Reemergence of Human and Animal Brucellosis, Bulgaria

Bulgaria had been free from brucellosis since 1958, but during 2005-2007, a reemergence of human and animal disease was recorded.The reemergence of this zoonosis in the country highlights the importance of maintaining an active surveillance system for infectious diseases that will require full cooperation between public health and veterinary authorities.A ccording to the World Health Organization (1), bru- cellosis is one of the most common zoonoses worldwide and is considered a reemerging infectious disease in many areas of the world.An estimated 500,000 new human cases occur annually worldwide (2).In Europe, 1,033 human brucellosis cases were reported in 2006 (3); data from a passive surveillance system were based on clinical fi ndings, supported by epidemiologic criteria, and confi rmed by serologic tests.Here we report the results of a survey performed in Bulgaria during 2005-2007, which has been considered free from Brucellosis melitensis and B. abortus disease since 1958 (4).In Bulgaria, until 1998 serologic screening was mandatory for all cattle, sheep, and goats >12 months of age.Afterward, based on risk assessment, animal surveillance activities covered 100% of heads reared in municipalities along the borders with countries endemic for brucellosis such as Turkey, Greece, and the former Yugoslav Republic of Macedonia; 50% of the animals reared in other municipalities of the regions bordering the aforementioned countries; and 25% of animals reared in the inner Bulgarian regions.Currently, an active surveillance system is in place for dairy factory employees and persons considered at risk after outbreaks in ruminants. The StudyDuring 2005-2007 (Figure 1), a total of 105 human cases of brucellosis were diagnosed among 2,054 persons