• Brucellosis

    (Undulant Fever; Bang’s Disease; Malta Fever)

    Definition

    Brucellosis is a rare bacterial disease that causes fevers to come and go. Brucellosis is mainly spread among animals. People can also get this disease from domesticated animals. It results in flu-like symptoms and may cause long-lasting symptoms.

    Causes

    Brucellosis is caused by the bacterium Brucella. This bacterium infects domesticated animals. It can be spread to humans through:
    • Drinking unpasteurized milk
    • Eating dairy foods from infected cows, sheep, or goats
    • Inhaling the bacteria
    • Breastfeeding (passed from mother to infant)
    • Sexual transmission
    • Tissue transplantation

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition. Risk factors for brucellosis include:
    • Working with domesticated animals and livestock, especially sheep, goats, cattle, deer, elk, and pigs, or their waste products, bodily fluids, or carcasses
    • Sex: male (possibly due to occupational exposure among farmers, ranchers, veterinarians, people working in tanneries, and slaughterhouse workers)

    Symptoms

    Symptoms of brucellosis usually appear within two weeks of infection. Symptoms can appear from five days to several months after infection.
    In the early stage, symptoms may include:
    • Discomfort
    • Sluggishness
    • Headache
    • Muscle pain
    • Fever
    • Chills
    • Severe headache and backache
    • Nausea, vomiting, and diarrhea
    • Rash
    • Abdominal fullness or discomfort
    • Joint pain
    As it progresses, brucellosis causes a severe fever (104° F to 105° F). This fever occurs in the evening along with severe sweating. It becomes normal or near normal in the morning, and usually begins again at night.
    This on and off fever usually lasts 1 to 5 weeks. After 5 weeks, symptoms usually improve or disappear for two days to two weeks. Then the fever recurs. In some patients, this fever returns only once. In others, the disease becomes chronic, and the fever returns, lessens, and then recurs again over months or years.
    In later stages, brucellosis can cause:
    • Loss of appetite
    • Weight loss
    • Abdominal pain
    • Headache
    • Backache
    • Joint pain
    • Weakness
    • Irritability
    • Insomnia
    Patients usually recover within 2 to 5 weeks. Rarely, complications can develop. These may include:
    • Abscesses within the liver or spleen
    • Enlargement of the liver, spleen, or lymph nodes
    • Inflammation and infection of organs in the body, such as:
    • Scrotal swelling
    Endocarditis
    Bacterial endocarditis, aortic valve
    Copyright © Nucleus Medical Media, Inc.
    Brucellosis is also believed to cause a high rate of miscarriage during early pregnancy in infected women.

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    Your doctor may need to test your bodily fluids. This can be done with:
    • Blood tests
    • Urine tests
    • Bone marrow tests
    • Tissue tests
    Your doctor may need pictures of your bodily structures. This can be done with:

    Treatment

    Many patients recover from brucellosis on their own. However, early diagnosis and treatment can reduce the risk of complications and infection. Talk with your doctor about the best treatment plan for you. Treatment options include:

    Antibiotics

    Your doctor may prescribe one or more antibiotics (usually doxycycline and rifampin) to control and prevent brucellosis. Antibiotics are given for up to six weeks.

    Prevention

    To help reduce your chances of getting brucellosis, take the following steps:
    • Avoid eating or drinking unpasteurized milk and dairy foods. If you are unsure if a dairy product is pasteurized, don’t eat it.
    • Wear rubber gloves and goggles, and securely cover open wounds when handling domesticated animals including their fluids, waste products, or carcasses.
    • Wear a protective mask when dealing with brucellosis cultures in a laboratory.
    • Have cattle and bison that live in areas heavily infected with brucellosis vaccinated by an accredited veterinarian or government health official. The vaccine contains a live virus and is dangerous to humans. For best results, calves should be vaccinated when they are 4-6 months old. There is no brucellosis vaccine for humans as of yet.

    RESOURCES

    Centers for Disease Control and Prevention http://www.cdc.gov

    National Foundation for Infectious Diseases http://www.nfid.org

    United States Department of Agriculture http://www.usda.gov

    CANADIAN RESOURCES

    Manitoba HealthCommunicable Disease Control http://www.gov.mb.ca/health/publichealth/cdc/index.html

    Public Health Agency of Canada http://www.phac-aspc.gc.ca

    References

    Brucellosis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/brucellosis/ . Updated November 12, 2012. Accessed January 7, 2013.

    Brucellosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated August 28, 2012. Accessed January 7, 2013.

    Patel PJ, Kolawole TM, Sharma N, et al. Sonographic findings in scrotal brucellosis. J Clin Ultrasound . 1988;16:483-86.

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