No abstract

BackgroundBrucellosis is a contagious zoonotic disease transferred from sick animals to humans and endemic in the Middle East and other countries. Humans mainly acquire the disease by consuming non-pasteurized dairy products from infected animals. This study assesses the rates of non-pasteurized dairy product consumption, knowledge and attitudes regarding brucellosis among Israeli Arabs, in towns with and without reported cases of brucellosis. The aim is to assess if there is an association between knowledge, attitudes and consumption of non-pasteurized dairy products and if encountering the disease in the community is associated with consumption, attitudes and knowledge.MethodsA cross sectional telephone survey of 306 respondents from five Arab towns in the northern part of Israel, three towns with and two without reported cases of the disease during 2014. The questionnaire included questions regarding knowledge and attitudes related to brucellosis and patterns of production, purchase and consumption of dairy products from non-regulated sources, mainly semi-hard low value white cheese.ResultsNearly 41% of respondents reported consuming cheese from non-regulated sources and 16.1% of respondents reported purchasing milk from non-regulated sources. Favorable attitudes towards factors enhancing transmission of brucellosis were associated with purchasing and consuming milk or homemade white cheese from non-regulated sources in multivariable logistic regression models (odds ratio- 2.21 and 2.66 respectively, confidence intervals between 1.7 and 3.9). However, knowledge about the disease was not associated with these behaviors. In towns with previous reported cases of the disease the purchasing and consumption of non-regulated cheeses was higher than in towns without reported cases and the opposite for non-regulated milk consumption.ConclusionsThe purchase and consumption of cheese from non-regulated sources is very common in specific communities among Israeli Arabs. Attitudes are a significant factor associated with the risky behavior, such as consuming milk and cheese from non-regulated sources. However, knowledge and previous reported cases of the disease in the community do not prevent most risky behaviors. Interventions should not focus only on dissemination of information.

We report preliminary findings of a large outbreak of human leptospirosis with 36 confirmed/probable and 583 suspected cases from June–August 2018, linked to contaminated water bodies in Northern Israel. There was a travel-associated case in Germany; additional cases are being investigated in other countries. The presumed chain of transmission, implicating wild boar and cattle, raises multiple challenges for risk assessment, risk management and risk communication currently being addressed by a public health response team.