Brucellosis in a refugee who migrated from Syria to Germany and lessons learnt, 2016

Abstract

A teenage woman migrating from Syria arrived in May 2015 in Germany. She gave birth to a healthy child in early 2016, but became febrile shortly after delivery. Blood cultures revealed Brucella melitensis. In retrospect, she reported contact with sheep in Syria and recurrent pain in the hip joints over about five months before diagnosis of brucellosis. We discuss consequences for adequate treatment of mother and child as well as for clinical and laboratory management.

Pediatric brucellosis

“…Most of these cases were associated with travel to brucellosis-endemic countries surrounding the Mediterranean Sea (namely, Italy, Spain, Turkey). 7 - 9 …”

Prevalence of brucellosis and its outcome in Tertiary Care Hospital Makkah.

“…23 My study showed an incidence rate of 4.01 cases per 100,000 population per year in Makkah that is better than other endemic regions of KSA but still higher than Al-Medina region and most other developed countries. 20,24,25 The factors that effect on the prevalence are different geographically from region to region.so prevalence of brucellosis is not well documented according to different cities. Moreover, the modern lifestyle of Makkah also affects its prevalence.…”

Zoonoses under our noses

“…Turkey has more than 15,000 new cases per year [54], and Syria has an incidence of >1000 in 100,000 [43]. In a recent case of brucellosis in a Syrian refugee in Germany, one of the ‘lessons learnt’ was that gaining a travel history from patients presenting with an undiagnosed ailment is of high import [55]. Molecular epidemiology tracing B. melitensis in Germany to immigrants and German travellers identified similar concerns for correct identification of non-endemic disease [54].…”