review · Vaccines
Brucellosis is a widespread zoonotic disease affecting human and animal health, particularly across the Middle East and Northern Africa. Because clinical symptoms are non-specific, accurate laboratory confirmation is essential for proper recovery. Bacterial culture remains the gold standard, but serological testing is the most common diagnostic approach in endemic areas due to its affordability, ease of use, and dependable negative predictive capacity. Nucleic acid amplification assays offer rapid, sensitive, and specific detection, yet recovered individuals can retain positive molecular results over long periods. As commercial molecular tests still lack proven interlaboratory reproducibility, clinical management relies heavily on combined culturing and serology. Furthermore, with no approved human vaccine available, controlling animal brucellosis through livestock vaccination remains the primary strategy to prevent human infection.
Brucellosis is a severe disease that passes from animals to humans, causing non-specific symptoms that delay treatment without accurate testing. Understanding the limits of existing diagnostic tools and the absence of human vaccines underscores the need to strengthen regional disease surveillance and animal vaccination programmes to safeguard public health and livestock productivity.
There is an ongoing need for standardised commercial diagnostic assays, particularly nucleic acid amplification tests with validated interlaboratory reproducibility, for diagnostic laboratories and healthcare providers. While existing diagnostic tools are applied in clinical settings, validated commercial molecular tests and human vaccines remain at an earlier research and development stage, necessitating reliance on established animal vaccines.
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Brucellosis is considered one of the most serious zoonotic diseases worldwide. This disease affects both human and animal health, in addition to being one of the most widespread zoonotic illnesses in the Middle East and Northern Africa. Human brucellosis generally presents in a diverse and non-specific manner, making laboratory confirmation of the diagnosis critical to the patient’s recovery. A coordinated strategy for diagnosing and controlling brucellosis throughout the Middle East is required, as this disease cannot be known to occur without reliable microbiological, molecular, and epidemiological evidence. Consequently, the current review focuses on the current and emerging microbiological diagnostic tools for the early detection and control of human brucellosis. Laboratory assays such as culturing, serology, and molecular analysis can frequently be used to diagnose brucellosis. Although serological markers and nucleic acid amplification techniques are extremely sensitive, and extensive experience has been gained with these techniques in the laboratory diagnosis of brucellosis, a culture is still considered to be the “gold standard” due to the importance of this aspect of public health and clinical care. In endemic regions, however, serological tests remain the primary method of diagnosis due to their low cost, user-friendliness, and strong ability to provide a negative prediction, so they are commonly used. A nucleic acid amplification assay, which is highly sensitive, specific, and safe, is capable of enabling rapid disease diagnosis. Patients who have reportedly fully healed may continue to have positive molecular test results for a long time. Therefore, cultures and serological methods will continue to be the main tools for diagnosing and following up on human brucellosis for as long as no commercial tests or studies demonstrate adequate interlaboratory reproducibility. As there is no approved vaccine that prevents human brucellosis, vaccination-based control of animal brucellosis has become an important part of the management of human brucellosis. Over the past few decades, several studies have been conducted to develop Brucella vaccines, but the problem of controlling brucellosis in both humans and animals remains challenging. Therefore, this review also aims to present an updated overview of the different types of brucellosis vaccines that are currently available.
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DOI: 10.3390/vaccines11030654
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