What are the other Names for this Condition? (Also known as/Synonyms)

• Bang’s Disease
• Infection by Brucella sp.
• Undulant Fever due to Brucellosis

What is Brucellosis? (Definition/Background Information)

• Brucellosis is an infection caused by bacteria belonging to the Brucella species. It is a zoonotic disease - one that is transmitted from animals to humans. Brucella sp. are commonly found in animals such as sheep, goat, cattle, deer, pigs, and dogs
• Human infection can occur through various means such as direct contact with the infected animals (through open cuts and wounds), inhalation of the bacteria, breastfeeding (from mother to child), and by sexual transmission
• Although Brucellosis can affect any individual, farmers, veterinarians, those working in slaughterhouses and meat packers, aid workers, and frequent travelers are more prone to the disease
• Brucellosis is characterized by long-lasting or chronic symptoms that include fever, joint pain, and tiredness. If left undiagnosed and untreated, several complications could arise as a result of the bacterial infection spreading to vital organs
• A healthcare provider might record the symptoms, medical and travel history, and require information from blood tests, CT scans, echocardiograph, and other tools to arrive at a diagnosis of Brucellosis, as well as to assess the extent of infection spread in the body
• The typical treatment for Brucellosis is taking antibiotics for six weeks. Depending on the severity and spread of infection, recovery may take from a few weeks to several months. Death from Brucellosis is not very common
• One could potentially avoid contracting Brucellosis by minimizing risk of exposure to the infecting bacteria. Some preventative measures include wearing gloves while handling infected animals, separating the slaughtering areas from processing areas, thoroughly cooking meat, and avoiding unpasteurized dairy products

Who gets Brucellosis? (Age and Sex Distribution)

Any individual (child or adult) is susceptible to Brucellosis. However, it is more common among the following category of people:

• Individuals who work in slaughter houses
• Those who are involved in cleaning and butchering livestock (and deer)
• Those who are closely associated with cattle, pigs, sheep, and goats; farm workers
• Individuals who consume unpasteurized dairy products and raw milk
• Veterinarians
• People whose occupation involves packing/packaging meat and dairy products
• Travelers, missionaries, and aid workers are generally more prone to Brucellosis

Brucellosis occurs worldwide and all racial and ethnic groups are at risk; no particular preference is observed.

What are the Risk Factors for Brucellosis? (Predisposing Factors) 

The risk factors for Brucellosis may include:

• Place of living: Some geographical areas in the world have been determined as high-risk, as far as Brucellosis infection is concerned. They include the following regions:
  • Mediterranean basin; near the Persian gulf
  • South and Central America; Latin America
  • Eastern Europe
  • Asia including the Indian subcontinent
  • Africa and the middle East
  • Caribbean islands
• Travelers: Individuals, who are involved in extensive travelling throughout the world, are at high risk of contracting this infection. Among travelers, generally it has been observed that eating unpasteurized cheese, known as “village cheese”, is the main source and cause of Brucellosis infection
• Occupations: People who are involved in fields listed below have a greater risk of getting infected. These include:
  • Veterinarians
  • Dairy farmers
  • Ranchers
  • Slaughterhouse workers
  • Hunters
  • Microbiologists

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Brucellosis? (Etiology)

Brucellosis is a bacterial infection that is transmitted from animals to humans. It is caused by the bacterium, Brucella sp (such as Brucella abortus). This bacterium commonly infects farm animals, such as cattle, sheep, goat, and pigs, wild animals, such as deer, and even pets like dogs.

A transmission to humans could result from:

• Direct contact with the infected animals; through the mucous membranes
• Cuts and wounds in the skin coming in direct contact with infected animal fluids
• Consuming unpasteurized dairy products including raw milk
• Breathing-in the bacteria
• Breastfeeding mothers passing the infection to their young ones
• Sexual transmission

What are the Signs and Symptoms of Brucellosis?

The signs and symptoms of Brucellosis may be grouped as short-term or long-term.

