Table 3.
Priority zoonotic diseases selected in Jordan during the One Health Zoonotic Disease Prioritization workshop.
| Zoonotic disease | Causative agent | Human disease burden | Animal disease burden | Diagnostics, treatment, and prevention |
|---|---|---|---|---|
| Rabies | Virus | According to MOH, 4753 patients were treated for rabies exposure in 2013, but no human rabies cases were reported for the last three years. In Jordan, between 2000 and 2007, a total of 15,690 animal bites were reported averaging 1961 annual cases (minimum 1332 in 2002 – maximum 2921 in 2007). |
MOA reported a total of seven cases and seven deaths to OIE in 2013. According to MOA reports, 22 cases were documented and reported in Jordan in 2018. In the MENA, dogs are the main reservoir for rabies, and it affects more domestic carnivores (50% of cases) than farm animals (40% of cases). |
An effective animal vaccine exists, and human vaccines are available. Post-exposure prophylaxis is available. Treatment is supportive. |
| Middle East Respiratory Syndrome (MERS) | Virus | Out of the 27 total cases of MERS-CoV in Jordan, 7 cases died. In 2019, 13 laboratory-confirmed cases were reported to be linked to an outbreak in Saudi Arabia in April 2019. As of January 2019, 2298 laboratory-confirmed human cases were identified from 27 countries with 811 deaths (fatality rate = of 35.2%). In the Middle East region, the affected countries with primary cases include Saudi Arabia, Qatar, Jordan, UAE, Oman, Kuwait, Egypt, Yemen, Lebanon, and Iran in Middle East. |
In Jordan, in 2016, 28 positive MERS-CoV camel samples seroprevalence was 78% less one year, 69% 1 to 2 years, and 100% over two years. In 2019, 11 PCR positive samples and 2 out of 12 seroprevalences with seropositivity. In Saudi Arabia, seventy-five dromedary camels (N = 584) were positive for MERS-CoV. Anti-MERS ELISA assays showed that 70.9% of camels related to human cases had antibodies to MERS-CoV. |
No vaccine exists. Treatment with supportive care. |
| Zoonotic avian influenza | Virus | An upsurge of influenza activity during 2014/15, 2015/16, and 2017/18 seasons was also reported. | Jordan MOH report published in 2017 reported that on March 23, 2006, Jordan reported an outbreak of HPAI virus, type H5N1, in poultry. This was the first confirmed occurrence of HPAI in Jordan. Several of Jordan's neighboring countries also announced outbreaks of the H5N1 virus in poultry. |
Treatment with oseltamivir and supportive care. |
| Brucellosis | Bacteria | According to the MOH report, fifty-five cases were reported in Jordan in the first six months of 2019. In Jordan, the number of human Brucelloses ranged between 132 cases in 2005 and 273 cases in 2015, with a total of 1554 cases (between 2005 and 2014). The disease is endemic in Jordan. The incidence rates in the last five years range from 3.6 to 6.6 per 100,000 population with a median of 5.6 per 100,000. A total of 23.4 infections diagnosed per millions of inhabitants were reported in Jordan, while in Syria and Iraq, the number of diagnosed cases per million inhabitants were 1603.4 and 278.4, respectively. Brucellosis burden is considered the highest reported in North Africa and Middle East (up to 269 cases per 100,000 person-years). |
Among animals in Jordan, 53 positive animal cases were reported by MOA 2018, with prevalence estimates, in 2009, in cattle (N = 671, 10.1%), in sheep (N = 602, 14.3%), and in goat (N = 1100, 27.7%). No estimates were provided for camels or buffalos. A similar number of reported cases among animals was reported in 2019. |
A vaccine is available for animals and treatment with antibiotics is available for humans. |
| Leishmaniasis | Parasite | The average incidence of CL (2009–2018) was 2.2 per 100,000, with small outbreaks of focal nature frequently occurred during the last ten years. One LV case was reported in 2019 from Wadi-Araba. The disease is sporadic, with about 23 cases reported from 1962 up to Oct. 2019, 5 cases of which were imported. Two deaths in 2003 and one death of an imported case in 2018 due to late diagnosis. CL is endemic in Jordan, especially in the Jordan valley. Outbreaks of CL have been reported in Aqaba, North Agwar, and South Shuneh. However, there has been severe underreporting of the cases by an estimated factor of 47 times. A study conducted in 2019 found that 20 and 9 out of the inspected 66 patients (39 Jordanian and 27 Syrian) were infected with L. major and L. tropica, respectively. A total of 558 Syrian refugee patients were clinically diagnosed with CL during 2010–2016. L. Major is the standard and more widespread form of cutaneous leishmaniasis in Jordan. |
No reported cases in the last five years. Diagnostic tests are not available in Jordan. | No vaccination is available. Treatment is available for humans. |
| Rickettsiosis | Bacteria | Epidemiological patterns of Mediterranean Spotted Fever (MSF) in Southern Jordan children were presented between 2013 and 2015. A total of 35 male and 20 female patients (age mean (SD) = 6 ± 3.6) were identified. The incidence of MSF was 7.9 cases/100,000 inhabitants/year; MSF affected 89% of individuals in the summer, 74.5% of those living in a rural area with tent housing, and 100% of those who had contact with animals. | No cases were reported in the last five years. | Treatment is available for humans. |
| Salmonellosis | Bacteria | Between 2005 and 2014, out of five MOH sites, 2 to 8 per 1000 specimens yielded Salmonella from 10,000–20,000 specimens annually. | One case was reported in 2019, and one case in 2018. The prevalence estimates of Salmonella enterica were: 1.6% in bulk tank milk and 3.8% in fecal samples. | Treatment is available for humans. |
Abbreviations: MOH: Ministry of Health; MOA: Ministry of Agriculture; OIE: World Organization for Animal Health; MENA: Middle East and North Africa; MERS-CoV: Middle East Respiratory Syndrome- coronavirus; WHO: World Health Organization; PCR: Polymerase chain reaction; ELISA: Enzyme-Linked Immunosorbent Assay; HPAI: Highly Pathogenic Avian Influenza; CL: Cutaneous Leishmaniasis; VL: Visceral Leishmaniasis; L. Major: Leishmaniasis Major; L. Tropica: Leishmaniasis Tropica; MSF: Mediterranean Spotted Fever.