Brucellosis is an infectious disease transmitted by certain bacteria, primarily through animals and animal products. If treatment is started in time, the disease is mostly harmless.
What is brucellosis?
Brucellosis is an infectious disease caused by bacteria of the genus Brucella. Both humans and animals can be affected. Depending on the pathogen, different brucelloses are distinguished:
The so-called Malta or Mediterranean fever is the type of brucellosis most commonly found in humans. It is caused by the bacillus species Brucella melitensis, which is mainly native to the Mediterranean region, Africa, and Central and South America. Bang’s disease, swine brucellosis and canine brucellosis rarely occur in humans. In Germany, brucellosis cases are subject to mandatory reporting.
Causes
Brucellosis is usually transmitted to humans via animals. Through direct contact, for example after petting cows or sheep, pathogens can enter the human organism via tiny skin lesions or through the mucous membranes. Infected raw milk, raw milk products and infected raw meat are also sources of infection. The bacteria can survive in these foods for several weeks. Animal feces and urine may also contain pathogens. In individual cases, brucellosis can be transmitted directly from person to person during breastfeeding. Extremely rare are transmissions via blood transfusions, bone marrow transplants, and sexual intercourse. If brucellosis is not recognized properly or not recognized at all, the disease can become chronic.
Symptoms, complaints, and signs
The symptoms of brucellosis are usually very similar to the common complaints and symptoms of an infectious disease. In the worst case, the disease can thereby also lead to the death of the affected person, if it is not treated properly or late. The affected person primarily suffers from swollen lymph nodes and also from fever or chills. There is a general feeling of illness, with the patient appearing tired and fatigued. Likewise, the resilience of the patient is significantly reduced the brucellosis. In many cases, patients also continue to suffer from nausea or night sweats. If the disease continues to be untreated, it also attacks the internal organs. In the process, the liver can be damaged, which can lead to liver insufficiency that is fatal for the affected person. Similarly, inflammation occurs in various regions of the body, so that pneumonia or inflammation of the heart valves can also occur. Life expectancy is considerably reduced by brucellosis if it is not treated. Furthermore, many patients suffer from depression and insomnia. Pain in the joints or muscles may also occur with this disease.
Diagnosis and course
Once the pathogens that cause brucellosis enter the body, they are transported by certain immune cells to the lymph nodes and from there into the bloodstream. The bacteria infect various organs, predominantly bone marrow, liver and spleen, causing inflammation. On average, the incubation period is four months. However, very variable periods ranging from five days to two years can pass between infection and the outbreak of the disease. 90 percent of the illnesses run their course without noticeable symptoms. The remaining ten percent of brucellosis cases can be either chronic or acute. Acute brucellosis is characterized by gradual or sudden attacks of fever with nausea, fatigue, headache and night sweats. Symptoms last from one to three weeks, with two to five days of symptom-free days in between. If the disease becomes chronic, symptoms such as reduced performance, general malaise, sweating and depressive moods become apparent. Complications such as inflammation of the vertebral bodies, the eyes, the lining of the brain or heart, the testicles, epididymis, gall bladder, pancreas or lungs may occur. If the bone marrow is affected, there may be a disturbance of blood formation. Due to the different and rather unspecific symptoms, brucellosis is not always easy to recognize. A detailed patient interview and various laboratory tests lead to the diagnosis.The pathogens can be detected in the blood and possibly in the bone marrow, liver, spleen, urine or cerebrospinal fluid. In addition, certain antibodies are found in the blood.
When should you go to the doctor?
