Brucellosis

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Brucellosis

Other names undulant fever, undulating fever, Mediterranean fever, Malta fever, Cyprus fever,
rock fever (Micrococcus Melitensis)[1]

Brucella spp.JPG

Specialty Infectious disease

Symptoms coughing

Brucellosis[2][3] is a highly contagious zoonosis caused by ingestion of unpasteurized milk or

undercooked meat from infected animals, or close contact with their secretions.[4] It is also
known as undulant fever, Malta fever, and Mediterranean fever.[5]

Brucella species are small, Gram-negative, nonmotile, nonspore-forming, rod-shaped (coccobacilli)

bacteria. They function as facultative intracellular parasites, causing chronic disease, which usually
persists for life. Four species infect humans: B. abortus, B. canis, B. melitensis, and B. suis. B.
abortus is less virulent than B. melitensis and is primarily a disease of cattle. B. canis affects dogs.
B. melitensis is the most virulent and invasive species; it usually infects goats and occasionally
sheep. B. suis is of intermediate virulence and chiefly infects pigs. Symptoms include profuse
sweating and joint and muscle pain. Brucellosis has been recognized in animals and humans since
the 20th century.

Signs and symptoms

A graph of the cases of brucellosis in humans in the United States from the years 1993–2010
surveyed by the Centers for Disease Control and Prevention through the National Notifiable
Diseases Surveillance System[6]

The symptoms are like those associated with many other febrile diseases, but with emphasis on
muscular pain and night sweats. The duration of the disease can vary from a few weeks to many
months or even years.

In the first stage of the disease, bacteremia occurs and leads to the classic triad of undulant fevers,
sweating (often with characteristic foul, moldy smell sometimes likened to wet hay), and
migratory arthralgia and myalgia (joint and muscle pain). Blood tests characteristically reveal a low
number of white blood cells and red blood cells, show some elevation of liver enzymes such as
aspartate aminotransferase and alanine aminotransferase, and demonstrate positive Bengal rose
and Huddleston reactions. Gastrointestinal symptoms occur in 70% of cases and include nausea,
vomiting, decreased appetite, unintentional weight loss, abdominal pain, constipation, diarrhea,
an enlarged liver, liver inflammation, liver abscess, and an enlarged spleen.

This complex is, at least in Portugal, Israel, Syria, and Jordan, known as Malta fever. During
episodes of Malta fever, melitococcemia (presence of brucellae in the blood) can usually be
demonstrated by means of blood culture in tryptose medium or Albini medium. If untreated, the
disease can give origin to focalizations[clarification needed] or become chronic. The focalizations
of brucellosis occur usually in bones and joints, and osteomyelitis or spondylodiscitis of the lumbar
spine accompanied by sacroiliitis is very characteristic of this disease. Orchitis is also common in
men.

The consequences of Brucella infection are highly variable and may include arthritis, spondylitis,
thrombocytopenia, meningitis, uveitis, optic neuritis, endocarditis, and various neurological
disorders collectively known as neurobrucellosis.

Cause

Granuloma and necrosis in the liver of a guinea pig infected with Brucella suis

Brucellosis in humans is usually associated with consumption of unpasteurized milk and soft
cheeses made from the milk of infected animals—primarily goats, infected with B. melitensis and
with occupational exposure of laboratory workers, veterinarians, and slaughterhouse workers.[7]
Some vaccines used in livestock, most notably B. abortus strain 19, also cause disease in humans if
accidentally injected. Brucellosis induces inconstant fevers, miscarriage, sweating, weakness,
anemia, headaches, depression, and muscular and bodily pain. The other strains, B. suis and B.
canis, cause infection in pigs and dogs, respectively.

Overall findings support that brucellosis poses an occupational risk to goat farmers with specific
areas of concern including weak awareness of disease transmission to humans and lack of
knowledge on specific safe farm practices such as quarantine practices.[8]