Screening of Brucellosis in Household Members of Patients with Brucellosis in Hamadan

Brucellosis is an endemic zoonosis in Iran. There are some reports regarding brucellosis infection in family members sharing the same risk factors and remain unrecognized. The aim of this study was to screen household members of index cases with brucellosis for detecting additional unrecognized cases in Hamedan, Iran.
Two-hundred and thirty family members of brucellosis index cases were enrolled in the study. The standard tube agglutination test (STA), Coomb's wright, and 2-mercaptoethanol (2ME) agglutination were checked in all the samples. A case with STA titer ≥ 1:80, 2-mercaptoethanol (2ME) agglutination ≥ 40 and compatible signs and symptoms was considered positive for brucellosis. A questionnaire containing demographic characteristics, previous history and risk factors for brucellosis, and symptoms and signs of brucellosis was completed for each subject. Data were analyzed using the SPSS 17 software.
Forty-eight (20.8%) of the family members were seropositive for brucella agglutinin and most of them (31 cases) were symptomatic. The most common symptoms were backache (41.7%), fatigue (41.7%), and arthralgia (39.6%). Significant differences were found between seropositivity and a previous history of brucellosis, contact with livestock, and clinical findings. All symptomatic seropositive cases were treated for brucella infection and recovered without any complications.
According to the results of the present study, family members of brucellosis patients are at risk of disease acquisition, and screening of household members provides an effective way for early diagnosis and prompt treatment. However, cost benefit of screening should be evaluated to reach definite decision for the implementation of the screening as a nationwide program.