Brucellosis in the Republic of Serbia The Epizootiological Situation

Macedonian Journal of Medical Sciences. 2010 Sep 15; 3(3):246-250. doi:10.3889/mjms.1857-5773.2010.0128 Public Health OPEN ACCESS Brucellosis in the Republic of Serbia The Epizootiological Situation Bosiljka Djuricic Faculty of Veterinary Medicine, Department for Infectious Diseases and Bee Diseases, Belgrade, Serbia Abstract Citation: Djuricic B. Brucellosis in the Republic of Serbia The Epizootiological Situation. Maced J Med Sci. 2010;3(3):246-250. doi.10.3889/ MJMS.1957-5773.2010.0128. Key words: brucellosis; zoonoses; diagnostic; prevention; control; eradication. Correspondence: Prof. Dr. Bosiljka Djuricic. Faculty of Veterinary Medicine, Department for Infectious Diseases and Bee Diseases, 11 000 Belgrade, Serbia. Phone: 381 11 2685187; Fax: 381 11 2685 080. E-mail: bosiljka.djuricic@gmail.com Received: 01-Feb-2010; Revised: 16-Jun-2010; Accepted: 16-Jun-2010; Online first: 10-Sep-2010 Copyright: 2010 Djuricic B. This is an openaccess article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Competing Interests: The author have declared that no competing interests exist. Aim. To present seroprevalence data of the brucellosis in livestock in Serbia. Methods. The classical serological diagnostic methods were used: Rose Bengal (RB) for screening, Complement Fixation Test (CFT) and Indirect ELISA as confirmatory tests. Results. Brucellosis in livestock is present in some regions in Serbia. During the period from 2003 to 2007, the prevalence of brucellosis in sheep was 19.5%-73% (26.8%), in goats 0%-67.1% (35%), in cattle 0%-36.1% (4.8%), and in pigs 0%-16.4% (5.8%). During 2004 new foci of brucellosis in livestock and humans were discovered in the territories of Srednjebanatski and Zapadnobacki counties. By the end of 2004, new foci were registered on the territory of 10 communities from five counties and brucellosis cases were diagnosed in 12 settlements. Actual epizootiological situation during the period from 2007 to 2009 in Serbia was additionally complicated both by the increased number of registered cases and remarcable number of newly affected areas. Conclusion. Brucellosis in Serbia during the last decade shows some specific characteristics such as rapid spread and easy transmission, and persistence. Outbreaks in new localities and increase of human cases were observed. The increase of brucellosis in the southern part of Serbia was facilitated by the border porosity and lack of control of animal movements toward Kosovo and Metohia territories and migration of infected sheep. Introduction 246 Brucelosis is an ancient desease in the relationship between humans and animals. Hipocrates described symptoms which probably relate to the desease. On the Greek island of Tasos, humans had had prolonged fever which lasted from spring to winter. This illness was also described by other authors. Brucellosis research began at the end of 19 th century on Malta (the first name of the disease was Malta fever) when English soldiers were infected by using raw milk of goats. The english doctor, Marston, was the first to describe brucellosis in 1861 as a separate disease. The primary hosts of brucellosis are cattle, sheep, goats and pigs. Other domestic and wild animal species may be infected by one or more of the three clasical species of the genus Brucella (B. melitensis, B. abortus, B. suis). Rabbits may be a reservoir for biotype 2 B. suis. Humans might be accidential hosts but their importance in further spreading and maintaing the disease is almost negligible. The presence of Brucella sp. in Serbia was confirmed by the isolation of B. suis from pigs (Pozarevac, 2001) [1]. The desease is still present and registered in

