Brucellosis

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Brucellosis: a simple guide

What is brucellosis?
Brucellosis is an infection caused by Brucella bacteria. It mainly affects animals but can spread to people. It is also known as undulant fever, Malta fever, or Mediterranean fever. The bacteria are often found in unpasteurized dairy products and in animals like goats, sheep, cattle, and pigs.

How do people get it?
- Eating or drinking unpasteurized milk or dairy products (like raw cheese).
- Contact with infected animals or animal birth products (blood, semen, fetal tissue), especially in farms, slaughterhouses, or laboratories.
- In rare cases, through the air in places where animals are infected.

Who can get it?
Humans and many animals can be infected. Four Brucella species commonly affect people:
- B. melitensis (goats and sheep) is the most infectious for people
- B. abortus (cattle)
- B. suis (pigs)
- B. canis (dogs)

What are the symptoms and complications?
- Early symptoms: fever that comes and goes, sweating at night, poor appetite, weight loss, tiredness, muscle and joint pain, headache.
- Other possible symptoms: diarrhea, abdominal pain, enlarged liver or spleen.
- Complications (possible, especially if not treated): infections of the brain or spinal cord (neurobrucellosis), heart lining (endocarditis), joints (arthritis), bones (osteomyelitis), and in men, inflammation of the testicles (epididymo-orchitis). It can become chronic in some people.

How is it diagnosed?
- Blood tests to detect bacteria or antibodies against Brucella.
- Blood cultures to grow the bacteria (positive in many cases).
- Serology tests (like the standard agglutination test or Rose Bengal) and newer methods (ELISA, PCR) may be used in some labs.

How is it treated?
- Brucellosis is treated with antibiotics for several weeks.
- A common adult regimen is a combination of doxycycline and rifampin for about 6 weeks.
- Other options include doxycycline with streptomycin or gentamicin for a shorter period, or other multi-drug regimens depending on the case.
- Endocarditis or severe neurobrucellosis may require surgery or more intensive treatment.
- Relapse can occur in some people, so completing the full course is important.

How can it be prevented?
- Pasteurize milk and dairy products; avoid raw milk and soft cheeses made from unpasteurized milk.
- Cook meat thoroughly.
- Use gloves and follow safety practices when handling animals, animal products, and in high-risk workplaces.
- Vaccinate livestock to reduce infection in animals and reduce human risk.
- Public health measures (pasteurization, animal vaccination, testing and removing infected animals) help prevent human cases.

A One Health message
Brucellosis is controlled best when humans, animals, and the environment work together. Vaccinating animals, safe food handling, and good workplace practices all help protect people.