Brucellosis is a systemic bacterial disease caused by Brucella bacteria, with symptoms including irregular fever, sweating, joint pain, and fatigue. It is most commonly transmitted from infected animals like cattle, goats, and pigs to humans through direct contact or consumption of unpasteurized dairy. While rarely fatal, it can cause long-term joint or reproductive organ complications if untreated. Control relies on vaccination and testing of livestock with elimination of infected herds to prevent transmission.

1. Brucellosis

2. BRUCELLOSIS :
• Undulant fever
• Malta fever
• Mediterranean fever

3. Identification
• A systemic bacterial disease of acute onset,
with irregular fever of variable duration;
headache; weakness; profuse sweating; chills;
arthralgia; depression; weight loss and
generalized aching.

4. • Osteoarticular complications occur in 20%–60%
of cases.
• Genitourinary involvement is seen in 2%–20% of
cases.
• The case-fatality rate of untreated brucellosis is
2% or less and usually results from endocarditis
caused by Brucella melitensis infections.

5. • Part or all of the original syndrome may
reappear as relapses.
• A neurotic symptom complex is sometimes
misdiagnosed as chronic brucellosis.

6. • Laboratory diagnosis is through appropriate isolation
of the infectious agent from blood, bone marrow or
other tissues, or from discharges.
• Current serological tests allow a precise diagnosis in
over 95% of cases, but it is necessary to combine a
test (Rose Bengal and seroaglutination)detecting
agglutinating antibodies (IgM, IgG and IgA) with
others detecting non-agglutinating antibodies
(Coombs–IgG or ELISA-IgG) developing in later
stages.

7. Infectious agents
• Brucella abortus, biovars 1–6 and 9
• B. melitensis, biovars 1–3
• B. suis, biovars 1–5
• B. canis.
• Reservoir
• Cattle, swine, goats and sheep.

8. Occurrence
• Worldwide, especially in Mediterranean countries (Europe and
Africa), Middle East, Africa, central Asia, central and South America,
India, Mexico.
• Sources of infection and responsible organism vary according to
geographic area. Brucellosis is predominantly an occupational
disease of those working with infected animals or their
tissues,especially farm workers, veterinarians and abattoir workers;
hence it is more frequent among males.
• Sporadic cases and outbreaks occur among consumers of raw milk
and milk products (especially unpasteurized soft cheese) from
cows, sheep and goats.

9. Mode of transmission
• Contact through breaks in the skin with animal
tissues, blood, urine, vaginal discharges, aborted
fetuses and especially placentas.
• ingestion of raw milk and dairy products
(unpasteurized cheese) from infected animals.
• Airborne infection occurs in pens and stables for
animals, and for humans in laboratories and
abattoirs.

10. Incubation period
• Variable and difficult to ascertain; usually 5–
60 days; 1–2 months commonplace;
occasionally several months.

11. Period of communicability
• No evidence of person-to-person
communicability.

12. Susceptibility
• Severity and duration of clinical illness vary.
Duration of acquired immunity uncertain.

13. Methods of control
• The control of human brucellosis rests on the
elimination of the disease among domestic
animals.

14. Preventive measures
1) Educate the public (especially tourists) regarding the risks
associated with drinking untreated milk or eating products
made from unpasteurized milk.
2) Educate farmers and workers in slaughterhouses, meat
processing plants and butcher shops as to the nature of the
disease and the risk in handling carcases and products from
potentially infected animals.

15. 3) Educate hunters to use protective outfits (gloves,
clothing) in handling feral swine and to bury the
remains.
4) Search for infection among livestock by serological
testing and by ELISA or testing of cows’ milk
eliminate infected animals.

16. 5) Pasteurize milk and dairy products from cows,
sheep and goats.
6) Exercise care in handling and disposal of
placenta, discharges and fetuses. Disinfect
contaminated areas.

17. Control of patient, contacts and the immediate
environment
1) Report to local health authority: Case report obligatory
in most countries.
2) Immmunization of contacts: Not applicable.
3) Investigation of contacts and source of infection: Trace
infection to the common or individual source, usually
infected domestic goats, swine or cattle, or raw milk or
dairy products from cows and goats. Test suspected
animals and remove reactors.

18. 4) Specific treatment: A combination of rifampicin (600–900
mg daily) or streptomycin (1 gram daily), and doxycycline
(200 mg daily) for at least 6 weeks is the treatment of choice.
In severely ill toxic patients, corticosteroids may be helpful.
Tetracycline should preferably be avoided in children under
7 to avoid tooth staining.
Trimethoprim-sufamethoxazole is effective, but relapses are
common (30%). Relapses occur in about 5% of patients
treated with doxycycline and rifampicin and are due to
sequestered rather than resistant organisms.

19. Epidemic measures
• Search for common vehicle of infection,
usually raw milk or milk products, especially
cheese, from an infected herd.
• Recall incriminated products.
• stop production and distribution unless
pasteurization is instituted.

20. International measures
• Control of domestic animals and animal
products in international trade and transport.
• WHO Collaborating Centres.