The short-term symptoms may include:

• Undulant fever, which is fever of variable duration
• Chills, sweating
• Weight loss, loss of appetite
• Vomiting
• Anemia
• Weakness and fatigue; prolonged tiredness
• Joint, muscle, and back pain; headache
• Depression, irritability
• Insomnia (unable to sleep)
• Mental disorders

The long-term symptoms may include:

• Fatigue
• Recurrent fever
• Arthritis and spondylitis
• Infection in the bones and joints
• Infection in various organs such as liver, kidney, spleen, heart valves and lining of the heart
• Infection of the central nervous system
• Testicular swelling in males

How is Brucellosis Diagnosed?

The following laboratory exams and tests may be undertaken to diagnose Brucellosis:

• Complete physical examination including evaluation of medical and travel history
• Blood or bone marrow sample tests to check for the presence of Brucella bacteria
• Blood tests may also be conducted to check the level of antibodies present in blood
• X-rays to observe any changes in the bones and joints
• CT (computerized tomography) or MRI (magnetic resonance imaging) scans to identify the presence and extent of inflammation in the brain and other tissues
• Cerebrospinal fluid culture to check for meningitis and encephalitis
• Echocardiography to check for any damage or infection in the heart

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Brucellosis?

Brucellosis can affect several organs of the human body and cause many complications that include:

• Endocarditis (infection of the heart’s inner lining): It is a very serious complication, which when left unattended, can damage the heart valves. It is a major cause for Brucellosis-related deaths
• Arthritis: It is characterized by pain, stiffness, and swelling in the joints, especially in the knees, hips, ankles, wrists, and spine
• Spondylitis: Inflammation in the bones of the spine or between the spine and pelvis
• Epididymo-orchitis (inflammation and infection of the testicles): Brucellosis can damage the coiled tube that connects the vas deferens and the testicle, causing severe swelling and pain. It can affect the prostate gland and the kidneys as well
• Infection of the central nervous system: This complication includes life-threatening illness that include:
  • Meningitis: Inflammation of the membranes surrounding the brain and spinal cord
  • Encephalitis: Inflammation of the brain

How is Brucellosis Treated?

• The main emphases of treatment for Brucellosis is on relieving symptoms, preventing relapse or recurrence of the disease, and in reducing the complications
• The recommended treatment for Brucellosis is a course of antibiotics for 6 weeks

How can Brucellosis be Prevented?

The following preventive measures may be adopted to avoid contracting Brucellosis:

• Avoiding unpasteurized dairy foods including raw milk
• Cooking meat thoroughly till it reaches an internal temperature of 145-165 deg. F, as high-temperature heating destroys the bacteria
• Avoiding buying meat from street vendors
• Wearing gloves while handling sick or dead animals, especially veterinarians, farmers, hunters and slaughterhouse workers
• Particular care must be taken while handling aborted animal fetuses (including tissue and fluids), while assisting animal birth, or while calving (in cattle); use long arm disposable plastic gloves
• Adhering to safety precautions in high-risk work places that deal with animals
• Handling specimens under bio-safety conditions (since lab workers could be at risk)
• In slaughterhouses, separating the slaughtering place from the processing area, can help avoid spread of the bacteria
• Eliminating Brucellosis from livestock by vaccinating domestic animals
• Having safe sex
• Pregnant women should avoid handling raw meat and meat products, since they may be infected
• Quarantine infected herds and eliminate them from the healthy stock of animals, since Brucellosis in animals has no treatment

What is the Prognosis of Brucellosis? (Outcomes/Resolutions)

• Recovery from Brucellosis may take from a few weeks to several months, depending on how soon the treatment was started and the severity of the illness
• Generally, the mortality rate from Brucellosis is reported to be low

Additional and Relevant Useful Information for Brucellosis:

Brucellosis frequently results in spontaneous abortion in animals (mostly reported in cattle), and hence, the condition is also known as Contagious Abortion in animals.