Brucellosis is an infectious
disease caused by the Brucella bacteria. These bacteria are
primarily passed among animals, and they cause disease in
many different vertebrates. Various Brucella species affect
sheep, goats, cattle, deer, elk, pigs, dogs, and several
other animals. Humans become infected by coming in contact
with animals or animal products that are contaminated with
these bacteria.
How is it caused?
Humans generally get infected by either
eating or drinking something that is contaminated with
Brucella, breathing in the organism (inhalation), or having
the bacteria enter the body through skin wounds. Eating or
drinking contaminated milk products is the most common way
to get infected. When sheep, goats, cows, or camels are
infected, their milk is contaminated with the bacteria. If
the milk is not pasteurised, these bacteria can be
transmitted to persons who drink the milk or eat cheese made
from it.
Inhalation of Brucella organisms is not a
common route of infection, but it can be a significant
hazard for people in certain occupations, such as those
working in laboratories where the organism is cultured.
Inhalation is often responsible for a significant percentage
of cases in abattoir employees.
Contamination of skin wounds may be a
problem for persons working in slaughterhouses or meat
packing plants or for veterinarians. Hunters may be infected
through skin wounds or by accidentally ingesting the
bacteria after cleaning deer, elk, moose, or wild pigs that
they have killed.
The illness may be chronic and persists
for years. People working in occupations requiring frequent
contact with animals or meat, such as slaughterhouse
workers, farmers, and veterinarians, are at high risk.
Brucellosis can be very common in countries where animal
disease control programmes have not reduced the amount of
disease among animals.
Can it be spread from person to person?
Direct person-to-person spread of brucellosis
is extremely rare. Mothers who are breast feeding may
transmit the infection to their infants. Sexual transmission
has also been reported. For both sexual and breast-feeding
transmission, if the infant or person at risk is treated for
brucellosis, their risk of becoming infected will probably
be eliminated within 3 days. Although uncommon, transmission
may also occur via contaminated tissue transplantation.
What are the symptoms?
In humans, brucellosis can cause a range of
symptoms that are similar to the flu and may include fever,
sweats, headaches, back pains, and physical weakness. Severe
infections of the central nervous systems or lining of the
heart may occur. Brucellosis can also cause long-lasting or
chronic symptoms that include recurrent fevers, joint pain,
and fatigue.
Acute brucellosis may
begin with mild flu-like symptoms or with fever, chills,
sweating, muscle aches (myalgia), joint aches and malaise.
Usually, fever occurs every afternoon to levels around 104
degrees Fahrenheit. Other symptoms may include weakness,
weight loss, fatigue, headache, abdominal pain, back pain,
loss of appetite, joint pain or swollen glands.
How is the diagnosis made?
Brucellosis is diagnosed in a laboratory by
finding Brucella organisms in blood or bone marrow culture.
Also, blood tests can be done to detect antibodies against
the bacteria. If this method is used, two blood samples
should be collected 2 weeks apart. Other tests are:
Urine culture
CSF culture
Serology detecting brucellosis antigen
How is it treated?
A combination antibiotic
therapy, such as doxycycline and rifampicin or an
aminoglycoside, is recommended to treat and prevent relapse
of infection. Usually, doxycycline and rifampicin are used
in combination for 6 weeks to prevent recurring infection.
Longer courses of therapy may be required for complications.
Depending on the timing of treatment and severity of
illness, recovery may take a few weeks to several months.
What is the prognosis?
Relapse may occur, and symptoms may persist
for years. Reactivation can occur after a long period of
time, as with tuberculosis. Mortality is low, and is usually
associated with endocarditis.
How can it be prevented?
Pasteurisation of milk and
eating only pasteurised cheese are the most important
preventive measures. Do not consume unpasteurised milk,
cheese, or ice cream while travelling. If you are not sure
that the dairy product is pasteurised, don't eat it.
People who handle meat should wear protective glasses and
clothing and protect skin breaks from infection. Detecting
infected animals controls the infection at its source.
Vaccination is available for cattle, but not humans.
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