Increasing Incidence of Human Brucellosis in Southern Israel after the Cessation of a Veterinarian Control Campaign

Brucellosis is highly endemic among domesticated animals in Middle East countries and cause significant human morbidity in the region [1]. In Israel, implementation of an infection control policy based on active surveillance, vaccination of female calves with Brucella abortus strain S19 and slaughter of infected animals, coupled with and economic compensation to farmers, resulted in eradication of B. abortus in beef cattle in 1984 and in dairy cattle in 1985[2]. However, brucellosis caused by B. melitensis remained endemic in herds of sheep and goats and continued to cause infections among the seminomadic Bedouin population of the Negev desert region of southern Israel [3]. Starting on 1993, a veterinary campaign aimed to eradicating the disease among small ruminants and consisting of a “test and slaughter” policy supplemented with administration of the B. melitensis Rev.1 strain vaccine to all ewe-lambs and female kid-goats was implemented countrywide [2]. Throughout the campaign, more than 40,000 animals were slaughtered and 72% of the flocks were declared free of disease [2]. It was hoped that the incidence of human brucellosis would decrease in parallel with the reduction of disease prevalence in animals, but this expectation was not met and the incidence rate among the Bedouin inhabitants of the Negev region remained high [4]. In 1997, it was decided to terminate the brucellosis control campaign altogether due to the apparent lack of success and insufficient financial resources available for a continued slaughter against compensation policy [2]. Unexpectedly, the incidence of human disease dropped in the years following the discontinuation of the campaign, and in 2004 the reported annual incidence of human brucellosis in Israel was 0.9 per 100,000 populations only [5].