Brucellosis

Definition

Definition of Brucellosis
Brucellosis, also called Bang's disease, Crimean fever, Gibraltar fever, Malta fever, Maltese fever, Mediterranean fever, rock fever, or undulant fever, is a highly contagious zoonosis caused by ingestion of unsterilized milk or meat from infected animals or close contact with their secretions. Transmission from human to human, through sexual contact or from mother to child, is rare but possible. Brucella spp. are small, Gram-negative, non-motile, non-spore-forming, rod shaped (coccobacilli) bacteria. They function as facultative intracellular parasites causing chronic disease, which usually persists for life. Symptoms include profuse sweating and joint and muscle pain.

Symptoms

Symptoms of Brucellosis
Acute brucellosis may begin with mild flu-like symptoms, or symptoms such as:

1. Abdominal pain
2. Back pain
3. Chills
4. Excessive sweating
5. Fatigue
6. Fever
7. Headache
8. Joint pain
9. Loss of appetite
10. Weakness
11. Weight loss

Causes

Causes of Brucellosis
Brucellosis is a systemic infectious disease transmitted from certain animals to humans (zoonotic disease). Brucellosis in humans is predominantly caused by four different species of Brucella bacteria: Brucella melitensis (goats, sheep, camels), Brucella suis (pigs), Brucella abortus (cows, buffalo, elk, camels, yaks), and Brucella canis (dogs). Though all of these species can cause human brucellosis, Brucella melitensis is the most prevalent worldwide, and it is felt to cause the most severe cases of brucellosis.

Diagnosis

Diagnosis of Brucellosis

1. Blood culture
2. Bone marrow culture
3. Clean catch urine culture
4. CSF culture
5. Serology for brucellosis antigen

Treatment

Treatment of Brucellosis
Antibiotics are used to treat the infection and prevent it from coming back. Longer courses of therapy may be needed if there are complications.

Prognosis

Prognosis of Brucellosis
Relapse may occur, and symptoms may continue for years. As with tuberculosis, the illness can come back after a long period of time.

Prevention

Prevention of Brucellosis
To reduce the risk of getting brucellosis, take these precautions:

1. Avoid unpasteurized dairy foods: In recent years in the United States, few cases of brucellosis have been linked to raw dairy products from domestic herds. Still, it's probably best to avoid unpasteurized milk, cheese and ice cream, no matter what their origin. Travelers to other countries should avoid all raw dairy foods.
2. Cook meat thoroughly: All meat should be cooked until it reaches an internal temperature of 145 to 165 F (63 to 74 C). When eating out, order beef and pork at least medium-well. It's unlikely that domestic meat in the United States contains brucella bacteria, but proper cooking destroys other harmful bacteria such as salmonella and Escherichia coli. When traveling abroad, avoid buying meat from street vendors, and order all meat well-done.
3. Wear gloves: Veterinarians, farmers, hunters and slaughterhouse workers should wear rubber gloves when handling sick or dead animals or animal tissue or when assisting an animal giving birth.
4. Take safety precautions in high-risk workplaces: Laboratory workers should handle all specimens under appropriate biosafety conditions. Workers who have been exposed should be treated promptly. Slaughterhouses should also follow protective measures, such as separation of the killing floor from other processing areas and use of protective clothing.
5. Vaccinate domestic animals: In the United States, an aggressive vaccination program has nearly eliminated brucellosis in livestock herds. Milk is tested two to four times a year for signs of the bacteria. Because the brucellosis vaccine is live, it can cause disease in people. Anyone who has an accidental needle stick while vaccinating an animal should be treated.