Brucellosis in the Mediterranean countries: history, prevalence, distribution, current situation and attempts at surveillance and control

This review focuses on the historical and current status of the disease in the 23 countries with coastlines along the Mediterranean. This work is mainly based on information collected and provided by local authorities, governmental bodies and National Reference Laboratories for Brucellosis, as well as national experts in each country. Expected in September 2019. Preface: Brucellosis is an endemic disease in the Mediterranean Basin but accurate epidemiological data are not available for most of the area’s countries, despite several national and international surveys. This is the first publication to compiles and describe the historical and current status of brucellosis in all Mediterranean countries. Thirty-five national experts from 22 institutes have contributed to summarising the past and present situations in relation to the disease as well as the perspectives of the 23 countries (on the Mediterranean coastline). The information in this book is based on national and international studies and data published for each country, and focuses on the key elements of successful control programmes and their ongoing challenges and the reasons for persistent epidemics. Based on this information, it is apparent that brucellosis still poses a significant threat in the Mediterranean. The consumption of unpasteurised milk and milk products being the main risk factor for human infection. Brucella melitensis bv 3 and B. abortus bv 1 are the Brucella spp. most frequently recovered from humans and livestock. While B. suis bv 2 is predominantly found in those European countries surrounding the Mediterranean, and B. suis is scarce in Afro–Asian countries due to religious and social preferences. Further biovars have been sporadically isolated in Croatia and Turkey. B. canis has been detected by serological tests and polymerase chain reaction (PCR) assays in sporadic cases among the dog populations of Greece, Italy, Montenegro and Turkey. While B. melitensis is able to cross species barriers and has established permanent reservoirs in cattle and bovines in Albania, Egypt, France, Israel, Italy and Turkey. Marine Brucella species have only been found in Croatia, France, Italy and Spain. B. ovis, moreover, has been detected in Croatia, Greece, Italy, Slovenia and Spain and should therefore be included in future surveillance programmes in the Mediterranean region. A test-and-slaughter strategy accompanied by vaccination with B. abortus RB51 and S19 for cattle and buffaloes and ‘reduced doses’ of B. melitensis Rev.1 for small ruminants succeeded in reducing brucellosis prevalence in regions of Spain and France with previously high prevalence. With the exception of a few European countries, the part of the budget dedicated to veterinary medicine that is allocated to the control and eradication of brucellosis is small. Biosafety and biosecurity measures are negligible, control of the trans-border movement of diseased animals is insufficient and there is still significant room for improvement in the collaboration between human and veterinary medicines