Djuricic B. Brucellosis in Livestock in Serbia this municiplity. Since 2000 B. canis in dogs in Serbia was reported [2, 3]. In the former Yugoslavia, brucellosis was reported for the first time in 1947 in the district of Istra. After few years the disease was eradicated. It reappeared in the 1960s, in Macedonia, probably through sheep imported from Israel. By the end of 1970s, it had spread to most territories of Macedonia, Kosovo and Metohia and South Serbia. In the 1990s, as a consequence of armed conflicts and uncontroled dislocation of infected sheep from Kosovo and Metohia territory, it spread to central and north Serbia [4, 5]. During 2004, 640 seropositive animals were registered in 4 communities in the area of South Banat which included 586 sheep, 50 goats, 1 cow and 3 dogs. In the majority of cases, those animals were diagnosed on the farms where cases where found in previous year, 2003. During the following years, as a part of the obligatory testing programs in Serbia, a number of seropositive animals were found, mostly sheep and goats, but also in other species (Table 1). The largest number of seropositive animals was registered in 2004 and 2005. Since Table 1: Brucella spp. antibodies in livestock in the affected regions of Serbia, 2003 2007. Methods The classical serological diagnostic methods were used: Rose Bengal (RB) for screening, and the Complement Fixation Test (CFT) and Indirect ELISA, for confirmation on positive samples test. For control and eradication program diagnose and remove approach was introduced for infected animals to be slaughtered. It means that serologically positive sheep and goats were killed. Vaccination of cattle and small ruminants was prohibited. Results During 2000/2001 a brucellosis epizootie in South Banat in Serbia was observed and probably linked to a sheep flock that was relocated from Kosovo territory, in 1997-1998. The desease was diagnosed in animals following a case in a farm worker. An increase in cases of brucellosis in sheep occured in 2000/2001 when several people in different areas of Banat were affected. A control action using serologic tests in all susceptible domestic animals in the area was conducted and cases were found in sheep, goats, donkeys, cattle and dogs. Seropositive cases were found in 5 cows, 476 sheep, 62 goats, 4 donkeys and 11 dogs. All seropositive animals were slaughtered. Seventeen people in this area were infected. Sporadic cases of brucellosis appearance in some other parts of Serbia were found during 2001, in the territories of North Banat, Srem, Kraljevo and South Serbia [4]. Many settlements in South Serbia were affected and various numbers of cases were registered in livestock, first of all in sheepand goats i.e. Vranje 1, Bujanovac 92, Leskovac 2, Trgoviste 2, Vlasotince 2, Bosilegrad 1, Crna Trava 1, Medvedja 1, Surdulica 1, Pirot 5, Aleksinac 1, Prokuplje 1, Blace 1, Nis 3, Razanj 1, and Svrljig 1 [5]. Maced J Med Sci. 2010 Sep 15; 3(3):246-250. than there has been a gradual decrease of the infection. Brucellosis in humans The presence of brucellosis in humans is in direct correlation with the disease distribution in domestic animals (especially goats and sheep), as well as with habits of keeping domestic animals, the way of feeding them, low hygienic standards and other socio-economical factors. Brucellosis epidemiological situation in the world shows, by the WHO estimates, that over half a million people are infected by brucellosis annually. In Europe about 20,000 cases are reported, mostly in the Russian Federation and Mediterranean countries [6, 7]. In former Yugoslavia, the disease was present in Slovenia, Istra, Macedonia, and in Serbia where the majority of cases were found in Kosovo and Metohia and recently in South Serbia [8]. Data analysis reveals that the epidemiological situation in the Republic of Serbia was good until 1980s. The critical increase in cases was in the territory of Kosovo and Metohia where the disease was present since 1979 and the number of cases was continuously increasing until 1991, when 241 cases were reported. During 1990s, there was also worsening of the epide- 247

Sremski and South Backa county. At that time, only a few persons from those areas were infected but the final diagnosis was in the beginning of the 2004. During 2004 new foci of brucellosis in humans were discovered in the territories of Srednjebanatski and Zapadnobacki coun- Table 2: Human Brucellosis in Vojvodina counties during 1999-2004. Figure 1: Brucellosis in Serbia in the period from 1951-2004. miological situation in Central Serbia, while the situation in Vojvodina remained constant until the end of the 20 th century (Figure 1). The epidemiological data showed that brucellosis in Vojvodina appeared mainly as sporadic and single cases. During the