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ARTICLE

Dr. S. MANZOOR KADRI

These Are Research Articles By The Members Of IMIA, Medical Students, Research Workers etc.

IMIA takes no responsibility about the authencity of contents, research or standard of the published material, which is the sole responsibility of the author/s.

TO WHOM  IT MAY CONCERN

I certify that the article submitted for publication is the original work of the contributors and has not been submitted for publication or presentation any where else                                                                                  S. Manzoor Kadri

S. MANZOOR KADRI *

ASIF RUKHSANA *

MANSOOR  A . LAHARWAL**

MASOOD TANVIR ***

·         *Department of Microbiology , Government of Medical College Srinagar , Kashmir (India)

·         ** Department of Pathology , Government of Medical College Srinagar , Kashmir (India)

·         *** Department  of Internal Medicine , Government of Medical College Srinagar , Kashmir (India)

Running title : Seroprevelence of Brucellosis  

ABSTRACT

Over A period of 5 years from 1992-1997 a total of 3,532 patients of Pyrexia of unknown origin (PUO) were subjected to Wright's tube agglutination test for brucellosis. Of the 3,532 patients tested,28 (0.8%) were found Sero-Positive for brucellosis.Males outnumbered females  by a ratio of 3:1.

Whereas the Seroprevalence among males clearly was aged-related,the Seroprevalence among women was not.The highest number (43%) of positive males belonged to the age group 21-30 years.The majority of patients had titers of 1:160 or 1:256,high titers of 1:512 and 1:1024 were found in 21.4% patients.

Key Words:-Brucellosis,Pyrexia of unknown origin, Serodiagnosis,

Tube agglutination test.

INTRODUCTION

 Brucellosis,a systemic disease characterised by paucity of signs but accompained with a myriad of nonspecific symptoms as fever,noctural sweating,maliase,fatigue,myalgias and backache,is usually difficult to diagnose clinically.Pts are often labelled as PUO and subjected to various laboratory investigations which generally do not include brucella serology particularly in the fields.This is because of a general perception that brucellosis is only seldom encountered in this part of the world.The present study was aimed to determine the role of brucella in the PUO problem in Kashmir valley.

 (MATERIAL AND METHOD)

 M&M:-The study was conducted in the Dept. of Microbiology,GMC Sgr,on 3532 Pts undergoing evaluation for Pyrexia of unknown origin in the 650-bedded teaching hospital (SMHS) from 1992 to 1997.Wright's Tube Agglutination Test (TAT) was performed on the subjects in which equal volumes of serial dilutions of the patient's serum and the standard antigen (a killed suspension of standard strain of Brucella abortus supplied by the CRL,Kasuali,HP) were mixed and incubated at 37 for 24 hours.A dilution titre of 1:160 or more was taken as positive for brucellosis.Sera in all cases were diluted beyond 1:320 to avoid prozone phenomenon.

 RESULTS:-

 RES:-A total of 28 patients out 3,532 (0.8%) tested positive (titter > 160),of whom 21 were males and 7 were females (M/F ratio 3:1) Agewise the worst involved group was 21-30 years (42.8%),and the least involved group 10-20 years (3.5%)Table1.Sexwise male preponderance was evident in all age groups with a progressive reduction in predominance with increasing age,till in the 51-60 years age group the sex ratio was equal.Females maintained a uniform distribution in all ages groups. Half of patients had a titre of 1:160 , while higher titres of 1:256 , 320 , 520 &1:1024 were observed ,respectively in 6,1,3 & 3 patients  (Table 2 )

 DISCUSSION:-

 Brucellosis is a major Zoonotic disease with a worldwide distribution with higher prevalence in Middle East,Maxico,Central and South America and the Indian subcontinent.There is a strong occupational predisposition,and most adults living in contact with or dealing with animals,animal excreta,and animal products (Such as butchers , milkmen,laboratory staff,veterinarians,farmers,cattle breeders etc) run a greater risk of contracting the disease.Non-occupational exposure can result consumption of raw milk or milk products and even handling of meat during processing by a housewife (1,2).

 In our studies males outnumbered females by a factor of 3,which is in conformity with other reports from India;Patel et al,(1986) found a ratio of 3:2 (3).Male preponderance in brucellosis is a universal phenomenon but a recent study in KSA has shown a higher incidence in females upto 64 years of age with a reversal of ratios beyond 65 yr.(4)

 There is a paucity of literature on human brucellosis in Indian subcontinent.Sharma et al (1979) in their studies conducted in UP and Delhi (5) found a seroprevalence of 0.9% in man with a very high prevalence in domestic animals (goats 5.5%,Sheep 3.4%,pigs 16%,Cattle 6.4%,Buffalloes 4.9%,and Horse 12.8%).Nawathe et al (1984) in Nagpur have reported a bovine serprevalence of 9.7% (6).Panjarethinam and Coworkers who studies 805  women with spontaneous abortion in a rural community of Ahmedabad found 6.5% of them were seropositive (7)

 Our studies showed a seroprevalence of 0.8% among the hospitalized patients  which means a much higher prevalence in actual field conditions since brucellosis a self-limiting condition in the majority. With a population exceeding 900 million and 80% living in rural areas with direct and constant contact with animals,brucellosis can be considered an important cause of PUO in India which generally remains undiagnosed.Clearly  studies are needed to assess the role of brucellosis as a cause of morbidity in India which has not received the attention it deserved.

 REFERENCES:-

 1.Young EJ and Suvannoporrat U.Brucellosis outbreak attributed to ingestion of unpasteurized goat cheese.Arch.Intern Med.1975;135:40-43.

2.Thapar MK and Young EJ.Urban outbreak of goat cheese brucellosis.Peditr.Infect.Dis.1986;5:640-643.

3.Patil C.S,Hemashettar B.M and Nagalotimath S.J.Genito Urinary Brucellosis in Men.Indian J.Pathol.Microbiol 1986;29:364-367.

4.Cooper C.W.The epidemiology of human brucellosis in a well defined urban population in Saudi Arabia.J.Trop.Med.Hyg.1991;94:416-422.

5.Sharma VP,Sethi MS,Yadav MP and Dube DC.Sero-Epidemiologic investigations on brucellosis in states of Uttar Pradesh (UP) and Delhi.Int.J Zoonosis 1979;6(2):75-81

6.Nawathe DR and Bhahwat SS.Observation of Brucellosis in Nagpur region India.Int J.Zoonoses  1984;11 (2):229-32.

7.Pajarathinam R.

Anti-brucella agglutinis in aborted women journal degynecologie,obsterigue et Biologie dela reproduction 1984; 13 (4);433-436.

  Fur Further Information Please Contact :

Dr. S. MANZOOR KADRI

Post Box # 1143

GPO, Srinagar –190001

 Kashmir , India

Contact # 91-194-46125

Facsimile : 91-194-461245