Have you been feeling unwell for a few days, with aches and pains, and a fever? Maybe you work with animals, or you eat raw milk or skim milk from a village. Then it is very important for you to be aware of this disease, which is called Brucellosis.
What exactly is Brucellosis?
Simply put, brucellosis is a disease caused by a type of bacteria called Brucella. The specialty of this is that it is a disease that is transmitted from animals to humans. In medicine, we call this a zoonotic disease. This disease can cause symptoms such as prolonged body discomfort, fever, joint pain, and excessive sweating. Other names for this disease include Malta fever or Mediterranean fever.
Although it is not very common in Sri Lanka, about 500,000 cases are reported worldwide every year. So, it is very important to be aware of this.
Who is at higher risk of developing this disease?
Not everyone gets this disease. But some people are at a slightly higher risk depending on their occupation or lifestyle. See if you fall into this category.
| At-risk group | Description |
|---|---|
| Veterinarians and those who work with animals | Due to frequent contact with body fluids or tissues of infected animals. |
| Dairy farms and farm workers | Because of close contact with infected animals such as cows, goats, and sheep. |
| Butchers and slaughterhouse workers | Due to handling raw meat and tissues of infected animals. |
| Hunters | Due to handling the meat and tissue of wild animals such as deer and elk. |
| Laboratory workers | When handling Brucella bacteria for testing. |
| People who eat raw dairy products and undercooked meat | By eating unpasteurized milk, cheese, yogurt, and undercooked meat. |
What are the symptoms of this disease?
Symptoms of Brucella usually appear two to four weeks, or even longer, after the bacteria has entered the body. These symptoms can come and go for months, even years. This can make it difficult to diagnose.
| Main symptoms | Explanation |
|---|---|
| Fever | The fever may increase day by day, and may show a pattern such as only getting the fever at the same time of day. |
| Sweating | You sweat profusely, especially at night, and sometimes you may smell a musty odor. |
| Joint pain | Severe pain, especially in the hips, knees, or lower back. |
| Weight loss | Weight loss without any obvious reason. |
| Other features | Headaches, stomach aches, loss of appetite, depression, swollen glands, and general malaise. |
How do we get this disease?
This disease is mainly transmitted through infected animals or products obtained from them. Let's see how.
- Drinking or eating unpasteurized dairy products: This bacteria can be found in raw milk, cheese, and ice cream from infected animals. But remember, drinking pasteurized milk will not cause this disease. This process kills the bacteria.
- Contact with the tissue or body fluids of an infected animal: If you have a cut or scratch on your skin, the bacteria can enter your body through it, or through your eyes, nose, or mouth.
- Inhaling the bacteria: The disease can also be spread by breathing in tiny particles that become airborne when working with tissue or blood from an infected animal. People who work on farms, slaughterhouses, meatpacking plants, and laboratories are at higher risk.
- Eating undercooked meat: There is also a risk of contracting the disease by eating the meat of an infected animal without cooking it thoroughly.
Importantly, human-to-human transmission of the disease is extremely rare. Although there have been very rare cases of transmission from a pregnant mother to her child, during breastfeeding, or during sexual intercourse, brucellosis is not a sexually transmitted disease (STI).
Doctor, how do you diagnose this as a disease?
When you go to see your doctor, he or she will ask about your symptoms, your occupation, whether you have contact with animals, and whether you eat things like raw dairy products. Because these symptoms are similar to many other diseases, some tests may be needed to make an accurate diagnosis.
| Test | What are you doing? |
|---|---|
| Blood tests | A blood sample is taken to check for antibodies made by the body against the Brucella bacteria, or an attempt is made to culture the bacteria in the blood. |
| Testing other body fluids | Samples of spinal fluid and joint fluid are taken and tested for the presence of bacteria. |
| Tissue biopsy | A small sample of tissue, such as bone marrow, is taken and tested. |
| Imaging tests | Tests such as X-rays, CT scans, and MRI scans are used to check for damage to bones or internal organs such as the liver and spleen. |
What are the treatments for this?
The good news is that brucellosis can be completely cured with antibiotics . However, one antibiotic alone is not enough. Usually, two or more types of antibiotics need to be used together.
The treatment period is a bit long. You have to take the medicine continuously for at least 6-8 weeks. Do not stop the medicine halfway just because you feel a little better. If you do, the chances of the disease coming back are very high. Therefore, it is imperative to take the medicine until the doctor prescribes it.
Some commonly used antibiotics are:
- Doxycycline ( Doxycycline )
- Rifampin
- Streptomycin or Gentamicin
- Trimethoprim/sulfamethoxazole (TMP/SMX)
Ask your doctor about ways to manage symptoms like fever and joint pain while taking these antibiotics.
What happens after treatment? Are there any complications?
Most people recover completely after antibiotic treatment, but some symptoms, especially joint pain such as arthritis, may persist for some time after treatment.
If the disease goes undiagnosed for a long time, some complications can occur. These are quite serious.
- Long-term arthritic conditions.
- Swelling of the liver (hepatomegaly) or spleen (splenomegaly).
- Infection of the inner lining of the heart (endocarditis).
- Infection of the brain or brain covering (encephalitis or meningitis).
- Infections of the spine or other bones (spondylitis, osteomyelitis)
- Inflammation of the testicles and associated ducts in men (epididymo-orchitis).
- For a pregnant mother, there is a risk of miscarriage.
But don't worry, death from this disease is extremely rare.
How can you avoid this disease?
There are some simple, yet very important steps we can follow to protect ourselves from this disease.
| What to do | Why is it important? |
|---|---|
| Avoid unpasteurized milk and products. | This is the main way the disease is transmitted. Avoid consuming anything labeled "raw milk." |
| Wear protective clothing when working with animals. | Wearing gloves and goggles can prevent bacteria from entering the body. |
| Cook the meat well and eat it. | Cooking the meat until it reaches the proper internal temperature kills the bacteria. |
| Take care of cleanliness. | Wash hands, knives, cutting boards, and other utensils thoroughly with soap after handling raw meat. |
When should you see a doctor?
If you have any of the symptoms mentioned in this article, especially if you belong to one of the risk groups mentioned above, see a doctor immediately. The earlier the disease is detected, the easier it is to treat and prevent complications.
When should you go to the Emergency Treatment Unit (ETU)?
If you have any of the following serious symptoms, go to the nearest hospital's Emergency Department (ETU) immediately.
- A high fever of more than 39.4 degrees Celsius (103 Fahrenheit).
- A very severe stomach ache.
- Confusion or altered consciousness.
Take-Home Message
- Brucellosis is a bacterial infection that can be transmitted from animals to humans.
- Recurrent fever, joint pain, and excessive sweating are the main symptoms.
- The best way to protect yourself is to avoid eating unpasteurized dairy products and undercooked meat.
- This can be completely cured with antibiotics, but it is essential to take the medication for the full duration prescribed by the doctor.
- If you have symptoms, especially if you work with animals, be sure to see a doctor.
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