period from 1951 to 1970, a total of 40 human cases were reported, with the highest number of 18 in 1965 [9]. From 1971 to 1999, brucellosis was not diagnosed either in humans or animals, and Vojvodina was seen as a brucellosis-free territory. After almost a 30 year brucellosis-free period from 1971, brucellosis appeared again in Vojvodina. In 1999, brucellosis was diagnosed in two farm workers in South Banat county area. During the period from 1999 to 2004, bacause of uncontrolled relocation of infected herds (illegal trade, nomadic livestock herding) brucellosis foci were continuously spreading. During the poor implementation of measures ordered by the veterinary service, in the few subsequent years, brucellosis foci were dispersad to neighboring countries where animals use the same pasture for grazing. Also, workers exposed to infected animals, and consumers of milk products (cheese processed from unpasteurized milk) were infected. As reported from the statements of the patients, sheep were purchased in South of Serbia but veterinary inspection showed that their origin was Bosnia and Hercegovina. Apart from sheep, brucellosis was proven in other animals on farm (pigs and dogs). The institute for health protection in Pancevo conducted wide serological and epidemiological studies which included over 1000 exposed workers. Based upon clinical signs, the epidemiological data and results of serological tests, 21 brucellosis cases were discovered in this area. Since that time brucellosis has been present in South Banat county and new cases are appearing in other surrounding counties (Table 1). At the end of 2003, jurisdictional veterinary service has discovered newly infected sheep flocks in 248 ties. By the end of 2004 new foci were registered in the territory of 10 communities from five counties and human brucellosis cases were diagnosed in 12 settlements (Table 2). Table 3: Epizootiological situation in Serbia during the period from 2007 to 2009. The true epizootiological situation in the Republic of Serbia was complicated during the period from 2007 to 2009 by increased number of registered infected animals and higher number of newly infected areas (Table 3). In 2007, brucellosis was reported in cattle, goats and sheep in 9 epizootiological areas with 19 foci and 59

Djuricic B. Brucellosis in Livestock in Serbia A) B) C) Figure 2: A) Brucellosis in 2007; B)Brucellosis in 2008; C)Brucellosis in 2009. Legend: Red color/cattle; blue/sheep and goats; green/pigs diseased animals (Figure 2A). During 2008, brucellosis was reported in 11 epizootiological areas with 35 foci and 83 diseased animals: brucellosis in cattle was reported on 13 localities with 16 diseased cows; in sheep and goats the disease was proven in 20 foci with 64 diseased animals; brucellosis in pigs was reported in two epizootiological areas, in two farms and in three diseased animals (Figure 2B). The total number of diseased animals in 2007 increased to 83. During 2009 (data until 30.09.2009.), there was a rapid increase in diseased sheep and goats in South Serbia in the border region with Kosovo and Metohia territories. An increase in infected sheep and goats was reported (157) in three localities, while the disease in cattle was reported separately in two cases of 2 animals (Figure 2C). Discussion An analysis of data for 2009 shows that brucellosis is increasing in the South Serbia territory (Bujanovac, Vranje). Since this is a border territory with those of the Republic of Macedonia and Kosovo and Metohia, where vaccination against brucellosis is implemented with alive attenuated vaccine, monitoring and analysis of the origin of seropositivity in animals in south territories of Serbia should remain. Similar findings can be expected on the western borders toward Bosnia and Hercegovina, where during last six months vaccination was also conducted. Porous borders, tradition of cattle breeding, nomad livestock herding and religious customs surely affect on presence of vaccinated animals in surrounding unvaccinated territories. Conclusion The appearance of brucellosis in the Republic of Maced J Med Sci. 2010 Sep 15; 3(3):246-250. Serbia during the last decade is reflective of its characteristics such as rapid spreading and persistence of infection. Brucellosis