Brucellosis in Italy: where it is most widespread, how dangerous it is and how to avoid it

Dire spoke to the president of the World Association for Infectious Diseases and Immunological Disorders (WAidid) Susanna Esposito

ROME – “Brucellosis is a zoonosis caused by bacteria belonging to the Brucella genus. It affects different types of animals, including cows, sheep, goats, deer, pigs and dogs. Those responsible for the infections are six species of gram negative bacteria, which belong to the Brucella genus, in particular Brucella melitensis, Brucella abortus, Brucella suis, Brucella canis, Brucella ovis and Brucella neotomae. The first four are also capable of infecting humans”. This was stated to the Dire agency by the president of the World Association for Infectious Diseases and Immunological Disorders (WAidid) and head of the technical table on infectious diseases and vaccinations of the Italian Society of Paediatrics (Sip), professor Susanna Esposito, full professor of pediatrics at the University of Parma, heard on the subject of brucellosis on the day in which politics calls for the establishment of a national commissioner.

WHEN MAN CAN GET SICK

“This is – underlines the expert – a very serious problem for public health because, especially in agricultural-pastoral areas, we can have both infections in farm animals and in humans, where inadequately cooked meat or unpasteurized milk is eaten”. “In fact – specifies Esposito – man can get sick either because he comes into contact with contaminated animals. Anyone who has contact, especially on farms, with different species is at risk of becoming infected: for example in the Caserta area there it is the topic of hoaxes or, currently, there is that of sheep in Calabria”. “The infection – continues Professor Susanna Esposito – can occur through contaminated food or drinksand,among workers, also through inhalation or through small wounds on the skin. We can say that the Brucella bacterium is present in the milk of infected animals and, therefore, if the milk is not pasteurized the infection passes to humans”. “As far as contagion from dogs is concerned – he continues – there are very few documented cases and, generally, even if the dog is infected, the infection does not pass from dog to human.

What about HUMAN-TO-HUMAN INFECTION?

Human-to-human infection is extremely rare: the most common situation is therefore linked to drinking unpasteurised infected milk or eating inadequately cooked meat”. “The symptoms – informs Esposito – are similar to those of the flu, therefore fever, headache, back pain and weakness, however there can also be infections in the central nervous system or conditions such as recurrent fevers, states of fatigue and pain to the joints. One of the problems is making the diagnosis, because it is often late, while antibiotic therapy is very long. There are specific antibiotics, which are doxycycline and rifampin, which must be prescribed in combination for six weeks to avoid relapses, while in the most serious cases hospitalization is necessary. The mortality risk is 2%, therefore quite low”.

THE MOST AFFECTED AREAS

“The south is particularly affected by the presence of brucellosis, the problem mainly concerns Campania, Calabria and Sicily – he states – and there are a series of ministerial circulars that They provide a prevention approach, following European guidelines. I would like to remind you that brucellosis has been a mandatory notifiable disease since 1934 In fact, % of cases concern Italy, Greece, Spain and Portugal, while Northern Europe is little affected

PREVENTION AND CONTRAST MEASURES

“In Italy – Susanna Esposito then announced – there is a Plan for the eradication of brucellosis and for this reason serological checks are necessary on cattle, buffalo and sheep and goat farms, which vary in frequency and percentage of animals to be checked based on to the health status of the province and region in which the farm is located. As regards the provinces of Caserta and Crotone the Ministry of Health has issued an ordinance forextraordinary eradication measures”.< /strong> “The advice is precisely to avoid consuming foods derived from raw milk that comes from the regions where the disease is endemic, namely Campania, Calabria and Sicily. Biosafety regulations must also be respected on farms, move animals in compliance with current legislation and use safety devices when handling potentially infected animals, organs or matrices”. “Just recently, in the month of April – says Professor Esposito – in Calabria there was a report of the loss of 60 thousand sheep out of a total of 70 thousand. The most concrete hypothesis is that to avoid the costs of disposing of the carcasses infected, which amount to 100 euros per head, the sick sheep were left to die and buried illegally, without therefore implementing the operational protocols for the eradication plan. In all regions, ministerial orders must instead be followed: in fact there is one great attention from veterinary healthcare”. “Despite this episode – he concludes – there is also careful monitoring of any losses which seem absolutely excessive, because recently there have been important reports of bovine tuberculosis, and these diseases can have an impact on transhumance of livestock, from pastures to the plains. It is therefore necessary that checks on infected animals are carried out adequately”.