Brucellosis (Maltese fever) is a zoonotic infectious disease caused by various types of Brucella.
The disease is prone to chronic course and is characterized by a non-specific clinical picture with multiple lesions of various organs and systems of the human body. It is very important to detect the symptoms of brucellosis in a timely manner, an experienced doctor can easily recognize them at the first examination.
The causative agent of brucellosis is nothing more than small microorganisms that are well adapted to any environmental conditions, called brucella. They do not die at low temperatures; they can be found in the soil, on pet hair, in cow's milk, as well as in water and frozen meat. And while the safety of brucella ranges from 1.5 to 5 months. When the temperature rises to 100 ° C, brucella die.
The synonyms of the disease are Maltese hyperthermia, Cyprus hyperthermia, Gibraltar hyperthermia, undulating hyperthermia, Bruce septicemia, Bang pathology.
What is brucellosis?
How can I get brucellosis, and what is it? Brucellosis is a zoonotic infection characterized by multiorgan pathologies and a tendency to chronicity. A significant pathogenetic component of brucellosis is allergic reactivity. The causative agents of brucellosis are bacteria of the genus Brucella, among which are recognized the existence of eight independent species, six of which are capable of causing disease in humans: B. melitensis, B. abortus, B. suis, B. canis, B. pinnipediae, B. cetaceae.
Of the common Brucella species B.melitensis is the most virulent and causes the most severe and acute cases of the disease. B.suis is associated with a prolonged course of the disease, accompanied by the development of purulent destructive lesions. B.abortus and B.canis, as a rule, cause mild or moderate sporadic diseases with a rare development of complications. Cases of the disease caused by B.pinnipediae and B.cetaceae have been described relatively recently.
Transmission of infection is carried out mainly by the fecal-oral mechanism, most often through the food and water, in some cases it is possible to implement a contact-everyday (when the pathogen is introduced through the microtrauma of the skin and mucous membranes) and air-borne (by inhalation of infected dust).
Milk obtained from sick animals and dairy products (cheese, koumiss, cheese), meat, products from animal raw materials (wool, leather) represent a significant epidemiological hazard. Animals contaminate the soil, water, food with feces, which can also contribute to human infection by non-food means. Contact-household and air-dust paths are implemented in the care of animals and the processing of animal raw materials.
Symptoms of brucellosis in humans
The incubation period for brucellosis is 7 days - 8 weeks, usually 2 weeks. Symptoms of brucellosis in humans develop, usually, gradually and have no special characteristics.
However, patients, as a rule, present 4 main complaints:
- Intermittent soreness in the joints, mostly in the lower limbs, from time to time very painful and strong.
- Increase in body temperature in the form of a long subfebrile condition (up to 38 ° C) or a wave-like type with sharp ups and downs.
- Increased sweating, perspiration, sometimes night sweats.
- Sharp asthenia and fatigue.
In some patients, a long subfebrile condition is noted. Fever can last for months, it is typical that even at high temperatures, patients remain conscious, the spleen and liver are enlarged. Brucellosis often affects the nervous, reproductive system and the musculoskeletal system.
There are also arthritis (hip, sacroiliac, and other large joints), periarteritis, bursitis, tendo-vaginths, spondylitis, neuralgia, neuritis (sciatic), less often meningitis, encephalitis, etc. in women, dysmenorrhea, oophoritis, salpingitis, and even abortion.
There comes a chronic form in the case of adaptation of the organism to the pathogen, while in a person the signs of the disease periodically worsen and subside. This form is characterized by symptoms in the form of mild intoxication and the absence of fever (sometimes up to 37.5). If the disease turns into a remission form of exacerbation, then the person has symptoms similar to a sharp appearance. A very common symptom is an enlargement of the lymph nodes, liver and spleen.
At this stage, many internal organs may already be affected, and the musculoskeletal system, and especially the joints and large muscles, is most often hit. Joint pain and swelling caused by uncontrolled growth of bone tissue.
The result of the transition of brucellosis to the chronic form can be neuritis, radiculitis, meningitis, encephalitis, metritis and other diseases, while pregnant women with a high percentage of the probability of losing a fetus. In men, pathogens in the chronic form of indisposition cause disruptions of hormones, the occurrence of impotence and in some situations of infertility, which is caused by a negative effect on the testes.
The chronic form of the disease can last for 2–3 years, but if re-infection occurs, the period becomes much longer.
Diagnosis of brucellosis
At detection of signs of a disease for statement of the diagnosis, except the anamnesis, it is necessary to conduct some laboratory researches.
To do this, a person needs to be tested for brucellosis, including 2 types of research:
- Serological diagnosis is the most common method of diagnosis, in which using a variety of techniques (agglutination reaction, enzyme immunoassay), an increase in antibody titer to certain types of brucella is detected.
- Bacteriological study with isolation of bacterial culture of the pathogen and their identification.
For additional diagnostics, in order to determine the severity and localization of structural changes in organs, a clinical analysis of blood and urine, X-ray and ultrasound methods of instrumental examination are used.
Treatment of brucellosis in humans
When the symptoms of brucellosis occur, the treatment is to destroy the pathogen that has entered the human body. Usually, doctors prescribe streptomycin, chloramphenicol, as well as other antibiotics of the tetracycline group, which successfully cure brucellosis as an antibacterial therapy: treatment lasts three to four weeks and is accompanied by additional supportive therapy.
With early detection and timely treatment of the disease can be successfully cured. Severe brucellosis can lead to infection of the central nervous system, endocarditis (inflammation of the inner lining of the heart or heart valves), abscess of the liver. In addition, brucellosis can cause prolonged symptoms similar to the symptoms of chronic fatigue: recurrent fever, weakness, fatigue, pain in the joints.
With improper or inadequate treatment, as well as with therapy that was started late, the disease becomes chronic in 80% of cases. Brucellosis in a person whose symptoms are so varied, and treatment is quite long, is rarely the cause of death.
However, we must remember that this disease often leads to disability. And the severity of the residual effects after the transferred disease depends on exactly what type of brucella infection occurred. The worst complication is spinal cord injury and paralysis. It is for this reason that much attention should be paid to the prevention of the disease.
In the case of brucellosis prophylaxis, this is the elimination of brucellosis foci among animals and the prevention of food infections, conducting specific vaccination of persons from 7 years of age with negative serological and allergic reactions to brucellosis when indicated. For the purpose of prophylaxis, persons vaccinated with live anti-bronchus vaccine are allowed to work no earlier than three weeks after vaccination.