Brucellosis: Symptoms, Causes & Treatment

What is Brucellosis?

Brucellosis is a zoonotic disease, meaning it spreads from infected animals to humans. The infection is caused by bacteria from the Brucella genus, which primarily affects livestock such as sheep, goats, cattle, and pigs. Dogs can also carry Brucella canis, but human infection from dogs is rare.. Humans can acquire brucellosis through direct contact with infected animals or by consuming contaminated animal products, especially unpasteurised dairy foods like milk and cheese.

Brucellosis can affect various organs and systems in the body, leading to a wide range of possible symptoms. The disease may present as an acute infection with sudden onset of fever and flu-like illness, or it can develop into a chronic condition with persistent or recurring symptoms over months to years. Without proper treatment, brucellosis can cause serious complications affecting the bones, joints, heart and central nervous system.

Causes of Brucellosis

• Consuming contaminated, unpasteurised dairy products like milk, cheese and ice cream
• Eating undercooked meat from infected animals
• Direct contact with body fluids or tissues of infected animals, especially through skin wounds or mucous membranes
• Inhaling airborne Brucella bacteria in high-risk workplaces like farms, slaughterhouses and laboratories
• Occupational exposure for veterinarians, farmers, hunters and meat-processing workers
• Handling infected animal foetuses, placentas or newborn livestock

Types of Brucella Bacteria

• Brucella melitensis - Found mainly in goats and sheep; the most common cause of human brucellosis
• Brucella abortus - Infects cattle
• Brucella suis - Affects pigs
• Brucella canis - Carried by dogs; rarely spreads to humans

Risk Factors for Brucellosis

• Working in occupations with animal contact, including farmers, veterinarians, slaughterhouse workers and laboratory technicians
• Consuming raw, unpasteurised dairy products
• Living in or travelling to areas where brucellosis is more common
• Exposure to infected animals during birthing or butchering
• Accidental exposure to Brucella cultures in laboratory settings

Symptoms of Brucellosis

Brucellosis symptoms can range from mild to severe and may appear anywhere from a few days to a few months after exposure to the bacteria. Common signs and symptoms include:

• Fever, which may come and go
• Chills and night sweats
• Fatigue and weakness
• Loss of appetite and weight loss
• Headache
• Muscle aches, joint pain and back pain
• Arthritis with swelling and pain in joints

In some cases, brucellosis can also cause:

• Abdominal pain, nausea, vomiting or diarrhoea
• Enlarged liver or spleen
• Swollen testicles or scrotum in men
• Depression, irritability or difficulty concentrating

Acute vs Chronic Brucellosis

• Acute brucellosis has a sudden onset of flu-like symptoms including fever, chills, body aches and headache. The acute phase usually lasts a few weeks.
• Chronic brucellosis refers to relapsing or persistent symptoms lasting months or years, such as fatigue, joint pain, or intermittent fever, often due to incomplete treatment or late diagnosis.

Complications of Brucellosis

• Arthritis and spondylitis (inflammation of joints and spine)
• Endocarditis (infection of the heart lining)
• Sacroiliitis (inflammation where lower spine meets the pelvis)
• Orchitis (swollen, painful testicles)
• Neurological problems like meningitis, encephalitis, brain abscesses
• Liver abscesses or granulomas (rare)
• Pregnant women with untreated brucellosis are at risk of miscarriage, premature delivery, or low birth weight.

How Brucellosis is Diagnosed

1. Clinical evaluation: Your doctor will assess your symptoms, possible exposure history and risk factors for brucellosis.
2. Blood tests: Samples of your blood will be analysed for antibodies against Brucella bacteria or the presence of the bacteria itself.
3. Cultures: In some cases, samples of blood, bone marrow or other bodily fluids may be cultured in a lab to isolate the Brucella organism.
4. Imaging tests: If complications are suspected, you may need X-rays, CT scans or MRIs to check for problems in your bones, joints or organs.

Medical History & Risk Assessment

Because the initial brucellosis symptoms are often vague and similar to other illnesses, your doctor will ask about any factors that may have exposed you to the infection. Be prepared to answer questions about:

• Recent travel to countries where brucellosis is prevalent
• Occupations or hobbies involving animal contact
• Consumption of raw or unpasteurised dairy products
• Development of unexplained fever, chills, weakness or body aches

Blood Tests

• Serological tests detect antibodies your immune system produces in response to Brucella bacteria.
• Blood cultures can identify the presence of live Brucella in your bloodstream.
• Polymerase chain reaction (PCR) tests rapidly detect traces of bacterial DNA in blood samples.

Imaging Tests

• X-rays can reveal changes in bones and joints, such as arthritis or spondylitis.
• Ultrasounds may be used to assess swelling in the liver, spleen or reproductive organs.
• MRI or CT scans help evaluate central nervous system complications like meningitis or brain abscesses.

Treatment of Brucellosis

Brucellosis treatment primarily involves antibiotic therapy to eliminate the bacterial infection. Additional treatment depends on managing specific symptoms and complications. The main approaches are:

• Antibiotics: Combinations of two or more antibiotics taken for at least 6 weeks
• Supportive care: Medications for pain, fever and inflammation; rest and hydration
• Monitoring: Follow-up visits to assess response to treatment and check for relapse

Antibiotic Therapy

According to WHO, brucellosis treatment requires multiple antibiotics to effectively clear the infection and prevent relapse:

1. Combination therapy with doxycycline and rifampin for at least 6 weeks is the WHO-recommended standard for uncomplicated brucellosis.
2. More severe cases may need the addition of intramuscular streptomycin or gentamicin for the first week or two of treatment.
3. Longer antibiotic courses are often necessary for chronic brucellosis or infections with complications.

