Screening of family members of patients with acute brucellosis in an endemic area of Iran.
OBJECTIVE
Brucellosis is a zoonotic disease and it's still endemic in Iran. There are some reports regarding brucellosis infection in family members sharing same risk factors and remain unrecognized. However, few studies on the importance of family screening are available. We aimed to screen household members of index cases with acute brucellosis for detecting additional unrecognized cases in central province of Iran.


METHODS
163 family members of 50 index cases were enrolled in the study. Standard Tube Agglutination Test (STA) and 2-mercaptoethanol (2ME) agglutination were checked in all samples. A case with STA titer ≥ 1:80, 2-mercaptoethanol (2ME) agglutination ≥ 40 and compatible signs and symptoms was considered positive for brucellosis.


RESULTS
15 (9.2%) of family members were seropositive for Brucella agglutinin and among them, 8 (53.3%) were asymptomatic and 7 (46.7%) were symptomatic. STA titer ranged from 1:80 to 1:640 in seropositive members. 4 of the 15 seropositive cases who identified by screening came from one index case with 6 family members. All symptomatic seropositive cases treated for Brucella infection and recovered without any complications in 6 months follow up.


CONCLUSIONS
On the basis of our data, family members of brucellosis patients are at risk of disease acquisition, and screening of household members provides an effective way for early diagnosis and prompt treatment. However cost benefit of screening should be evaluated to reach definite decision for the implementation of the screening as a nationwide program.
Tuberculosis and Pediatric Infectious Research Center, Arak University of Medical Sciences, Arak, Iran.
Masoomeh
M
Sofian
Arak University of Medical Sciences, Arak, Iran.
Leila
L
Safaeipour
Clinical Research Dept., Pasteur Institute of Iran, Tehran, Iran.
Arezoo
A
Aghakhani
Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran.
Mohammad Reza
MR
Sharif
Iranian society for support of patients with infectious disease, Tehran, Iran.
Mohammad
M
Banifazl
Department of Infectious Diseases, Kashan University of Medical Sciences, Kashan, Iran.
Alireza
A
Sharif
Tuberculosis and Pediatric Infectious Research Center, Arak University of Medical Sciences, Arak, Iran.
Ali-Asghar
AA
Farazi
Clinical Research Dept., Pasteur Institute of Iran, Tehran, Iran.
Ali
A
Eslamifar
Tuberculosis and Pediatric Infectious Research Center, Arak University of Medical Sciences, Arak, Iran.
Farshideh
F
Didgar
Clinical Research Dept., Pasteur Institute of Iran, Tehran, Iran.
Amitis
A
Ramezani
Acute Brucellosis; Family member; Index cases; Screening