A cluster of Brucella melitensis in Melbourne, Australia 2023: clinical and public health actions
DOI:
https://doi.org/10.33321/cdi.2025.49.015Keywords:
Brucellosis, Brucella melitensis, Victoria, australiaAbstract
Brucellosis is a rare zoonotic infection most commonly seen in parts of the Northern Hemisphere. Infections in Australia are uncommon and occur predominantly in Queensland and New South Wales due to exposure to Brucella suis through wild pig hunting activities. We describe a clustering of two cases of brucellosis in Victoria confirmed by genomic analysis but with no identified exposure. We detail the medical management, laboratory confirmation, and the public health investigation. While the source of the outbreak remains unclear, the two cases demonstrate a detailed and coordinated public health response to a rare infection with a unique geographical and temporal relationship.
Downloads
References
Laine CG, Johnson VE, Scott HM, Arenas-Gamboa AM. Global estimate of human brucellosis incidence. Emerg Infect Dis. 2023;29(9):1789–97. doi: https://doi.org/10.3201/eid2909.230052.
Carroll KC, Pfaller MA, Landry ML, McAdam AJ, Patel R, Richter SS et al, eds. Manual of Clinical Microbiology (twelfth edition). Washington DC: ASM Press; 2019.
Mesner O, Riesenberg K, Biliar N, Borstein E, Bouhnik L, Peled N et al. The many faces of human-to-human transmission of brucellosis: congenital infection and outbreak of nosocomial disease related to an unrecognized clinical case. Clin Infect Dis. 2007;45(12):e135–40. doi: https://doi.org/10.1086/523726.
Ruben B, Band JD, Wong P, Colville J. Person-to-person transmission of Brucella melitensis. Lancet. 1991;337(8732):14–5. doi: https://doi.org/10.1016/0140-6736(91)93332-4.
Public Health Laboratory Network (PHLN). Brucellosis (Brucella sp.) Laboratory case definition. Canberra: Australian Government Department of Health and Aged Care, PHLN; 25 October 2006. Available from: https://www.health.gov.au/sites/default/files/documents/2022/06/brucellosis-laboratory-case-definition_0.pdf.
Australian Department of Health and Aged Care, National Notifiable Disease Surveillance System (NNDSS). National Communicable Disease Surveillance Dashboard. [Webpage.] Canberra: Australian Department of Health and Aged Care, NNDSS; 2023. Available from: https://nindss.health.gov.au/pbi-dashboard/.
Australian Government Centre for Population. National, state and territory population, March 2022. [Webpage.] Canberra: Australian Government Centre for Population; 26 September 2022. Available from: https://population.gov.au/data-and-forecasts/key-data-releases/national-state-and-territory-population-march-2022.
State Government of Victoria. Public Health and Wellbeing Act 2008. [Legislation.] Melbourne: State Government of Victoria; 2022. Available from: https://www.legislation.vic.gov.au/in-force/acts/public-health-and-wellbeing-act-2008/065.
Clinical and Laboratory Standards Institute (CLSI). Methods for antimicrobial dilution and disk susceptibility testing of infrequently isolated or fastidious bacteria (third edition). CLSI guideline M45. Wayne: CLSI; August 2016.
Whatmore AM, Koylass MS, Muchowski J, Edwards-Smallbone J, Gopaul KK, Perrett LL. Extended multilocus sequence analysis to describe the global population structure of the genus Brucella: phylogeography and relationship to biovars. Front Microbiol. 2016;7:2049. doi: https://doi.org/10.3389/fmicb.2016.02049.
Australian Government Department of Agriculture, Fisheries and Forestry. National list of notifiable animal diseases. [Webpage.] Canberra: Australian Government Department of Agriculture, Fisheries and Forestry; 1 May 2024. Available from: https://www.agriculture.gov.au/biosecurity-trade/pests-diseases-weeds/animal/notifiable.
Geering WA, Forman AJ, Nunn MJ. Exotic diseases of animals: a field guide for Australian veterinarians. Canberra: Australian Government Publishing Service; 1995.
Therapeutic Guidelines (eTG). Brucellosis. [Webpage.] West Melbourne: Therapeutic Guidelines Limited; April 2019. Available from: https://tgldcdp.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Antibiotic&topicfile=brucellosis&guidelinename=Antibiotic§ionId=toc_d1e47#toc_d1e47.
Solera J, Espinosa A, Martínez-Alfaro E, Sánchez L, Geijo P, Navarro E et al. Treatment of human brucellosis with doxycycline and gentamicin. Antimicrob Agents Chemother. 1997;41(1):80–4. doi: https://doi.org/10.1128/AAC.41.1.80.
Colmenero JD, Fernández-Gallardo LC, Agúndez JA, Sedeño J, Benítez J, Valverde E. Possible implications of doxycycline-rifampin interaction for treatment of brucellosis. Antimicrob Agents Chemother. 1994;38(12):2798–802. doi: https://doi.org/10.1128/AAC.38.12.2798.
Huang S, Wang H, Li F, Du L, Fan W, Zhao M et al. Better efficacy of triple antibiotics therapy for human brucellosis: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2023;17(9):e0011590. doi: https://doi.org/10.1371/journal.pntd.0011590.
Published
How to Cite
License
Copyright (c) 2025 Communicable Diseases Intelligence

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
