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Original PapersBrucellosis – Emerging Zoonosis in Bosnia and HerzegovinaSajma Dautović-Krkić¹, Edina Bešlagić², Meliha Hadžović-Čengić¹, SnježanaMehanić¹, Adnan Karavelić¹, Sead Ahmetagić³, Ibrahimpašić Nevzeta 4 , EldiraHadžić 5 , Ivo Curić 6 , Nazif Derviškadić 6 , Janja Bojanić 7¹ Clinic for Infectious Diseases,Clinical Center of Sarajevo University, Sarajevo² Institut for Microbiology Medical FacultyUniversity of Sarajevo³ Clinic for Infectious Diseases,University Clinical Center Tuzla4Department for Infectious Diseases,Cantonal Hospital Bihać5Department for Infectious Diseases,Cantonal Hospital Zenica6Department for Infectious Diseases,Clinical Hospital Mostar6Department for Infectious Diseases,Hospital Južni logor, Mostar7Institut for Epidemiology, Banja LukaCorresponding author:Clinic for infectious diseases,Clinical Center of Sarajevo University, SarajevoBolnička 25, 71000 SarajevoBosnia and HerzegovinaE-mail: sajmadautovic@gmail.comBrucellosis is a zoonotic disease present across the world.Disease in humans has an acute, sub acute or chronic course,whereas in animals, usually, occurs as asymptomatic chronicinfection. In Bosnia and Herzegovina (B&H), brucellosis isimported by livestock donated to refugees and displaced personsafter aggression on Bosnia and Herzegovina and the warfrom 1992–1995 and since then has spread throughout thecountry in both Entities.AIM of this study was to make comparable analysis of researchresults on brucellosis data in the period 2000/2005,with the results reported for the period 2006/2009 and toencourage professionals of veterinary and human medicineto take active action and cooperation with government structuresin order to found an optimal solution to control anderadicate this anthropozoonosis.Results of research showed that during the 2006/2009 (44months) was hospitalized six times more cases than in theprevious period 2000/2005 (72 months), the increasing numberof sick children, as well as recurrence, regardless of thetherapy. Mode of expansion and maintenance of the diseasein some regions in the last ten years indicates its endemicity.The authors CONCLUDE that brucellosis in B&H is emergentzoonotic disease that has become endemic, based onnature of continuing epidemic outbreaks in some areas, andthat the work of state institutions was not nearly enough tocombat the disease and place it under control. Likewise, therewas no and there is no planned and programmed and supportedcooperation with experts from human and veterinarymedicine.Key words: brucellosis, epidemic, endemia, emergent zoonosis22
Dautović-Krkić S. et al.: Brucellosis - Emerging Zoonosis in Bosnia and HerzegovinaIntroductionBrucellosis is the most widespread zoonosis,that affects more than a half million peopleper year, all over the world. Causative agentis Brucella species, domestic and wild animalsare reservoirs, and it affects mostly humans(1).In humans, Brucella causes acute, subacute or chronic disease. In a first 3-6 weeks,brucellosis is manifested with general flulikesymptoms, and thereafter is localized incertain organs, most commonly the jointsand intervertebral discus, then the liver,lungs, testicles, less on the heart valves, andother organs (2, 3, 4, 5, 6, 7, 8, 9). Often, thedisease manifests in humans, only whenbecame chronic and has consequences oncertain organs. In older patients the diseasecan be mistaken for rheumatoid or reactivearthritis of other etiology, thus creating diagnosticdifficulties, delayed early therapyand leaves the possibility of disability (5).The disease is widespread in livestockregions of the world and in most countriesof the Mediterranean region is endemic. InBosnia and Herzegovina disease appearedafter the war 1992-1995 and since then hasbeen steadily spreading among animals andhumans, with no signs of reduction in thenumber of infected and affected. Brucellosiswas imported from neighboring countries,with donated livestock to refugees and displacedpersons, since, due to political reasons,there was not adequately controled ofimport of livestock on the borders.Objectives– To make a comparative analysis ofhospitalized patients with brucellosisin Bosnia and Herzegovina in twoconsecutive periods: 2000–2005 and2006–2009.– To make conclusions and guidelinesfor suppression and surveillance ofbrucellosis– To encourage better cooperationamong clinicians, veterinarians andauthorities in order to engage allavailable potentials in suppressionand surveillance of brucellosisFigure 1. Distribution of human brucellosis in Bosnia and Herzegovina 1999–2009.23
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