Cover Image
close this bookWHO Recommended Surveillance Standards (WHO - OMS, 1999, 157 p.)
close this folderDiseases
View the documentB20-B21-B22-B23-B24 AIDS
View the documentA22 Anthrax
View the documentA23 Brucellosis
View the documentA00 Cholera
View the documentA81.0 Creutzfeldt-Jakob disease
View the documentA90, A91 Dengue fever (A90) including Dengue haemorrhagic fever (DHF) & Dengue shock syndrome (DSS, A91)
View the documentA36 Diphtheria
View the documentB72 Dracunculiasis (Guinea worm disease)
View the documentA98.3, A98.4 Ebola-Marburg viral diseases
View the documentA83.0 Japanese encephalitis
View the documentB74 Lymphatic filariasis
View the documentB96.3 Haemophilus influenzae type b
View the documentB15-B17 Acute viral hepatitis
View the documentB20-B24 HIV infection
View the documentJ10, J11 Influenza
View the documentA96.2 Lassa fever
View the documentA48.1 Legionellosis
View the documentB55.1, B55.2 Cutaneous leishmaniasis
View the documentLeishmania / HIV co-infections
View the documentB55.0 Visceral leishmaniasis
View the documentA30 Leprosy
View the documentA27 Leptospirosis
View the documentB50-54 Malaria
View the documentB05 Measles
View the documentA39 Meningococcal disease
View the documentA87 Viral meningitis
View the documentB73 Onchocerciasis
View the documentA37.0 Pertussis
View the documentA20 Plague
View the documentA36 Poliomyelitis
View the documentA82 Rabies
View the documentA02.0 Salmonellosis
View the documentB65 Schistosomiasis
View the documentA50-52 Syphilis
View the documentA33 Tetanus, neonatal
View the documentB56-0, B56-1 African trypanosomiasis
View the documentB57 American trypanosomiasis
View the documentA15-A19 Tuberculosis
View the documentA75.3 Scrub typhus
View the documentA95.9 Yellow fever

A23 Brucellosis

(human)

RATIONALE FOR SURVEILLANCE

Brucellosis is the most widespread zoonosis transmitted from animals (cattle, sheep, goats, pigs, camels and buffaloes), through direct contact with blood, placenta, foetuses or uterine secretions, or through consumption of infected raw animal products (especially milk and milk products). Human brucellosis due to Brucella melitensis has serious public health consequences in areas where sheep and goat are raised. Brucellosis has an important worldwide impact on human health and the animal industry. In most countries brucellosis is a notifiable disease. Control measures are based on prevention. Surveillance is a key element for management of prevention and control programmes.

RECOMMENDED CASE DEFINITION

Clinical description

An illness characterized by acute or insidious onset, with continued, intermittent or irregular fever of variable duration, profuse sweating particularly at night, fatigue, anorexia, weight loss, headache, arthralgia and generalized aching. Local infection of various organs may occur

Laboratory criteria for diagnosis

· Isolation of Brucella spp. from clinical specimen or

· Brucella agglutination titre (e.g., standard tube agglutination tests: SAT>160) in one or more serum specimens obtained after onset of symptoms or

· ELISA (IgA, IgG, IgM), 2-mercaptoethanol test, complement fixation test, Coombs, fluorescent antibody test (FAT), and radioimmunoassay for detecting antilipopolysaccharide antibodies; and counterimmunoelectrophoresis (CIEP)

Case classification

Suspected: A case that is compatible with the clinical description and is epidemiologically linked to suspected or confirmed animal cases or contaminated animal products.

Probable: A suspected case that has a positive Rose Bengal test.

Confirmed: A suspected or probable case that is laboratory-confirmed.

RECOMMENDED TYPES OF SURVEILLANCE

Routine surveillance must be undertaken, particularly among high-risk groups (farmers, shepherds, workers in slaughterhouses, butchers, veterinarians, laboratory personnel).

Mandatory early case-based reporting by health care providers or laboratory to upper levels of the public health sector as welt as to the appropriate level of the animal health sector. In endemic countries where investigation of all reported cases may not be feasible, a representative proportion of reported cases should be investigated routinely.

RECOMMENDED MINIMUM DATA ELEMENTS

Case-based data for investigation and reporting

· Case classification
· Unique identifier, age, sex, geographical information, occupation and ethnic group if appropriate

Date of clinical onset, date of reporting

· Exposure history
· Outcome

Aggregated data

· Number of cases by case classification (probable/confirmed), age, sex, geographical area, occupation

RECOMMENDED DATA ANALYSES, PRESENTATION, REPORTS

Graphs: Number of probable/confirmed cases by month.

Tables: Number of probable/confirmed cases by age, sex, month, place.

Maps: Number of probable/confirmed cases by place.

PRINCIPAL USES OF DATA FOR DECISION-MAKING

Surveillance data

· Estimate the magnitude of the problem in humans and animals

· Monitor the distribution of the disease in humans and animals

· Monitor and evaluate impact of prevention activities in humans, and of control/elimination measures in animals

Investigation data

· Identify populations at risk
· Identify potentially contaminated products of animal origin
· Identify potentially infected animal sources (herds or flocks)

SPECIAL ASPECTS

The surveillance activities of both public health and animal health sectors must be fully coordinated and integrated. Administrative arrangements between the two sectors must be established to facilitate immediate cross-notification of cases, as well as joint investigations.

Surveillance and control programmes must be promoted in goat-raising areas.

CONTACT

Regional Offices

See Regional Communicable Disease contacts on section "Communicable disease contacts in Regional Offices".

Headquarters: 20 Avenue Appia, CH-1211 Geneva 27, Switzerland

Communicable Diseases Surveillance and Response (CSR)

E-mail: cosivio@who.ch / outbreak@who.ch
Tel: (41 22) 791 2531/4687/2111
Fax: (41 22) 791 48 93/07 46 attn CSR