Doğan, Mustafa

Güneş, Hayati

Libyan Journal of Medicine

English

PubMed

Namik Kemal University Institutional Repository

False-positivity in diagnosis ofbrucellosis associated with Rev-1vaccineBrucellosis is a zoonotic disease caused by Brucellaspp. and is still a serious problem of public healthfor some regions around the world such as theMediterranean Sea, Middle East, Latin America, andAsia (1).These pathogenic bacteria can infect humans as well assheep, goats, etc. B. melitensis (sheep and goats) is themost important causative agent for human brucellosisand is followed by B. ovis (sheep), B. abortus (cattle),B. suis (pigs), and B. canis (dogs). Brucella causes animportant disease characterized by decreased fertility inrams, sporadic abortions in sheep and increased lambmortality. Control strategies to prevent human brucello-sis include pasteurization of milk, livestock vaccinationand elimination of infected animals. In animal popula-tions, mass vaccination accompanied by a strict surveil-lance scheme is a first step to reduce the number ofinfected animals (2). A test-and-slaughter program can beapplied in order to obtain brucellosis-free flocks andregions (3). Despite the fact that subcutaneous vaccina-tions can create interferences with the serological diag-nosis of brucellosis and that this strain can be pathogenicfor humans (4), the live attenuated Brucella melitensisRev-1 vaccine is considered to be the best vaccineavailable for the control of sheep and goat brucellosis(3, 4). This vaccine has variable protective efficacyranging between 40 and 100% because of the stringencyof the challenge and other factors (5).Agri is a city in eastern Turkey with a population500,000 in the city center, districts, and villages. Thepeople live on agriculture and animal husbandry.The Provincial Agricultural Directorate performeda vaccine campaign for the prevention of brucellosisin sheep in Agri. Rev-1 vaccine was administeredsubcutaneously to 300,000 sheep and a total of 46individuals  including 33 veterinarians and 13 veterinarytechnicians  commissioned in this campaign.After finishing the campaign, Brucella serological testsof the assigned staff were examined. Rose-Bengal test waspositive in 10 of them. The Wright agglutination testswere applied to the sera for confirmation of Rose-Bengaltest results. The titer was 1/80 in one of them and positivein the remaining, i.e. 1/160 and higher. The treatmentwas started for two of these individuals with prominentclinical findings. One of them stopped receiving thetreatment after 2 weeks, and the other received treatmentfor 6 weeks. This test was repeated after 2 weeks and allof the Brucella tube agglutination titers were determinedas 1/80 and below.Brucellosis has grave economic impacts in the localpopulation and can also cause serious problems in thenational agricultural economy. Since slaughtering isthe only solution when an animal is infected, Brucellavaccination in animals has gained great significance.Starting the treatment as a result of false-positivity leadsnot only to increased treatment costs but also to un-wanted side effects. Repeating the tests adds costs andtakes time that may delay treatment. In a recent study(6), the modified Rose-Bengal test showed lower valuesfrom 1/4 dilutions in such individuals. Therefore, weconclude that after the Rev-1 vaccine, we can observefalse-positivity of Brucella Rose-Bengal test. In this case,the modified Rose-Bengal test should be applied withthe lower values from 1/4 considered as negative.Hayati GunesDepartment of Medical MicrobiologyMedical FacultyNamik Kemal UniversityTekirdağ, TurkeyEmail: dr_hgunes@yahoo.comMustafa DoganDepartment of Infectious DiseaseMedical FacultyNamik Kemal UniversityTekirdağ, TurkeyReferences1. Memish ZA, Balkhy HH. Brucellosis and international travel.J Trav Med. 2004; 11: 4955.2. Smits HL, Kadri SM. Brucellosis in India: a deceptive infectiousdisease. Indian J Med Res. 2005; 122: 37584.3. Jelastopulu E, Bikas C, Petropoulos C, Leotsinidis M. Incidenceof human brucellosis in a rural area in Western Greece after theimplementation of a vaccination programme against animalbrucellosis. BMC Publ Health. 2008; 8: 241.(page number not for citation purpose)LETTER TO THE EDITORLibyan J Med 2013. # 2013 Hayati Gunes and Mustafa Dogan. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction inany medium, provided the original work is properly cited.1Citation: Libyan J Med 2013, 8: 20417 - http://dx.doi.org/10.3402/ljm.v8i0.204174. Munoz PM, de Miguel MJ, Grillo MJ, Marin CM, BarberanM, Blasco JM. Immunopathological responses and kineticsof Brucella melitensis Rev 1 infection after subcutaneous orconjunctival vaccination in rams. Vaccine. 2008; 26: 25629.5. Galindo RC, Muñoz PM, de Miguel MJ, Marin CM, Blasco JM,Gortazar C, et al. Characterization of possible correlates ofprotective response against Brucella ovis infection in ramsimmunized with the B. melitensis Rev 1 vaccine. Vaccine. 2009;27: 303944.6. Dı́az R, Casanova A, Ariza J, Moriyón I. The Rose Bengal testin human brucellosis: a neglected test for the diagnosis of aneglected disease. PLoS Negl Trop Dis. 2011; 5: e950.Hayati Gunes and Mustafa Dogan2(page number not for citation purpose)Citation: Libyan J Med 2013, 8: 20417 - http://dx.doi.org/10.3402/ljm.v8i0.20417

False-positivity in diagnosis of brucellosis associated with Rev-1 vaccine

Hayati Gunes

Mustafa Dogan

Directory of Open Access Journals

Brucellosis and international travel.

Brucellosis in India: a deceptive infectious disease.

Characterization of possible correlates of protective response against Brucella ovis infection in rams immunized with the B. melitensis Rev 1 vaccine. Vaccine.

Incidence of human brucellosis in a rural area in Western Greece after the implementation of a vaccination programme against animal brucellosis. BMC Publ Health.

Moriyo ´n I. The Rose Bengal test in human brucellosis: a neglected test for the diagnosis of a neglected disease. PLoS Negl Trop Dis.

False-positivity in diagnosis of brucellosis associated with Rev-1 vaccine

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