Brucellosis

BRUCELLOSIS (Brucella melitensis, abortus, suis. and canis) 

Brucellosis is an infectious disease caused by the bacteria of the genus Brucella. These bacteria are primarily passed among animals, and they cause disease in many different vertebrates. Various Brucella species affect sheep, goats, cattle, deer, elk, pigs, dogs, and several other animals. Humans become infected by coming in contact with animals or animal products that are contaminated with these bacteria. In humans brucellosis can cause a range of symptoms that are similar to the flu and may include fever, sweats, headaches, back pains, and physical weakness. 

Sever infections of the central nervous systems or lining of the heart may occur. Brucellosis cab also cause long-lasting or chronic symptoms that include recurrent fevers, joint pain, and fatigue. 

Brucellosis is not very common in the United States, where 100 to 200 cases occur each year. But brucellosis can be very common in countries where animal disease control programs have not reduced the amount of disease among animals. 

Although brucellosis can be found worldwide, it is more common in countries that do not have good standardized and effective public health and domestic animal health programs. Area.s currently listed as high risk are the Mediterranean Basin (Portugal, Spain, Southern France, Italy, Greece, Turkey, North Africa), South and Central America, Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. Unpasteurized cheeses, sometimes called village cheeses, from these areas may represent a particular risk for tourists. 

Cyprus fever Gibraltar fever Malta fever Mediterranean fever Rock fever Undulant fever 

Phagocytyzed, multiply and spread in lymphatics within WBCs and macrophages to regional lymph nodes, then into bloodstream in systemic acute infection chronic reaction to form granulomas, esp in liver, spleen and other reticuloendothelial tissue, with fibrosis and calcification after healing. 

Sources Cattle, goats, dogs, pigs, sheep, deer, horses, 

Human-to-Human Rare except breast feeding 

Gastrointestinal Liver/biliary tract/pancreas Lymphatic Musculoskeletal Nervous 

THE DISEASE Epidemiology Pathogenesis Clinical Manifestations Diagnosis Treatment 

Colonel, Medical Corps, U.S, Army Department of Bacterial Diseases, Walter Reed Army Institute of Research, Washington, D. C. 20307-5100 and Associate Professor of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814-4799 Colonel, Medical Corps, U.S. Army Chief, Bacteriology Division, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21702-5011 and Clinical Associate Professor of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814-4799 

Brucellosis is a zoonotic infection of domesticated and wild animals, caused by organisms of the genus Brucella. Humans become infected by ingestion of animal food products, direct contact with infected animals, or inhalation of infectious aerosols. 

In that same year, B. Bang, a Danish investigator, identified an organism, which he called the Bacillus of abortion, in placentas and fetuses of cattle 

Brucella Species Animal Host Human Pathogenicity 

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A variety of other clinically important infections, such as brucellosis, listeriosis, salmonellosis, and various Mycobacterium infections, are of interest as these are often localized in organs rich in MPS cells. Liposome encapsulation has been demonstrated to improve therapeutic indices of several drugs in a number of infectious models. The natural avidity of macrophages for liposomes can also be exploited in the application of the vesicles as carriers of immunomodulators to activate these cells to an microbicidal, antiviral, or tumoricidal state. These studies were recently reviewed by Emmen and Storm (1987), Popescu et al. (1987), and Alving (1988). In addition to the treatment of "old" infectious diseases, the concept of MPS-directed drug delivery is of considerable interest for the therapy AIDS, possibly enabling control of human immunodeficiency virus replication in human macrophages. 

Jarisch-Herxheimer reaction following treatment of syphilis, brucellosis, schistosomiasis, or trypanosomiasis... 

Suggested Alternatives for Differential Diagnosis Brucellosis, chlamydial pneumonias, infective endocarditis, legionnaires disease, mycoplasma infections, pneumonia, Cox-iella burnetii infection, Francisella tularensis infection, Q fever, tuberculosis, tularemia, typhoid fever, and all atypical pneumonia. 

Fact Sheet 173 Brucellosis. Geneva Health Communications and Public Relations, July 1997. 

