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Brucellosis - Causes and Symptoms

Other Names: Cyprus Fever, Gibraltar Fever, Malta Fever, Rock Fever, Undulant Fever

Definition of Brucellosis

Brucellosis is a disease caused by a bacteria, Brucella canis. It is found throughout the world. It is spread through contact with aborted fetuses and discharges from the uterus of infected bitches, during mating, through maternal milk and possibly through airborne transmission in some cases. It is a highly contagious disease of ruminant animals that also affects humans. Although brucellosis can attack other animals, its main threat is to cattle, bison, and swine. The disease is also known as contagious abortion or Bang's disease.

Brucellosis can be transmitted from animals to humans by ingestion of infected food products, direct contact with an infected animal, or inhalation of aerosols. The bacteria enters the body through mucous membranes and spreads from there to lymph nodes and the spleen. It also spreads to the uterus, placenta and prostate gland as well as other internal organs at times.

Causes of Brucellosis

Brucellosis is commonly transmitted through abrasions of the skin from handling infected mammals. In the United States, occurs more frequently by eating uncooked or undercooked contaminated meat or drinking unpasteurized milk or dairy products. Brucellosis is caused by the nonmotile, nonspore-forming, Gram-negative coccobacilli of the genus Brucella, notably B. suis (found in swine), B. melitensis (in goats), B. abortus (in cattle), and B. canis (in dogs).

People may also get brucellosis by handling the tissues, blood, urine, vaginal discharges, aborted fetuses, or placentas of infected animals. Spreading of brucellosis from one person to person other is usually rare but can occur very easily through sexual contact with an infected person, through transplantation of infected tissues, or through an infected mother to her infant during breastfeeding. Also, exposure to the drainage from fistulous withers in horses can cause brucellosis in humans.

Symptoms of Brucellosis

The symptoms of Brucellosis - which often mimic a severe bout of 'flu' - are acute or insidious in onset. The chronic phase consists of:

  • abdominal pain
  • continued and recurrent depression
  • sleep disturbances
  • irregular fever
  • fatigue
  • headache
  • back pain
  • sweating
  • weakness
  • profuse sweating
  • loss of appetite
  • chills
  • sexual impotence
  • enlarged liver
  • joint pain

Osteoarticular complications are seen in 20%-60% of cases; sacroileitis is the most frequent joint manifestation. Genitourinary involvement may occur. Urogenital symptoms may dominate the clinical presentation in some patients. The duration of the disease can vary from a few weeks to many months.

As the disease progresses, it may cause a severe fever (104-105° F). This fever occurs in the evening along with severe sweating. It becomes normal or near normal in the morning, and usually begins again at night. Additionally, abscesses may form in the testes, ovaries, kidneys, and brain (meningitis and encephalitis). About 10% to 15% of patients with such brain abscesses develop hearing and visual disorders, hemiplegia, and ataxia.

Treatment of Brucellosis

Some of the treatment options for brucellosis includes:

  • Treatment consists of bed rest during the febrile phase.
  • Antibiotic therapy includes a combination of doxycycline and an arninoglycoside such as streptomycin, gentamicin, or netilmicin for 4 weeks followed by the combination of doxycycline and rifampin for 4 weeks. Longer courses of therapy may be required for complications.
  • In pregnancy, trimethoprim-sulfamethoxazole can be given along with rifampin.
  • Tetracycline or tetracycline plus streptomycin is the treatment of choice. Early diagnosis leading to prompt treatment is essential to prevent chronic infection.
  • In the case of endocarditis, heart valve replacement may be necessary.
  • Doxycycline (taken in doses of 12.5 mg/kg two times daily orally) for 2 weeks with gentamicin (2 mg/kg subcutaneous or intramuscular injection twice daily) for 1 week may be helpful for the treatment of brucellosis.
  • Severe cases may also need intravenous and oral corticosteroids to treat inflammation.

Prevention

There is no human vaccine for brucellosis, but humans can be protected by controlling the disease in livestock. It is only available for cattle, but not humans. After checking to make sure an animal is not already infected, and destroying those that are, all livestock should be immunized.

Some of the preventive measures to be taken are:

  • Do not consume un-pasteurized milk, cheese, or ice cream while traveling. Farming families, in particular, are especially advised to take precautions. The prevalence of un-pasteurised milk consumption among irish farming families is very common. Almost 80% of them consume it.
  • If you are not sure whether the dairy product is pasteurized or not, don't eat it.
  • Hunters and animal herdsman should use rubber gloves when handling viscera of animals.
  • 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.

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