title: Cases of human brucellosis in Sweden linked to Middle East and Africa.
abstract: BACKGROUND
  Human brucellosis cases are still reported each year in Sweden despite eradication of the disease in animals. Epidemiological investigation has never been conducted to trace back the source of human infection in the country. The purpose of the study was to identify the source of infection for 16 human brucellosis cases that occurred in Sweden, during the period 2008-2012.
  
  
  RESULTS
  The isolates were identified as Brucella melitensis and MLVA-16 genotyping revealed 14 different genotypes of East Mediterranean and Africa lineages. We also reported one case of laboratory-acquired brucellosis (LAB) that was shown to be epidemiological linked to one of the cases in the current study.
  
  
  CONCLUSIONS
  Brucella melitensis was the only species diagnosed, confirming its highest zoonotic potential in the genus Brucella, and MLVA-16 results demonstrated that the cases of brucellosis in Sweden herein investigated, are imported and linked to travel in the Middle East and Africa. Due to its zoonotic concerns, any acute febrile illness linked to recent travel within those regions should be investigated for brucellosis and samples should be processed according to biosafety level 3 regulations.
authors.affiliation: National and OIE Reference Laboratory for Brucellosis, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy. g.garofolo@izs.it.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Garofolo
authors.affiliation: Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Foggia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fasanella
authors.affiliation: National and OIE Reference Laboratory for Brucellosis, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Di Giannatale
authors.affiliation: National and OIE Reference Laboratory for Brucellosis, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy.
authors.forename: Ilenia
authors.initials: I
authors.lastname: Platone
authors.affiliation: National and OIE Reference Laboratory for Brucellosis, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy.
authors.forename: Lorena
authors.initials: L
authors.lastname: Sacchini
authors.affiliation: National and OIE Reference Laboratory for Brucellosis, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Teramo, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Persiani
authors.affiliation: Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden.
authors.forename: Talar
authors.initials: T
authors.lastname: Boskani
authors.affiliation: Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Rizzardi
authors.affiliation: Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden.
authors.forename: Tara
authors.initials: T
authors.lastname: Wahab
mesh_terms: D000349:Africa; D002006:Brucellosis / Q000453:epidemiology*; D006801:Humans; D008877:Middle East; D013548:Sweden / Q000453:epidemiology
keywords: Brucella melitensis; Brucellosis; MLVA