Supportive Care

• Pain relievers and anti-inflammatory medicines to ease body aches and joint pain
• Corticosteroids may be considered in selected cases with severe inflammation or complications, always under specialist supervision
• Bed rest and fluid intake to help with fever and fatigue
• Hospitalisation for high fevers, severe symptoms or intravenous antibiotic therapy

Managing Chronic Brucellosis

Chronic brucellosis requires close medical supervision to manage persistent symptoms, monitor for complications and adjust treatment as needed. Some people need repeated courses of antibiotic therapy to keep the infection in check. A multidisciplinary approach involving infectious disease specialists, rheumatologists or neurologists may be necessary to address chronic brucellosis affecting the bones, joints, heart or nervous system.

Prevention of Brucellosis

• Avoid consuming raw or unpasteurised dairy products like milk, cheese and ice cream.
• Cook meat thoroughly and avoid undercooked or raw meat dishes.
• Wear gloves and protective gear when handling animals, especially during birth or slaughter.
• Vaccinate livestock against brucellosis in endemic areas.
• Properly dispose of animal placentas, foetuses and discharges during birthing.
• Educate workers in high-risk settings about brucellosis prevention.

Living with Brucellosis

Most people with brucellosis recover fully with proper antibiotic treatment, but some experience recurring symptoms and long-term effects. Chronic brucellosis can impact quality of life with ongoing fatigue, depression, body aches and arthritis that may require extended treatment and pain management. Pace yourself, get enough rest and work closely with your doctor to keep brucellosis symptoms under control.

If you've been treated for brucellosis, be sure to schedule regular check-ups to monitor for any signs of relapse. Take precautions to avoid re-exposure, especially if you work with animals or live in a high-risk area. Don't hesitate to seek medical advice if symptoms return or new health issues develop.

When to See a Doctor

• Unexplained fever, chills or sweating
• Persistent fatigue, weakness or body aches
• Painful, swollen joints
• History of consuming unpasteurised dairy or contact with infected animals
• Symptoms that persist or recur after brucellosis treatment
• Travel to regions where brucellosis is endemic

Conclusion

Brucellosis is a bacterial infection that can have significant consequences if not promptly diagnosed and treated. By understanding the symptoms, causes, risk factors, and complications associated with brucellosis, you can take steps to protect yourself and your family. If you suspect brucellosis based on your symptoms and exposure history, don't hesitate to consult with a doctor. With proper care and prevention measures, the vast majority of people recover from brucellosis without lasting effects.

At Metropolis Healthcare, we understand the importance of accessible, reliable diagnostic services in managing conditions like brucellosis. With a network spanning over 750 towns in India, supported by 220+ laboratories, 4600+ service centers, and 10,000+ touchpoints, we're committed to providing accurate testing and personalised care. Our focus on innovation, patient-centric service, and trustworthy reporting has made Metropolis a leader in diagnostic testing. If you need support on your journey to wellness, explore our website and at-home sample collection services.

FAQs

How is brucellosis transmitted?

Brucellosis spreads to humans through direct or indirect contact with infected animals. You can get the infection by handling animal tissues, fluids or waste products, especially during birth or slaughter. Inhaling airborne bacteria in barns, stables or laboratories is another route of transmission. Consuming raw or unpasteurised milk, cheese or ice cream from infected animals is the most common way brucellosis spreads to the general public.

Can brucellosis be cured?

Yes, brucellosis is curable with appropriate antibiotic therapy. Treatment usually involves taking a combination of two or three antibiotics for at least six weeks. Some cases of brucellosis are more difficult to cure and may require longer treatment, but the vast majority of people recover completely. It's important to take all medications exactly as prescribed and attend follow-up appointments to ensure the infection clears.

Is brucellosis contagious between humans?

Human-to-human transmission of brucellosis is extremely uncommon. There have been rare instances of spread through blood transfusions, bone marrow transplants, sexual contact, and from infected mothers to newborns. However, the vast majority of human brucellosis cases are acquired from animals or contaminated animal products. Standard hygiene practices are sufficient to prevent spread between people.

How long does it take to recover from brucellosis?

The recovery timeline for brucellosis varies depending on factors like the severity of infection, promptness of diagnosis and treatment, and individual health status. Most people start feeling better within a few days to weeks after starting antibiotic therapy. However, completing the full course of treatment is crucial to prevent relapse, even if symptoms improve. Chronic brucellosis may take several months to resolve and require extended treatment and monitoring.

Are children at risk of brucellosis?

Children can contract brucellosis through the same routes as adults - exposure to infected animals, consuming raw dairy products, or accidental ingestion of the bacteria. In endemic regions, children may be at higher risk if they live in close proximity to livestock or consume unpasteurised milk. Rarely, infants may acquire brucellosis from an untreated mother during pregnancy or breastfeeding. Prompt diagnosis and age-appropriate antibiotic therapy are essential for preventing complications in children.

References

1. https://www.cdc.gov/brucellosis/about/index.html
2. https://my.clevelandclinic.org/health/diseases/17886-brucellosis
3. https://www.ncbi.nlm.nih.gov/books/NBK441831/
4. https://www.who.int/news-room/fact-sheets/detail/brucellosis
5. https://medlineplus.gov/ency/article/000597.htm