Brucellosis as an Occupational Disease in the Republic of Macedonia

Abstract

Brucellosis, a bacterial disease caused by species of the genus Brucella, is an important zoonosis and recognized as an occupational disease. A high risk of infection with Brucella is associated with certain workplaces related to direct contact with infected animals or their products. Infection may occur by inhalation of infectious aerosols, conjunctival contamination, skin contamination, contact with laboratory cultures and tissue samples, and accidental injection of live vaccines. Brucellosis is included as an occupational disease in the Macedonian List of Occupational Diseases, and diagnosis and verification of the occupational diseases, according to the national medical criteria, are realized at the Occupational Health Institute of R. Macedonia. According to the official health statistics, in the last two decades in Macedonia as an endemic region, a high incidence of human brucellosis has been registered, with more than 300 reported cases per year. In spite of a possible high occupational risk of infection with Brucella sp in the confirmed cases of disease, during 2008-09 just 12 cases of brucellosis (6 stockmen, 5 veterinarians and an agronomist) were confirmed as an occupational disease. These data suggest that human brucellosis is underdiagnosed and underreported as an occupational disease at national level. An adequate management of brucellosis with a multidisciplinary approach should provide more accurate reported data in occupational epidemiology in the country. There is a need to strengthen joint actions within the health care system, to promote an intersectoral collaboration and to support the successful realization of national control programme at the community level.