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What is brucellosis
This disease refers to zoonotic infections, that is, passing from animals to humans. It is characterized by fever, damage to the musculoskeletal system, nervous system and genital organs. It can become chronic with the development of relapses of the disease and disability. In addition, one of the mechanisms in brucellosis is the general allergization of the body.
The disease can last for a long time, up to several months or even years.
The causative agent of brucellosis
The infection is provoked by bacteria of the genus Brucella (Brucella) – these are immobile microbes.
The course of the disease depends on the type of Brucella it is caused by. Symptoms will be most severe when infected with Brucella melitensis.
Brucella reproduce inside the cells of the human body, but they are quite viable in the external environment. They are viable in water up to 2 months, in raw meat – up to 3 months, in salted meat – up to 1 month, in cheese – up to 4 months, on animal hair – up to six months. Moreover, these bacteria are resistant to adverse factors. But brucella do not withstand boiling, when heated above 60 ° C, they die in half an hour.
Ways of infection with brucellosis in humans
The main reservoirs for Brucella are sick animals: cows, pigs, sheep or goats. Somewhat less often, camels, horses, and wild animals become a source of infection. The bacteria are shed in urine or stool, amniotic fluid, and milk. The infection is transmitted by the fecal-oral route (disease of dirty hands), as well as through water or food. In rare cases, penetration of Brucella through damaged skin or mucous membranes is possible, by inhalation of dust containing bacteria.
Particularly dangerous in terms of infection are milk and dairy products that are obtained from sick animals, as well as meat, skin and skins.
When infected with brucellosis during pregnancy, the bacteria can be transmitted intrauterine to the fetus, as well as during lactation with breast milk.
After the illness, immunity lasts up to 9 months, re-infection is possible in 2-7% of people.
Forms of brucellosis
Experts note a number of forms of brucellosis, which are distinguished on the basis of one of the characteristic features. According to the course of the disease:
- acute form (up to 3 months);
- subacute form (up to 6 months);
- chronic form (more than 6 months);
- primary latent form (subclinical).
Separately, residual forms of the disease are distinguished – these are long-term consequences that can manifest themselves several months, or even years after the extinction of the main symptoms.
Symptoms of brucellosis in humans
The incubation period for brucellosis lasts from 1 to 3 weeks, with the development of the primary latent form (without clinical manifestations) it can last up to 5 months.
Depending on the form of the disease, there are a number of typical manifestations.
Sharp form. It starts abruptly, but in old age a gradual onset is possible. Patients at first complain of general malaise, pain in the joints or muscles, insomnia, feelings of fatigue and increasing intoxication.
Then the temperature jumps sharply, severe chills occur, which are replaced by severe sweating, while intoxication does not correspond to the severity of the fever (the patients feel good).
High body temperature lasts for several days, sometimes dragging on for up to 3-4 weeks. There are problems with sleep and appetite, emotional instability, headache. At the peak of the temperature increase, reddening of the face and neck is typical with a general pallor of the body.
The lymph nodes in the neck and armpits are enlarged, they are painful to the touch. Fibrositis and cellulitis also occur – these are painful and dense areas in the area of uXNUMXbuXNUMXbthe tendons, muscle fibers and subcutaneous tissue. The formations are the size of peas or a little more.
Subacute form. It is characterized by periods with a change in fever and normal temperature. Moreover, the temperature can be from subfebrile (within 38 ° C) to extremely high, with fluctuations throughout the day. Against the background of an increase in temperature, there is pain in the muscles, joints, a feeling of goosebumps, weakness, heart rhythm disturbance (bradycardia at the peak of fever). If the temperature is normal, there may be an increase in heart rate, muffled heart sounds, constipation, dry mouth and thirst.
Cellulitis and fibrosis are also noted, against the background of a severe course, pericarditis and toxic shock are possible. Allergic manifestations develop – dermatitis, vascular reactions, joints suffer, testicles with appendages are affected in men, endometritis – in women.
It is possible to terminate a pregnancy when infected with brucellosis at different times.
Chronic form. In this case, the disease proceeds in waves, general intoxication is not pronounced, the temperature is low. Periods of exacerbation occur every couple of months. Most often, joints, connective tissue, subcutaneous tissue suffer, pain occurs in the lower back, elbows. The joints hurt and deform, collapse. Possible neuritis, including auditory and visual, paresthesia, radiculitis. The gonads also suffer with the formation of infertility. The disease lasts up to 2 – 3 years.
Primary latent form. It proceeds without any complaints and clinical manifestations. When examining a patient, a doctor may reveal multiple small lymph nodes and mild hyperhidrosis (sweating) of the skin. With a decrease in immunity, this form of the disease can go into acute or primary chronic.
Treatment of brucellosis in humans
Treatment is required for each patient to prevent dangerous complications and the transition of the infection to a chronic form that threatens disability.
Diagnostics
The basis of the diagnosis is the detection of Brucella in the patient’s body. To do this, they often take blood, less often – cerebrospinal fluid, the contents of the lymph nodes.
A faster confirmation of the diagnosis is the determination of antibodies to Brucella in the patient’s blood, serological studies.
The Wright agglutination test is one of the main diagnostic methods, the presence of the disease shows a diagnostic titer of 1:100 and above. It is used to confirm the diagnosis of acute and subacute forms of brucellosis.
The Heddelson agglutination test is simple to perform and is used for express diagnostics and mass screening for brucellosis.
ELISA (enzymatic immunoassay) is used to diagnose all forms of the disease.
PCR (polymerase chain reaction) allows you to determine the type of pathogen. For research, any biological samples can be used.
Modern treatments
With a mild form, you can be treated at home, but with severe manifestations and the risk of complications, the patient is hospitalized. When the temperature rises, it is important to observe bed rest.
The basis of therapy is taking antibiotics, which inhibit the activity of Brucella and can penetrate the cell wall. A combination of two antibiotics effective against Brucella is used with a course duration of up to 6 weeks. If the infection recurs, repeated courses of antibiotics are indicated.
In addition, drugs are used to detoxify the body if the infection is severe, immunostimulants, anti-inflammatory drugs, blockades with novocaine, if sciatica or spondylitis occurs.
As the condition improves, treatment is indicated in a sanatorium or physiotherapy clinic in order to restore the functions of the joints, ligaments, and eliminate the phenomena of fibrosis and cellulite.
All those who have had brucellosis, regardless of the clinical form, are subject to dispensary observation for 3 years..
Prevention of brucellosis in humans at home
A set of preventive measures includes the control of animals in farms and private farms, compliance with the requirements for the production, storage and transportation of food products, annual medical examinations of farm workers and villagers.
Animals are subject to vaccination, and people working with animals must use overalls and follow hygiene rules.
Popular questions and answers
Answered popular questions about brucellosis infectious disease doctor Tatyana Kovaleva.
Emergency hospitalization in the infectious diseases department is recommended for neurobrucellosis (meningitis, meningoencephalitis). Myelitis of brucellosis etiology is also an emergency indication for hospitalization in the neurological department.