One Health approach in human brucellosis: a comprehensive review of epidemiology, transmission, diagnosis, management, and control strategies

Brucellosis exemplifies the inseparable interconnection between animal health, human health, and environmental factors, making it an ideal candidate for application of the One Health framework. This comprehensive review examines the epidemiology, pathogenesis, transmission dynamics, clinical manifestations, diagnostic methodologies, treatment strategies, and prevention and control measures of human brucellosis through the lens of the One Health approach. The One Health concept recognizes that human health is inextricably linked to animal health and the health of the ecosystems in which they coexist. Brucellosis primarily affects livestock species, including cattle (Brucella abortus), sheep and goats (Brucella melitensis), swine (Brucella suis), and dogs (Brucella canis), with Brucella melitensis and Brucella abortus accounting for the majority of human infections worldwide. Transmission to humans occurs through direct contact with infected animals or their products, consumption of unpasteurized dairy products, and occupational exposure, making it a particular hazard for farmers, veterinarians, laboratory workers, and abattoir personnel. Effective control of human brucellosis requires coordinated veterinary, medical, and public health interventions. Vaccination of reservoir hosts, improved animal husbandry practices, pasteurization of dairy products, occupational safety measures, and robust surveillance systems form the pillars of a One Health-based control strategy. The review highlights significant gaps in integrated surveillance, transdisciplinary collaboration, and resource allocation in low- and middle-income endemic countries. Emerging challenges, including antimicrobial resistance, wildlife reservoirs, and climate-driven expansion of endemic zones, necessitate a holistic, ecosystem-based approach. Adopting the One Health paradigm in national and international brucellosis control programs offers the most promising pathway toward achieving sustained reduction in disease burden across species and ecosystems.