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Brucellosis in Household Members of Brucella Patients Residing in a Large Urban Setting in Peru

During home visits and using a point-of-care test for brucellosis, we screened the household members of adult patients found to have brucellosis by investigation at the Hospital Nacional Daniel Alcides Carrión in Callao, Peru. A total of 206 household members of 43 patients were screened, and 15 (7.3%) household members in 10 (23.3%) households tested seropositive. Brucellosis was diagnosed in 14 of them, all but 4 presenting with acute or subacute uncomplicated disease. Regardless of attempts to control brucellosis in Peru, the disease continues to be reasonably common among household members of brucellosis patients. Household members presumably remain the single most important identifiable risk group in an urban setting, and screening them provides an effective means for their early diagnosis. Although contact with livestock was rare, the consumption of unpasteurized dairy products was reported by almost all patients with brucellosis, their household members, and hospitalized non-brucellosis patients.

Received September 20, 2007. Accepted for publication January 3, 2008.

Acknowledgments: The authors acknowledge the dedicated efforts of the other members of the "Brucellosis Working Group in Callao" in realizing this work; Laura Castañeda-Castañeda, Jenny Manrique, Nancy Cordova, Pilar Tuesta, Pilar Osorio, and Zósimo Yausen from the Hospital Nacional Daniel Alcides Carrión, Callao, Peru, and Melissa Méndez and Milagros Zavaleta from the Departments of Microbiology and Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru. The authors thank Gavin Jackson and Coosje Tuijn for editing the manuscript. Approval for the study was obtained from the Institutional Review Boards of HNDAC and of Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura (A.B. PRISMA), a non-governmental organization based in Lima.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the US government. E. Hall, B. Espinosa, and D. Blazes are US military service members working at the US Navy Medical Research Center Detachment in Lima, Peru. This work was prepared as part of their official duties. Title 17 U.S.C. 105 provides that copyright protection under this title is not available for any work of the United States Government. Title 17 U.S.C. 101 defines a US government work as a work prepared by a military service member or employee of the US government as part of that person’s official duties. The authors declare to have no competing interests in the publication of this report.

^* Address correspondence to H. L. Smits, KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Meibergdreef 39, 1105 AZ Amsterdam, The Netherlands. E-mail: h.smits{at}kit.nl

Authors’ addresses: Marjorie Mendoza-Núñez, Maria L. Castañeda, and Nilo Bonifacio, Department of Infectious Diseases, Hospital Nacional Daniel Alcides Carrión, Gaurdia Chalaca 2176, Callao Peru. Maximilian Mulder, Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, MN, USA. María Pía Franco, Department of Neurology, University of Minnesota, Minneapolis, MN, USA. Kathlène S. J. S. M. Maas, Theresia H. Abdoel, and Henk L. Smits, KIT Biomedical Research, Royal Tropical Institute/ Koninklijk Instituut voor de Tropen (KIT), Meibergdreef 39, 1105 AZ Amsterdam, The Netherlands, Tel: 31-(0)20-5665470, Fax: 31-(0)20-6971841, E-mail: h.smits{at}kit.nl. Jesús Chacaltana, Department of Epidemiology, Hospital Nacional Daniel Alcides Carrión, Gaurdia Chalaca 2176, Callao, Peru. Elena Yagui, Department of General Laboratory, Hospital Nacional Daniel Alcides Carrión, Gaurdia Chalaca 2176, Callao, Peru. Robert H. Gilman, Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, 615 N Wolfe St. Rm W5515, Baltimore, MD, USA and A. B. PRISMA, Calle Gonzales 251, Maranga, Lima 32, Peru. Benjamin Espinosa, David Blazes, and Eric Hall, United States Naval Medical Research Center Detachment, Unit 3800, APO AA 34041-3800, Lima, Peru.