title: Imported brucellosis: A case series and literature review.
abstract: BACKGROUND
  Brucellosis is one of the main neglected zoonotic diseases. Several factors may contribute to the epidemiology of brucellosis. Imported cases, mainly in travellers but also in recently arrived immigrants, and cases associated with imported products, appear to be infrequently reported.
  
  
  METHODS
  Cases of brucellosis diagnosed at a referral unit for imported diseases in Europe were described and a review of the literature on imported cases and cases associated with contaminated imported products was performed.
  
  
  RESULTS
  Most imported cases were associated with traditional risk factors such as travel/consumption of unpasteurized dairy products in endemic countries. Cases associated with importation of food products or infected animals also occurred. Although a lower disease incidence of brucellosis has been reported in developed countries, a higher incidence may still occur in specific populations, as illustrated by cases in Hispanic patients in the USA and in Turkish immigrants in Germany. Imported brucellosis appears to present with similar protean manifestations and both classical and infrequent modes of acquisition are described, leading on occasions to mis-diagnoses and diagnostic delays.
  
  
  CONCLUSIONS
  Importation of Brucella spp. especially into non-endemic areas, or areas which have achieved recent control of both animal and human brucellosis, may have public health repercussions and timely recognition is essential.
authors.affiliation: National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, Ctra. de Colmenar Km 9, Madrid 28034, Spain. Electronic address: ffnorman@gmail.com.
authors.forename: Francesca F
authors.initials: FF
authors.lastname: Norman
authors.affiliation: National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, Ctra. de Colmenar Km 9, Madrid 28034, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Monge-Maillo
authors.affiliation: National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, Ctra. de Colmenar Km 9, Madrid 28034, Spain.
authors.forename: Sandra
authors.initials: S
authors.lastname: Chamorro-Tojeiro
authors.affiliation: National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, Ctra. de Colmenar Km 9, Madrid 28034, Spain.
authors.forename: Jose-Antonio
authors.initials: JA
authors.lastname: Pérez-Molina
authors.affiliation: National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, Ctra. de Colmenar Km 9, Madrid 28034, Spain.
authors.forename: Rogelio
authors.initials: R
authors.lastname: López-Vélez
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002006:Brucellosis / Q000453:epidemiology* / Q000208:ethnology / Q000382:microbiology / Q000635:transmission*; D002648:Child; D002675:Child, Preschool; D003611:Dairy Products / Q000382:microbiology*; D054242:Emigrants and Immigrants; D005060:Europe / Q000453:epidemiology; D005260:Female; D005516:Food Microbiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012307:Risk Factors; D014195:Travel; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult; D015047:Zoonoses / Q000453:epidemiology / Q000382:microbiology
keywords: Brucella spp.; Brucellosis; Immigrant; Travel