Brucellosis is a potentially life-threatening disease if severe, although the disease often does not have fatal complications. If an infection is suspected, the nearest doctor must be consulted immediately. After an incubation period that can last months, the first symptoms appear similar to those of the flu. Those affected suffer from fever and chills, joint pain and a pronounced loss of appetite. But also an increasing exhaustion appears as a typical feature. The general ability to work under pressure is greatly reduced. This characteristic initially makes it difficult to distinguish brucellosis from an ordinary cold or influenza. In general, persistent limb pain, fever, and inflammation should be referred to the physician for control regardless of the presumed cause. A clear indication of brucellosis is the rapidly fluctuating fever episodes and the high constancy of the overall clinical picture. Medical clarification is appropriate in cases of previous contact with transmitting animal species. These include breeding animals such as sheep, pigs, cattle or horses, which pass on the pathogen to humans. In particular, extended stays in designated infection areas or injury from sick animals increase the risk of infection. Without appropriate treatment by a doctor, the suffering can last for many weeks and massively impair the quality of life. In general, the disease can be treated well in its early stages and its duration can be significantly shortened. Therefore, examination by the family doctor remains advisable at mere suspicion, even if it could be just a conventional cold.
Treatment and therapy
Brucellosis is usually treated with a combination of various antibiotics and, if necessary, complementary medications that must be taken for six to twelve weeks. If complications occur or chronic disease is present, the duration of drug administration is extended to approximately six months. If heart valves or bones are affected, surgery may be necessary. If treatment is started immediately, the chances of recovery are high and the disease is usually over after two to three weeks. If treatment is started too late, the likelihood of brucellosis becoming chronic is very high. It can take up to 20 years to overcome chronic brucellosis. Especially if the patient is generally weakened, relapses may occur. Therefore, re-testing of the blood for antibodies is recommended one year after therapy. The mortality rate is about two percent.
Outlook and prognosis
Making an accurate prognosis about the course of brucellosis is not always easy. For example, the course of the disease varies from patient to patient. In addition, the outlook also depends on different factors such as pre-existing conditions, severity, and type of infection. For these reasons, a very individual prognosis must usually be made. If brucellosis is treated in a timely and professional manner, the outlook is favorable for most affected individuals. However, if treatment is started very late, there is sometimes a risk of a chronic course of the disease, which can last up to twenty years. Chronic brucellosis affects up to 5 percent of all patients. It manifests itself after the acute symptoms have subsided. In the chronic form, patients continue to suffer from fever episodes for years. Without proper treatment of brucellosis, there is an increased risk of relapses of the disease. No prognosis can be made for untreated brucellosis. In about 90 percent of all cases, the infection is subthreshold. While the acute form often resembles influenza, chronic brucellosis is at risk of spreading to major organs such as the heart, lungs or liver. Mortality from untreated brucellosis is about 2 percent. Especially in patients with Mediterranean fever, the disease often goes unnoticed, posing a risk of life-threatening endocarditis.
Prevention
Vaccination against brucellosis is possible in animals, but not yet in humans.Preventive measures are therefore limited to avoiding sources of infection: Milk and dairy products should only be used in pasteurized or boiled form. Consumption of raw meat should be avoided. Contact with pets should be avoided, especially in areas of distribution such as Turkey and the Mediterranean region.
What you can do yourself
If brucellosis is suspected, it is essential to consult a doctor. Under no circumstances should affected persons attempt to treat the disease themselves, as there is a risk of permanent chronic inflammation of the meninges, lungs, pancreas or other important organs. There are no self-help remedies against the underlying bacterial disease. However, sufferers can strengthen their immune system, which can prevent the onset of the disease and speed up convalescence. The best means of strengthening the immune system is a healthy lifestyle. Above all, it is important to eat a vitamin-rich diet that avoids foods of animal origin as far as possible, but includes plenty of fruits and vegetables as well as whole grain products. In addition, regular exercise in the fresh air is beneficial for the constitution. People who very often fall ill with infections can also resort to medication to stimulate the immune system. In naturopathy, the red coneflower (Echinacea purpurea) in particular is used. Corresponding preparations are available as juice, drops or lozenges in pharmacies. The patient can also treat a number of the symptoms of brucellosis himself. In the case of fatigue and chills, bed rest is particularly important. The patient should not work or exercise during acute brucellosis. Home remedies such as willow bark tea or cold foot compresses help against fever.
