With the advent of civilisation, man has learnt to domesticate animals and use them for various purposes. This has improved life in many ways, but, it has also brought diseases. These are the ones which are transmitted from animals to people. Brucellosis is also one of them. It has been recognised in humans and animals since the 20th century.
Brucellosis is caused by Brucella which are germs residing inside the body cells of an affected animal. There are four species, out of which man is commonly affected by Brucella melitensis. It is a highly infectious illness.
Brucellosis, also called as “undulant fever” or “Malta fever”, is caused by eating raw or uncooked meat or drinking uncooked milk. It may also occur by direct contact with infected animals as it happens with veterinarians or butchers or with the secretions of infected animals. Brucella has a unique property to penetrate through intact human skin. Therefore, infection can also be acquired by direct contact of the hand with infectious material.
The disease is manifested by undulant fever, that is, episodes of fever associated with afebrile phases. It is a chronic illness and may range from weeks to months. The fever is high with profuse sweating. Sweat has a typical smell like wet hay and is associated with musculoskeletal pains. Any bone or joint can be affected. But the lumbar spine and sacroiliac joints are most commonly affected. Chronic infection can also affect the brain, causing headache, vomiting and paralysis of various body parts. Complete blood count and other blood tests done during acute phase demonstrate reduction in white blood cells count and elevation of liver enzymes.
Diagnosis is made by X-rays showing the typical changes in the bones, that is, reduction in bone density and stiffness of joints. A high suspicion is needed to consider Brucellosis, because these changes can be confused with degenerative spondylosis . Biopsy of affected parts can also aid in the diagnosis. Blood cultures can demonstrate the germs and are diagnostic, but it takes over two months for Brucella to grow and be seen in the culture, waiting for which treatment can be delayed.
Cultures also pose a risk for the laboratory personnel dealing with the dishes in which these microbes are grown. Hence, they have to be very vigilant about it.
Treatment is by suitable combination of anti-infective agents like doxycycline, rifampicin and streptomycin.
Unfortunately, there is lack of awareness about Brucellosis, which delays diagnosis and treatment. The symptoms are similar to many other diseases presenting with fever, particularly malaria. Brucellosis is thought of when there is no response to empirical treatment given for other illness and tests done for them come negative repeatedly.
Greater awareness needs to be generated about this sickness, particularly among rural people who live with cattle and other animals. They should know about preventive measures. Regarding preventive measures to prevent exposure to Brucellosis, it is very important to see that the meat purchased for food is from a reliable source.
Meat from a sick animal should be avoided. People dealing with sick or infected animals directly like butchers and veterinary doctors should always use hand gloves while dealing with these animals. After handling them, thorough hand washing is a must. This will prevent entry of microbes in the body. Before consumption, the meat should be cooked very well. Similarly, milk should never be consumed without boiling thoroughly or ensuring that it is pasteurised.