Suggested Alternatives for Differential Diagnosis Bartonellosis, brucellosis, other causes of encephalitis, coxsackieviruses, cryptococcosis, cysticercosis, cytomegalovirus, histoplasmosis, legionellosis, leptospirosis, listeria, lyme disease, malaria, rabies, tuberculosis, mumps, stroke, metabolic encephalopathy, Reye syndrome, Bartonella infection, Naegleria infection, Ebstein-Barr virus, prion disease, toxic ingestions, and AIDS. 

Suggested Alternatives for Differential Diagnosis In pigs Nipah virus, Aujeszky s disease, brucellosis, porcine reproductive and respiratory syndrome (PRRS) virus, Classical swine fever, parvovirus. In horses Equine encephalomyelitis (Western, Eastern, and Venezuelan), Rabies, Borna disease, Lead poisoning, Tetanus. 

Suggested Alternatives for Differential Diagnosis Anthrax, brucellosis, dengue, ehrlichiosis, infectious mononucleosis, Kawasaki disease, leptospirosis, malaria, meningitis, men-ingococcemia, relapsing fever, Rocky Mountain spotted fever, syphilis, toxic shock syndrome, toxoplasmosis, tularemia, typhoid fever, rubella, measles. 

BCG (bacillus Calmette-Guerin) vaccine Brucellosis vaccine Cholera vaccine Cytomegalovirus vaccines... 

Active immunization against brucellosis Active immunization against cholera Active immunization against cytomegalovirus... 

Category B agents There are eleven Category B agents as follows brucellosis, epsilon toxin (clostridium perfringens), glanders, melioidosis, psittacosis, Q fever, ricin toxin, staphylococcus enterotoxin B, typhus fever, viral encephalitis, and water safety threats. 

In June of 2003, the U.S. Army unearthed 113 bacteria-containing vials, including live strains of brucellosis and non-virulent anthrax, during excavation of its Fort Detrick site to eliminate toxic chemicals and hazardous waste. (Credit The Council for Responsible Genetics)... 

Guides for Emergency Response Biological Agent or Weapon Brucellosis... 

Probable Form of Dissemination Aerosol sabotage of the food supply. Brucellosis is a hindrance bacteria symptoms can take months to appear, and deaths are few and far between even without medical care. 

Caution Avoid drinking unpasteurized milk products and practice good veterinary vaccination practices to avoid natural forms of brucellosis. In a terrorism attack with aerosol, livestock could possibly become contaminated. If this occurs, animal products should be pasteurized, boiled, or thoroughly cooked prior to eating. Water would have to be treated by boiling or iodination after any intentional contamination with brucella aerosols. 

Field First Aid Brucella is typically an acute, non-specific feverish illness with chills, sweats, headache, fatigue, myalgias, artthralgias, and anorexia (loss of appetite). Cough occurs in 15 to 25 percent of cases but a chest X-ray is usually normal. Complications may include arthritis, sacroiliitis, and vertebral osteomyelitis. Untreated disease may persist for month to years, often with relapses and remissions. Disability may be pronounced, and lethality may approach six percent. Brucellosis may be indistinguishable clinically from the typhoidal form of tularemia (see Guide For Emergency Response for Tularemia) or from typhoid fever itself. 

The recommended treatment is doxycycline (200 mg/day) plus rifampin (600 mg/day) for six weeks. An alternative effective treatment is six weeks of doxycycline (200 mg/day) plus streptomycin (1 gm/day) for three weeks. Trimethoprim-sulfamethoxazole given four to six weeks is less effective. In 5 to f 0 percent of cases, there may be a relapse or treatment failure. Regarding prophylaxis, killed and live attenuated human vaccines are available in many countries but are considered of unproven efficacy. There tends to be no information on the use of antibiotics for prophylaxis against human brucellosis. 

Vaccines There is no human vaccine available for brucellosis, although there are a number animal vaccines since this disease is one of the most important veterinary diseases in the entire world. 

Biological Agents BACTERIA (Anthrax, Brucellosis, Cholera, Plague, Tularemia). VIRUSES (Crimean-Congo Hemorrhagic Fever, Rift Valley Fever, Smallpox, Venezuelan Equine Encephalitis (VEE), Viral Hemorrhagic Fever (Ebola)). TOXINS (Botulinum, Ricin, Staphylococcal Enterotoxin B (SEB), Trichothecene Mycotoxins/T-2). 

Q Mvdoo has been diagnosed with brucellosis Is that a riskfor me g How is brucellosis diagnosed- ... 

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