Brucellosis

Brucellosis is a bacterial infection transmitted from infected livestock to humans, most commonly through unpasteurised dairy products or direct contact with infected animals. It causes a prolonged, often relapsing illness and is an occupational risk for farmers, herders, and abattoir workers.

• Prolonged or recurring fever, often with drenching sweats, particularly at night
• Fatigue and general body aches, including joint and back pain
• Loss of appetite and weight loss
• Enlarged liver, spleen, or lymph nodes in some cases
• Symptoms can wax and wane over weeks to months if untreated, and can affect joints, the heart, or other organs in more complicated cases

• Caused by Brucella bacteria, transmitted to humans through consumption of unpasteurised milk or dairy products from infected animals, or through direct contact with infected animal tissue, blood, or birth fluids (such as during calving or slaughter).
• Occupational risk is highest for farmers, livestock herders, veterinary workers, and abattoir workers.
• The infection is not usually transmitted directly from person to person.

• Suspected in anyone with prolonged, unexplained fever together with a relevant history of livestock contact or consumption of unpasteurised dairy products.
• Blood culture can confirm the diagnosis but may require prolonged incubation, and laboratory staff should be alerted to the possibility given infection risk to laboratory personnel.
• Serological blood testing (antibody testing), where available, supports the diagnosis, particularly when blood culture is not accessible or has not grown the organism.

A combination of antibiotics is required, as single-agent treatment is associated with high relapse rates; a commonly used combination includes doxycycline together with either rifampicin or an injectable aminoglycoside such as gentamicin or streptomycin, given for a course of at least six weeks.

Longer treatment or additional agents may be needed for complicated brucellosis, such as infection affecting the heart, bones, or nervous system, and this should be managed with specialist input where possible.

Relapse can occur even after appropriate treatment, so follow-up is important to ensure the infection has fully resolved.

• Avoid drinking unpasteurised milk or eating dairy products made from unpasteurised milk; boil milk before consumption where pasteurisation is not available.
• Use protective equipment (such as gloves) when handling animals, especially during calving, slaughter, or when in contact with animal blood or birth fluids.
• Support veterinary vaccination and testing programmes for livestock where available.
• Seek medical assessment for prolonged, unexplained fever, particularly with relevant occupational or dietary exposure.