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Abstract：
Brucellosis is an endemic disease in many developing countries and ranked by the World Health Organization among the top seven \"neglected zoonoses\". Although a Palestinian brucellosis control program was launched in 1998, the disease re-emerged after 2012. Interestingly, a similar re-emerging pattern was reported in the neighbouring Israeli regions. The aim of this work was to characterize the re-emerging strains and delineate their genetic relatedness. During 2015-2017, blood samples from 1324 suspected human cases were analyzed using two serological tests. Seropositive samples were cultured, and their DNAs were analyzed by different genetic markers to determine the involved Brucella species and rule out any possible involvement of the Rev.1 vaccine strain. The rpoB gene was sequenced from nine isolates to screen for rifampicin resistance mutations. Multi locus VNTR analysis (MLVA-16) was used for genotyping the isolates. The molecular analysis showed that all isolates were Brucella melitensis strains unrelated to the Rev.1 vaccine. The rpoB gene sequences showed four single nucleotide variations (SNVs) not associated with rifampicin resistance. MLVA-16 analysis clustered the isolates into 22 unique genotypes that belonged to the East Mediterranean lineage. Altogether, our findings show that the re-emergence of brucellosis was due to B. melitensis strains of local origin, the Palestinian and Israeli control programs\' weaknesses could be a major factor behind the re-emergence of the disease. However, other socioeconomic and environmental factors must be investigated. Moreover, strengthening brucellosis control programs and enhancing cooperation between all stakeholders is essential to ensure long-term program outcomes to fight brucellosis.
摘要：
布鲁氏菌病是许多发展中国家的地方病，被世界卫生组织列为“被忽视的人畜共患病”前七名。尽管1998年启动了巴勒斯坦布鲁氏菌病控制计划，但该疾病在2012年后再次出现。有趣的是,据报道，邻近的以色列地区也出现了类似的重新出现模式。这项工作的目的是表征重新出现的菌株并描述它们的遗传相关性。在2015年至2017年期间，使用两项血清学测试对1324例疑似人类病例的血液样本进行了分析。血清阳性样本进行培养，通过不同的遗传标记分析它们的DNA，以确定涉及的布鲁氏菌物种，并排除任何可能涉及的Rev.1疫苗株。对9个分离株的rpoB基因进行测序，以筛选利福平抗性突变。使用多位点VNTR分析(MLVA-16)对分离物进行基因分型。分子分析表明，所有分离株均为与Rev.1疫苗无关的布鲁氏菌菌株。rpoB基因序列显示四个与利福平抗性无关的单核苷酸变异(SNV)。MLVA-16分析将分离株聚集为属于东地中海谱系的22种独特基因型。总之,我们的研究结果表明，布鲁氏菌病的重新出现是由于当地的B.melitensis菌株，巴勒斯坦和以色列控制计划的弱点可能是疾病重新出现的主要因素。然而,必须调查其他社会经济和环境因素。此外，加强布鲁氏菌病控制计划和加强所有利益相关者之间的合作对于确保抗击布鲁氏菌病的长期计划成果至关重要。
