Scenario of pathogenesis and socioeconomic burden of human brucellosis in Saudi Arabia

Abstract

Brucellosis is considered a prevailing endemic infectious disease in the Kingdom of Saudi Arabia and represents a health problem with socio-economic burden. There are two main Brucella species that cause human brucellosis; Brucella abortus, and Brucella melitensis. The clinical features range from asymptomatic to the acute symptoms of fever, joint pain, muscle pain, headache, nausea/vomiting, anorexia and malaise in addition to the subsequent complications that might occur. The endemicity of brucellosis might be explained due to obstacles in controlling the importation of animals for slaughtering during Hajj periods and for several other predisposing factors. The distribution of the disease is all over the country and the most prevalent part is the south followed by north and then the east and central parts. However, in the complexity of brucellosis control measures, there are several activities which have been implemented to tackle the disease such as mass vaccination of animals, regulating importation of slaughter animals, and improving public awareness. This review provides a detailed description of the status of brucellosis in Saudi Arabia, which includes epidemiology, clinical characteristics, virulence and pathophysiology, and prevention of the disease.

Keywords: Brucellosis; Epidemiology; Prevalence; Saudi Arabia; Virulence.

Fig. 1

Incidence of Brucellosis in KSA (2003–2018); Source: Ministry of Health, KSA (Statistical Year Book. Ministry of Health, Kingdom of Saudi Arabia, 2008, Statistical Year book. Ministry of Health, Kingdom of Saudi Arabia, 2018, Ministry of Health).

Fig. 2

Region-wise yearly average Brucellosis cases in KSA (2009–2018). Source: Ministry of Health, KSA (Ministry of Health).

Fig. 3

Average yearly Brucellosis cases in KSA as per age group (2009–2018); Source: Ministry of Health, KSA (Ministry of Health)

Fig. 4

Average share of Brucellosis cases in KSA as per gender and residency status (from total of 40,682 cases during 2009–2018); Source: Ministry of Health, KSA (Ministry of Health)

Fig. 5

Average month-wise Brucellosis cases in KSA yearly from 2009 to 2018; Source: Ministry of Health, KSA (Ministry of Health)

Fig. 6

Cellular Invasion, Intracellular trafficking, and replication by Brucella; Smooth Brucella invasion into a cell by lipid rafts, modification of lipid rafts, interaction with lysosomes, regulation of intracellular trafficking from autophagosome to ER, and the replication of Brucella. Rough Brucella gets exterminated by lysosomes as they do not penetrate by lipid rafts.