Brucellosis is a bacterial zoonotic disease caused by the Brucella genus. It is a major public health problem in Nepal, where it is commonly transmitted from infected animals like cattle, sheep, and goats to humans through the ingestion of raw milk or close contact. Symptoms in humans include fever, joint pain, and weakness. Prevention focuses on vaccination programs for animals and pasteurization of milk, while treatment involves prolonged antibiotic therapy.

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Brucellosis
By ; Samiksha kafle

3. Introduction ;
• One of the major bacterial zoonoses and in humans is also known as
undulent fever , malta fever or mediterranean fever .
• Occasionally transmitted to man by direct or indirect contact with infected
animals .
• Caused by different species of the brucella group of organism .
• Highly contagious zoonosis caused by ingestion of unsterilized milk or
meat from infected animals or close contact with their secretions .
• Person to Person transmission is rare .
BRUCELLOSIS

4. CONT….
❏ Brucella organisms are small aerobic intracellular
coccobacilli.
❏ These are found in the reproductive organs of host animals,
causing abortions and sterility.
❏ They are shed in urine, milk, placental fluid, and other fluids
of the animals.

5. cont….
❏ Many species have been identified, but the following four
have moderate-to-significant human pathogenicity:
❏ Brucella melitensis (from sheep)
❏ Brucella suis (from pigs)
❏ Brucella abortus (from cattle)
❏ Brucella canis (from dogs)
❏ Brucella melitensis and suis have the highest pathogenicity
while Brucella abortus and canis have moderate
pathogenicity.

6. ❏ More than 500,000 new human cases of brucellosis are
reported worldwide each year.
❏ However, this number is likely an underestimate as
brucellosis cases are underreported and often misdiagnosed
because symptoms are nonspecific, physicians may lack
awareness, and laboratory capacity for diagnosis is limited.
❏ B. melitensis is the most frequently reported cause of human
illness worldwide, while the most widespread potential source
of infection is B. abortus.
PROBLEM STATEMENT

7. CONT….
❏ Human infections occur most frequently among people who
have traveled to or who live in areas where the disease is
endemic in animals (mainly cattle, sheep, and goats) along the
Mediterranean Basin, South and Central America, Eastern
Europe, Asia, Africa, and the Middle East.
❏ Although not commonly reported in travelers, clinicians
should also be aware of the possibility of B. suis or B. canis
infection, as these Brucella speciesimal populations (such as
B. suis in feral swine and caribou/reindeer and B. canis in
canines) that certain travelers may co are present in anntact.

8. In Nepal
Brucellosis is a significant public health problem in Nepal. The
first human case was reported in 1979 when the disease was
diagnosed in a shepherd from Pokhara by the isolation of B.
melitensis, who most likely acquired the disease from his sheep.
As recorded by various authors [64, 65, 66], the incidence of
brucellosis in Nepalese in males is between 5.6%-9.42%, while in
females it is between 2.9%-6.60%,.

9. Agent factors
✔ Agent
They are small , gram negative , rod shaped , non motile , non
sporing and intracellular coccobacilli of the genus Brucella .
✔ Reservoir of infection
Main reservoir of human infection are cattle ,sheep, goats, swine ,
buffaloes ,horses and dogs .
In animal the disease can cause abortion , premature expulsion of the
foetus or death .
Epidemiological Determinant

10. HOST FACTORS
▪ Human brucellosis predominantly a disease of adult male .
▪ At special risk : farmers , shepherds , butchers , and abattoir
workers , veterinarians & laboratory workers .
ENVIRONMENTAL FACTORS
▪ Overcrowding of herds , high rainfall , lack of exposure to
sunlight ,unhygienic practices in milk and meat production , all
favour the spread of brucellosis .
▪ Infection can survive for weeks , or months in favourable
conditions of water ,urine , faeces, damp soil and manure.

11. a) Contact infection
▪ Occurs by direct contact with infected tissues blood , urine ,
vaginal discharges , aborted foetuses and specially placenta.
b) Food-borne infection
▪ May take place by the ingestion of raw milk from Infected
animals , fresh raw vegetables, if grown on soil containing
manure from infected farms .
c) Air-borne infection
▪ Environment of cowshed may be heavily infected .Brucellae
may be inhale din aerosol form in slaughter houses and lab.
MODE OF TRANSMISSION

12. c) Air-borne infection
▪ Environment of cowshed may be heavily infected .Brucellae
may be inhale din aerosol form in slaughter houses and lab.
INCUBATION PERIOD
▪ Usually 1-3 weeks , but may be as long as 3 months or more .
Cont…

13. ▪ It is an acute febrile disease to a chronic low-grade-ill-defined
disease, lasting for several days, months or occasionally years .
Acute phase is characterized by ;
▪ Swinging pyrexia (up to 40 -41 degree celsius ) , rigors and
sweating,
▪ Arthralgia /arthritis involving large joint (hips , knee , shoulder
and ankle etc, )
▪ Low back pain ,
▪ Headache and insomnia ,
▪ Small firm Splenomegaly and Hepatomegaly ,
▪ Leucopenia with relative lymphocytosis .
PATTERN OF DISEASE

14. • Prevention is based on surveillance and the prevention of risk
factors .
▪ The most effective strategy is the elimination of infection in
animals .
▪ Vaccination of cattle , goats , and sheep is recommended in
enzootic areas with high prevalence rates .
▪ Pasteurization of milk for direct consumption to prevent
transmission from animals to humans .
PREVENTION & CONTROL

15. In agricultural work and meet processing protective barriers
and correct handling and disposal of afterbirths ,animal
carcasses and internal organ is an important prevention
strategy.
Cont…

16. ▪ Treatment options include doxycycline 100 mg twice a day for 45 days,
plus streptomycin 1 g daily for 15 days.
▪ The main alternative therapy is doxycycline at 100 mg, twice a day for 45
days, plus rifampicin at 15mg/kg/day (600-900mg) for 45 days.
▪ The optimal treatment for pregnant women, neonates and children under 8
is not yet determined; for children, options include
trimethoprim/sulfamethoxazole (co-trimoxazole) combined with an
aminoglycoside (streptomycin, gentamycin) or rifampicin.
Treatment

17. ❏ https://www.who.int/news-room/fact-
sheets/detail/brucellosis#:~:text=Prevention%20and%20contr
ol&text=The%20most%20effective%20prevention%20strateg
y,in%20areas%20with%20low%20prevalence.
❏ Brucellosis - StatPearls - NCBI Bookshelf (nih.gov)
❏ Parks Textbook of Preventive and Social Medicine
❏ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6269619/#:~
:text=As%20recorded%20by%20various%20authors,which%
20was%204.48%25%20in%20humans.
Reference