National epidemiology of culture-confirmed brucellosis in Israel, 2004-2022

Miriam Weinberger*, Jacob Moran-Gilad, Michal Perry Markovich, Svetlana Bardenstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Brucellosis, a global zoonosis, is endemic in Israel. We used a national database of cultureconfirmed cases (2004-2022) to analyze the trends of brucellosis. Of 2,489 unique cases, 99.8% were bacteraemic, 64% involved males, and the mean age was 30.5 years (IQR 12.7- 46.3). Brucella melitensis was the dominant species (99.6%). Most cases occurred among the Arab sector (84.9%) followed by the Jewish (8.5%) and the Druze (5.5%) sectors. The average annual incidence rates overall and for the Arab, Druze and Jewish sectors were 1.6/100,000 , 6.6/100,000, 5.5/100,000 and 0.18/100,000, respectively. The annual incidence rates among the Arab (IRR=36.4, 95% CI: 23.3-60.2) and the Druze (IRR=29.6, 95% CI: 14.1, 60.0) sectors were significantly higher than among the Jewish sector (p<0.001). The highest incidence rates among the Arab sector occurred in the South district, peaking at 41.0/100,000 in 2012. The frequencies of B. melitensis biotypes isolated )biotype 1 - 69.1%, biotype 2 - 26.0%, biotype 3 - 4.3%) differed from most Middle Eastern and European countries. A significant switch between the dominant biotype was noted in the second half of the study period. Efforts for control and prevention should be sustained and guided by a One Health approach mindful of the differential trends and changing epidemiology.

Original languageEnglish
JournalEpidemiology and Infection
StateAccepted/In press - 2024


  • Brucella
  • Brucella melitensis
  • brucellosis
  • brucellosis epidemiology
  • brucellosis incidence
  • epidemiology
  • humans
  • incidence
  • Israel
  • zoonosis


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