Brucellosis as an Emerging Disease in Thailand: A Report of Three Cases with Review of Literatures - โรคบรูเซลโลซิสในประเทศไทย

บทคัดย่อ

         Human brucellosis, an important zoonosis, had been virtually absent from Thailand for decades before reemerging in 2003 with only 3 published reports. In this study, three additional cases of Thai brucellosis were reported with additional review and summary of all the 38 cases, 35 of whom occurred during the last 5 years and coincided with the implementation of the government policy to promote goat rearing. This reaffirms that brucellosis is an emerging disease in Thailand. Almost all of the patients were adults while only two were children. Most patients presented with prolonged fever with musculoskeletal symptoms and were diagnosed by serologic means. The blood culture was positive for Brucella spp. in 12 (31.6%) of 38 cases, half of which were identified as Brucella melitensis. The disease usually occurred in small clusters and was occupationally related to goat rearing. Only one patient contracted the disease from sheep. Acquisition of the disease usually followed caprine abortion outbreaks and manual evacuation of infected goat fetuses and/or placenta with unprotected hands was the most important risk factor. Only 3 (7.9%) of patients admitted of ever drinking raw goat milk. Most responded to treatment with antibiotics which consisted mainly of doxycycline and/or rifampicin and/or ciprofloxacin. Physicians should be aware of the possibility of brucellosis in patients who presents with prolonged fever and musculoskeletal symptoms and should inquire about history of occupational risk factors. In addition farmers should be warned about the dangers of contacting with infected animals and trained on hygienic practices in rearing goats.

Key words: brucellosis, Thailand, goats, transmission, placenta