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Folia Medica 2011; 46 No 1:22-27Material and methodsWe performed a retrospective study of brucellosisfiles from three clinics and four departmentsfor infectious diseases from bothBosnian entities (Federation of Bosnia andHerzegovina and Republic of Srpska). Diagnosiswas confirmed either by ELISA andRose-Bengal test or by isolation of Brucellaspecies in blood. We used following statisticaltests: Student T-test and Chi-square test.ResultsBrucellosis was imported in Bosnia andHerzegovina after the war 1992–1995 withimported sheep and cattle that were donatedto refugees and returnees. First cases wereconfirmed in Veterinarian institute “VasoButozan” in Banja Luka (Republic of Srpska)in 1999. Tested sera had been taken from returneesliving in Trebinje region. There werethree Brucella-positive sera, but only onewas officially reported. In period 2000–2005human brucellosis was spreading acrossFederation of Bosnia and Herzegovina andslowly becoming a continuous epidemic.Spreading of human brucellosis was closelyconnected to spreading among the animalson a certain territory.Figure 2. Brucellosis in Republic Bosnia andHerzegovina 1946–1999.DiscussionThere were only four isolated cases of brucellosisreported in period 1946–1992 inBosnia and Herzegovina. All four of themwere reported in military camps (Manjača,Konjic, Han Pijesak, and Bihać). Infectedsheep were euthanized, with all precautionsand epidemiological measures undertaken.Number of infected people was limited, referringto those who were in contact with infectedanimals on daily basis; cattle-breedersTable 1. Distribution of human brucellosis by the place of hospitalization, 1999–2005.FB&H* RS** B&H***Year Sarajevo Tuzla Mostar Zenica Bihać1999. 0 0 0 0 0 1 12000. 8 0 8 0 0 0 162001. 3 0 1 0 0 3 72002. 4 0 3 7 0 0 142003. 28 0 5 14 0 1 482004. 47 0 10 31 1 0 892005. 65 0 6 64 0 0 135Total 155 0 33 116 1 5 310*Federation of Bosnia and Herzegovina, **Republic of Srpska, ***Bosnia and Herzegovina24
Dautović-Krkić S. et al.: Brucellosis - Emerging Zoonosis in Bosnia and HerzegovinaFigure 3. Brucellosis in Bosnia andHerzegovina 1999–2009and soldiers (10). Brucellosis emerged againin 2000 after the war in Bosnia and Herzegovina(1992–1995). It emerges simultaneouslyin three cantons of Federation ofBosnia and Herzegovina: Sarajevo, CentralBosnia, Herzegovina-Neretva. In CantonZenica-Doboj first case of brucellosis wasreported in 2002, and in Canton Una-Sanain 2004 (11, 12). There were 305 casesof human brucellosis reported in Federationof Bosnia and Herzegovina at the endof 2005. Mean age of patients was 40 years(0.8-85). Men were four times more affectedthen women. The most vulnerable populationwere cattle-breeders, then pupils andhousewives. Osteoarticular form of brucellosiswas dominant clinical form. There wasone death case due to Brucella endocarditis.In the same period (1999-2005) therewere only five reported cases of human brucellosisin Republic of Srpska. All reportedcases were among returnees to their pre-warhomes. Infection was transmitted from infectedcattle that were donated through differentaid-programs. There was no significantspread of the diseases among the cattle,since there was not much contact betweenreturnee’s and local people’s cattle.During the following four years (2006–2009) human brucellosis was rapidly spreadingamong people in all areas of Bosnia andHerzegovina. There were six times morereported cases of human brucellosis (1797)than it was in former period (1999–2005)in Federation of Bosnia and Herzegovina.During this period the disease spread allacross Bosnia and Herzegovina. There were323 cases reported in Republic of Srpska,with 216 of them reported in 2008. Meanage of the patients was 36 years (1.5–82years). Men were 2–4 times more affectedthen women. Concerning fact was increasednumber of infected children (one tenth ofreported cases), as well as increased numberof relapsing diseases regardless of therapy.There was a possibility that one part of therelapses is a reinfection, since people hasn’tbeen educated of self protection.Table 2. Distribution of human brucellosis by the place of hospitalization, 2006–2009.FB&H* RS** B&H***Year Sarajevo Tuzla Mostar Zenica Bihać2006. 64 0 4 84 6 4 1622007. 119 0 22 124 207 24 4962008. 133 113 49 319 139 216 9692009. 87 44 12 136 105 79 493Total 403 157 87 663 457 323 2120*Federation of Bosnia and Herzegovina, **Republic of Srpska, ***Bosnia and Herzegovina25
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