In brucellosis (synonyms: Abortus bang infection; Bang infection; Bang disease; Brucella infection; Brucella sepsis; Brucellosis due to Brucella abortus; Brucellosis due to Brucella canis; Brucellosis due to Brucella melitensis; Brucellosis due to Brucella suis; Endemic bacillococcosis [brucellosis]; Febris mediterranea; Febris melitensis; Febris undulans; Febris undulans bang; Febris undulans bovina; Febris undulans melitensis; Gibraltar fever; Brucella abortus infection; Brucella canis infection; Brucella melitensis infection; Brucella suis infection; Malta fever; Mixed form of brucellosis; Mediterranean fever; Abortus Bang disease; Bang’s disease; Neapolitan fever; Pyelonephritis in brucellosis; Swine brucellosis; Septic brucellosis; Undulant fever – see. a. Brucellosis; Cyprus fever; ICD-10-GM A23.-: Brucellosis) is a group of infectious diseases caused by different biotypes of the bacterium Brucella. Brucellae are small, immobile, non-spore-forming, Gram-negative, aerobic, as well as coccoid (sphere-like form) rod-shaped bacteria. The most important pathogens include B. abortus and B. suis.
The disease belongs to the bacterial zoonoses (animal diseases).
The pathogen reservoir relevant to humans is livestock (B. abortus occurs in cattle, B. melitensis in sheep, goats, and B. suis in pigs).
Occurrence: Infection occurs primarily in the Mediterranean region, the Arabian Peninsula, the Middle East, Africa, or Central and South America. In Central and Northern Europe, brucellosis has been successfully controlled in livestock and occurs only rarely. Within Europe, Portugal, Spain, southern Italy, Greece and Turkey are particularly affected, according to the Federal Institute for Risk Assessment (BfR). Diseases in Germany are usually due to imported animals.
Brucella are stable at ambient temperatures in urine, dust, water, soil, milk and dairy products (raw milk and raw milk cheese) for several days to several weeks and remain infective. However, they are heat labile. At temperatures above 60°C, they are killed within 10 minutes. Furthermore, brucella are sensitive to disinfectants.
Transmission of the pathogen (route of infection) occurs through direct contact with infected farm animals (through skin lesions, including microlesions) or through consumption of contaminated meat or contaminated dairy products. Rarely, transmission through breastfeeding, sexual intercourse, blood transfusions, and bone marrow transplants has been described.
Human-to-human transmission: Yes, but very rare.
The incubation period (time from infection to onset of disease) ranges from 5 to 60 days, with an average of 2-3 weeks.
The following types can be distinguished:
- Brucella melitensis (Malta fever).
- Brucella suis (swine fever)
- Brucella abortus (Bang’s disease)
- Brucella canis
Frequency peak: the disease occurs predominantly in adults.
Brucellosis is one of the most common infectious diseases worldwide. Annually, up to 500,000 cases of newly ill people are reported.
Course and prognosis: Brucellosis is diagnosed very late due to its diverse symptoms. Approximately 90% of infections are subclinical (subthreshold). In most cases, the disease is acute and resembles influenza (flu). However, there are also chronic forms in which the liver, lungs, heart and other internal organs can be affected.
The lethality (mortality in relation to the total number of people suffering from the disease) is up to 2% in untreated brucellosis.
In Germany, direct or indirect detection of Brucella spp. as far as it indicates an acute infection is reportable by name according to the Infection Protection Act (IfSG).
