laboratory features of human brucellosis in Germany in the years 2002 and 2003. Thirty-one bacterial isolates from 30 patients sent to the German national reference laboratory were characterized using the genus-specific bcsp31 real-time PCR, the species-specific AMOS-PCR, and standard microbiological methods for the detection and identification of Brucella spp. The medical records of all patients with bacteriologically confirmed brucellosis were evaluated. All 31 isolates proved to be Brucella (30 Brucella melitensis and 1 Brucella suis). Most of the brucellosis patients were infected in endemic countries while visiting friends and relatives during their summer holidays. One case of laboratory-acquired infection was identified. Brucellosis was transmitted mainly by the consumption of contaminated unpasteurized milk or cheese from goats and sheep. The patients presented primarily with flu-like symptoms, i.e. fever, chills, sweating, headaches, arthralgia, and myalgia. In most cases, however, symptoms and signs of focal complications, e.g. spondylitis, endocarditis, and meningoencephalitis, predominated. The rate of complications was much higher than that in endemic countries, presumably as a result of diagnostic delay due to a low index of suspicion. In summary, physicians in nonendemic countries such as Germany must be aware of brucellosis being a possible cause of fever of unknown origin in immigrants and tourists travelling from endemic countries.