in the Republic of Serbia still represents one of the most significant bacterial zoonoses. New outbreaks and an increase in the number of infected animals and humans are conclusive that brucellosis in Serbia is increasing. During this period, regardless of radical methods of eradication, uncontrolled relocation of infected animals has resulted in the brucellosis spread to the surrounding territories, of which was observed by the increase in numbers of infected animals yearly. The spread of brucellosis in the south part of Serbia was assisted by the lack of control of animal movement from Kosovo and Metohia territory and migration of infected sheep flocks. High technology and methodology implementation and communication, has motivated development of mass-casualties programs and for developing levels of infectious diseases monitoring [10-12]. Based on previous data on brucellosis in the Republic of Serbia, there is a need to fulfill new OIE and EU standards and challenges aimed to survey and risk assessment for appearance and spread of infectious diseases, including brucellosis. There is a need for continuous training and elevation of professionalism and efficiency. An appropriate control and eradication program should increase veterinary management of Serbia, cooperation among relevant sectors and services and cooperation with surrounding countries. It would increase efficiency on their competencies and practicing veterinary standards as key points and recommendations given in OIE s Codex of animal health. References 1. Rogozarski D, Stokic S, Milicevic M, Dobrosavljevic I, Djuricic B, Radojicic S. Implementation of drug therapy in eradication of brucellosis epizootia in pigs with low extent caused by B. suis biovar 2. [In Serbian]. Epizootiological Days in Serbia, Jagodina, 2005. Proceedings: 34-6. 2. Radojicic S, Djuricic B, Dimitrov Z, Debeljak Z, Zivojinovic M, Petrovic M. Brucellosis-epizootiological situation in FR Jugoslavia in the period from 2000-2001. [In Serbian]. First Congress of veterinarians of the Republic of Srpska, Banja Luka, October 28-30 th, 2001. Proceedings: 5. 3. Radojicic S, Lako B, Djuricic B, Valcic M. Dot ELISA as a rapid method for serological diagnosis of canine brucellosis. Acta vet. 2001;5-6:317-24. 4. Djuricic B, Dimitrov Z, Radojicic S, Stankov M. Brucellosis 249

in the South Banat. [In Serbian] 13th Meeting of Veterianrians of the Republic of Serbia, Zlatibor, September 2001. Proceedings:124-6. 5. Petrovic MM, Spasic M, Djuricic B, Ignjatovic R. Epizootiological and epidemiological picture of brucellosis at the teritory of Niš and South Morava epizootiological Region from 2000-2002. [In Serbian]. Veterinarian Journal of the Republic of Srpska, Banja Luka. 2003;3(1-2):14-16. 6. Rust R, Worrel TE. Brucellosis. Available at: http:// www.emedicine.com/neuro/topic42.htm Accessed: 16.04.2010. 7. Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis; Lancet Infect Dis. 2006;6:91 9. Available from: http://www.thelancet.com/ journals/laninf/article/piis1473-3099%2806%2970382-6/ fulltext Accessed: 16.04.2010 8. Federal Institute for Health Protection-Belgrade. Annual reports for health status and health care of the population 1951-1998. [In Serbian]. Belgrade, Serbia, 2000. 9. Institute for Health Protection-Novi Sad. Acute communicable diseases in Vojvodina 1999-2004. [In Serbian]. Institute for Health Protection-Novi Sad, Serbia, 2006. 10. Robinson A. Guidelines for coordinated human and animal brucellosis surveillance. FAO animal production and health paper 156. Food and Agriculture Organization of the United Nations, Rome 2003. Available from: http://www.fao.org/ docrep/006/y4723e/y4723e00.htm Accessed: April 22, 2010 11. Food and Agriculture Organization of the United Nations, World Organization for Animal Health (Office International des Épizooties), World Health Organization. (2006): Global Early Warning and Response System for Major Animal Diseases Including Zoonoses (GLEWS). Available from: http:// www.oie.int/fr/oie/accords/glews_tripartite- Finalversion010206.pdf Accessed: April 23, 2010 12. WAHID Interface. OIE World Animal Health Information Database (WAHID) Database. Available from: URL: http:// www.oie.int/wahis/public.php?page=home Accessed: April 23, 2010 250