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Questions and Answers
What is rarely needed for person-to-person transmission of brucellosis?
What is rarely needed for person-to-person transmission of brucellosis?
Mucous membrane skin intact is rarely needed for person-to-person transmission.
What is the incubation period for brucellosis in humans?
What is the incubation period for brucellosis in humans?
The incubation period for brucellosis varies from 5 days to three months.
List two constitutional symptoms of brucellosis.
List two constitutional symptoms of brucellosis.
Fever and fatigue are two constitutional symptoms of brucellosis.
What are some gastrointestinal symptoms associated with brucellosis?
What are some gastrointestinal symptoms associated with brucellosis?
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What is a common neurological complication of brucellosis?
What is a common neurological complication of brucellosis?
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What diagnostic test shows a four-fold rise in titer for diagnosing brucellosis?
What diagnostic test shows a four-fold rise in titer for diagnosing brucellosis?
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What treatment consideration is noted concerning the fatality of brucellosis?
What treatment consideration is noted concerning the fatality of brucellosis?
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What significant neonatal issues might congenital brucellosis cause?
What significant neonatal issues might congenital brucellosis cause?
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Identify a respiratory symptom that can occur with brucellosis.
Identify a respiratory symptom that can occur with brucellosis.
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What are some musculoskeletal symptoms of brucellosis?
What are some musculoskeletal symptoms of brucellosis?
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What are the alternate names for Brucellosis?
What are the alternate names for Brucellosis?
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Which species of Brucella is associated with the most severe infection in humans?
Which species of Brucella is associated with the most severe infection in humans?
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Identify one method of transmission of Brucellosis to humans.
Identify one method of transmission of Brucellosis to humans.
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What is the gram stain and shape classification of Brucella spp.?
What is the gram stain and shape classification of Brucella spp.?
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List two populations at risk of Brucellosis infection.
List two populations at risk of Brucellosis infection.
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Describe the environmental persistence of Brucella spp.
Describe the environmental persistence of Brucella spp.
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What is the role of mucous membranes in the transmission of Brucellosis?
What is the role of mucous membranes in the transmission of Brucellosis?
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Which Brucella species is commonly associated with swine?
Which Brucella species is commonly associated with swine?
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What action can individuals take to prevent Brucellosis infection?
What action can individuals take to prevent Brucellosis infection?
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How can veterinary workers be exposed to Brucellosis?
How can veterinary workers be exposed to Brucellosis?
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Study Notes
Brucellosis Overview
- Brucellosis, also known as Undulant Fever, Malta Fever, Mediterranean Fever, Enzootic Abortion, Epizootic Abortion, and Bang's Disease, is a bacterial infection.
- The causative agent is Brucella spp., a gram-negative coccobacillus.
- Brucella are facultative, intracellular organisms, meaning they can survive and multiply within host cells.
- They are strictly aerobic, requiring oxygen for survival.
- Multiple species exist, each associated with specific animal hosts.
- The bacteria are environmentally persistent and can withstand drying.
- Temperature, pH, and humidity influence their survival.
Etiology
- Different Brucella species infect different animals:
- Brucella melitensis: Goats, sheep, camels (most severe infection).
- Brucella abortus: Cows, other bovidae animals, and camels (severe infection).
- Brucella canis: Dogs.
- Brucella suis: Pigs (less severe infection).
Transmission in Humans
- Humans typically contract brucellosis through:
- Ingesting unpasteurized milk or dairy products.
- Consuming raw or undercooked meat from infected animals.
- Contacted with infected animal issues (aborted fetuses, vaginal discharges).
- Direct skin contact with infected animals or contaminated materials.
- Direct person-to-person transmission is rare.
Pathogenesis
- The Brucella bacteria enter through mucous membranes.
- They replicate within regional lymph nodes, often causing enlarged and hyperplastic nodes.
- They enter the blood stream through the thoracic duct, causing bacteremia.
- Then they localize to specific organs, particularly genital organs, spleen, bone marrow, liver.
Disease in Humans
- Incubation period is variable, from 5 days to 3 months.
- Any organ can be affected.
- Symptoms are often cyclical, with flu-like illness, fever, and possible inflammation that waxes and wanes.
- Chronic illness is possible.
Symptoms
- Constitutional symptoms, including fever, fatigue, headache, night sweats, tiredness, and weight loss.
- Gastrointestinal symptoms, such as abdominal pain, diarrhea, vomiting, and dysphagia.
- Musculoskeletal symptoms, such as joint pain, joint swelling, muscle pain, and limited joint movement.
- Neurological symptoms, including limb weakness, slurred speech, and visual disturbances.
- Respiratory symptoms, such as cough, nasal congestion, sore throat.
- Dermatological symptoms (possible rash).
- Some individuals remain asymptomatic.
Complications
- Arthritis, spondylitis, epididymo-orchitis (inflammation of the testicles and epididymis) are common.
- Chronic fatigue is also common.
- Neurological complications (meningitis).
- Cardiovascular complications (endocarditis, inflammation of the heart).
- The disease may relapse.
Congenital Brucellosis
- Congenital brucellosis can affect newborns exposed during pregnancy.
- Symptoms are variable but can include:
- Premature delivery
- Low birth weight
- Fever
- Failure to thrive
- Jaundice
- Hepatomegaly
- Splenomegaly
Diagnosis
- Culture of the organism from blood, bone marrow, and other tissues.
- Serum agglutination test (Brucella agglutination test) looking for presence of antibodies, requiring 2 sample tests taken 2 weeks apart that show a four-fold rise in titer.
- Immunofluorescence assays.
- Polymerase chain reaction (PCR).
Treatment and Prognosis
- Antibiotics are necessary for treatment.
- The case-fatality rate is low if treated.
- Relapse is possible, especially without completing the full course of antibiotics.
- Endocarditis and meningitis are serious complications.
- Infections may require surgical intervention.
Prevention
- Avoid consuming unpasteurized milk, raw dairy products and raw meat products.
- Avoid contact with (sick) animals or their body products (aborted fetuses).
- Regularly check animals for brucellosis.
- Avoid mixing animal herds and proper vaccination and elimination of infected animals.
Government Role
- The government should implement screening programs and vaccinations for animals.
- Arrange and maintain a collaborative team among government sectors (health, agriculture, custom authorities, etc.).
- Screen family members of patients with acute brucellosis in endemic areas to increase detection and to initiate early treatment.
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Description
This quiz provides an overview of Brucellosis, including its causative agents, various species, and transmission in humans. Learn about the characteristics of Brucella bacteria and their environmental endurance. Test your knowledge on this important infectious disease and its impact on both animals and humans.