An overview of the eradication of Brucella melitensis from KwaZulu-Natal.

Brucella melitensis is a Gram-negative bacterium whose primary hosts are goats and sheep. Like the other BrucelIa spp., with the exception of Brucella ovis, it is not particularly host specific as it is pathogenic for a variety of other mammal species including humans. In humans the disease caused by it is rated as one of the most important zoonoses. Three outbreaks have been recorded in goats and sheep in South Africa; the first outbreak occurred in sheep in 1965 in the Mpumalanga and Northern Provinces (then both part of the Transvaal Province), the second occurred in sheep in 1989 near Pretoria, Gauteng Province, and the third and current outbreak was diagnosed in a flock of goats in northern KwaZulu-Natal in September 1994. Following the initial diagnosis of B. melitensis in north-eastern KwaZulu-Natal, a serological survey was conducted in order to identify foci of infection in the goat and sheep populations. Six positive foci were identified. In March 1996 a test-and-slaughter eradication campaign was initiated in these areas. Initial test results revealed a prevalence of between 1.23% and 4.02 %. All positive animals were identified and slaughtered. Eradication programmes were repeated between March 1996 and June 2000, in the populations at risk, and the disease prevalence was reduced in all the affected populations.

Brucella melitensis biotype 1 outbreak in goats in northern KwaZulu-Natal.

Brucella melitensis biotype 1 was confirmed in indigenous, outbred goats in three northern districts of the KwaZulu-Natal province following the diagnosis of human Malta fever in the same area. Six foci of infection were found during an extensive serological survey involving 6266 goats carried out in most of the districts of the KwaZulu-Natal province. The prevalence in the positive herds varied between 17% and 100%. The diagnosis was confirmed by culturing milk samples from serologically positive animals. Infected goats were found in only three districts (Ubombo, Ingwavuma and Pongola) and all infected herds fell within a 50-km radius.

Acute spreading osteomyelitis of the skull complicating frontal sinusitis.

Three patients with acute spreading osteomyelitis of the skull complicating a frontal sinusitis are presented. The pathology and clinical features of this complication are discussed. Early rigorous antibiotic treatment accompanied by surgical intervention to drain purulent collections in the sinuses and scalp has been effective in controlling the disease. One patient required a craniectomy for removal of an area of chronic ostemoyelitis. The other two patients maintained on antibiotics for three months have shown no evidence of progression to chronic osteomyelitis and have remained free from relapse.