Brucellosis Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which species of Brucella has the highest pathogenicity?

Brucella melitensis (correct)

Brucella suis

Brucella canis

Brucella abortus

What is the primary mode of transmission for Brucellosis?

Consumption of contaminated food or water (correct)

Insect bites

Direct contact with infected humans

Airborne particles

Which of the following regions is NOT commonly associated with endemic cases of Brucellosis?

Mediterranean countries

Central and South America

North America (correct)

Middle East

The age group with the highest incidence of Brucellosis in the Mediterranean is predominantly which demographic?

Males in their mid-20s Signup and view all the answers

Which Brucella species is specifically associated with pigs?

Brucella suis Signup and view all the answers

What is a common alternative name for Brucellosis?

Undulant fever Signup and view all the answers

Which occupational group has a higher risk of contracting Brucellosis?

Farm workers Signup and view all the answers

Which factors contribute to the persistence of Brucellosis in certain regions?

Endemic presence in domestic animals and insufficient control measures Signup and view all the answers

Which of the following Brucella species is specifically linked to dogs?

Brucella canis Signup and view all the answers

What percentage of brucellosis cases occurred in individuals aged 40-60 years in a report from northern Saudi Arabia?

16% Signup and view all the answers

What is the male-to-female ratio of brucellosis cases reported in northern Saudi Arabia?

1.7:1 Signup and view all the answers

Which syndrome is especially common among patients with brucellosis?

Brucella sacro-iliitis Signup and view all the answers

What is the recommended duration for the use of doxycycline and rifampin in treating acute brucellosis in adults and older children?

6 weeks Signup and view all the answers

Which group has the highest prevalence of brucellosis in Jordan?

Individuals younger than 24 years Signup and view all the answers

Which regimen is believed to be more effective in preventing relapse of acute brucellosis?

Doxycycline and streptomycin Signup and view all the answers

What common manifestations of genito-urinary involvement are reported in brucellosis?

Epididymitis and orchitis Signup and view all the answers

What is a common vehicle of infection for brucellosis?

Raw milk and milk products Signup and view all the answers

Which age group is particularly vulnerable to the manifestation of brucellosis due to unknown reasons?

Men aged 13-40 years Signup and view all the answers

Which of the following statements about brucellosis is true?

The disease causes flu-like symptoms. Signup and view all the answers

Which of the following complications occurs in up to 60% of brucellosis cases?

Bone and joint involvement Signup and view all the answers

What demographic characteristic contributes to the higher prevalence of brucellosis in males?

Engaging in activities that increase exposure Signup and view all the answers

For what purpose are international measures implemented concerning brucellosis?

To control domestic animals and animal products in trade. Signup and view all the answers

Which alternative to streptomycin has shown equal efficacy in treating brucellosis?

Gentamicin Signup and view all the answers

Which symptom is not typically associated with brucellosis?

Diarrhea Signup and view all the answers

How may brucellosis be transmitted to infants?

Ingestion of raw milk Signup and view all the answers

Which preventive measure is focused on educating consumers about the risks of certain dairy products?

Educating tourists about unpasteurized milk risks Signup and view all the answers

What is the primary purpose of the RB51 vaccine for cattle?

To reduce virulence for humans in case of accidental injection Signup and view all the answers

Which method of infection control involves reporting to health authorities?

Isolation protocols for patients Signup and view all the answers

What is the recommended action when pasteurization of dairy products is not possible?

Boil the milk Signup and view all the answers

Which type of educational outreach is suggested for those handling potentially infected wildlife?

Educating about protective gear usage Signup and view all the answers

What should be done with animals that are found to be infected?

Segregate and possibly slaughter them Signup and view all the answers

What is the role of serological testing in infection control among livestock?

To identify and eliminate infected animals Signup and view all the answers

Which measure is crucial when handling placenta and fetuses of infected animals?

Careful handling and disposal with disinfection Signup and view all the answers

In high prevalence areas, which vaccination is recommended for young goats and sheep?

Rev-1 strain of B.melitensis Signup and view all the answers

What is the primary focus of the concurrent disinfection method?

To eliminate infectious agents in purulent discharges Signup and view all the answers

What is the general case fatality rate for untreated endocarditis?

2% or less Signup and view all the answers

Which of the following is NOT a mode of transmission for brucellosis?

Vector-borne transmission Signup and view all the answers

What is the primary reservoir for Brucella canis?

Dogs Signup and view all the answers

What can cause a brucellosis relapse?

Antibiotic resistance Signup and view all the answers

Which test is typically used to achieve a diagnosis of brucellosis with around 95% accuracy?

Serological tests including ELISA Signup and view all the answers

What is the incubation period range for brucellosis?

1-3 weeks, but can be longer Signup and view all the answers

What is the most effective method for preventing human brucellosis?

Control and eradication in animal reservoirs Signup and view all the answers

In a case scenario of brucellosis, which lab finding is least likely to be observed?

Elevated lymphocyte count Signup and view all the answers

How is brucellosis primarily transmitted to humans?

Contact with fluids or ingestion of contaminated animal products Signup and view all the answers

In which setting has airborne transmission of brucellosis been reported?

In laboratories and slaughterhouses Signup and view all the answers

Study Notes

Brucellosis Overview

Brucellosis is a zoonotic bacterial disease, primarily an infection of animals transmissible to humans.
Caused by small, gram-negative, rod-shaped, non-motile, non-spore-forming, intracellular coccobacilli of the genus Brucella.
Various Brucella species primarily infect domestic livestock.
Examples of infected livestock: cattle (B. abortus), sheep and goats (B. melitensis), pigs (B. suis), and dogs (B. canis).
Other names for brucellosis include undulant fever, Malta fever, and Mediterranean fever.
Brucellosis is a global issue, traditionally associated with farm workers, veterinarians, and those involved in handling meat or dairy products.

Objectives

Epidemiology and transmission of brucellosis.
Preventive measures, epidemic control, and international efforts to control brucellosis.

Identification

Brucella species are prevalent in domestic animals.
The infection can be transmitted to humans.
The type of animal impacted determines the pathogenicity level:
B. melitensis (sheep): highest pathogenicity
B. suis (pigs): high pathogenicity
B. abortus (cattle): moderate pathogenicity
B. canis (dogs): moderate pathogenicity

Pathogenicity

Brucella melitensis has the highest pathogenicity.

Spread of Brucellosis

Transmission is linked to the infected animal.

Geographical Distribution

Worldwide distribution.
Higher incidence in specific regions (Mediterranean countries, Africa, Middle East, parts of Asia, and Central/South America and Mexico)
Cases can occur in people returning from endemic regions.
Often under-diagnosed.
Relatively rare in many European countries, North America, and Australia.

High incidence in mid-20s males, particularly in the Mediterranean region.
Data reveals a pattern of high incidence between ages 13-40 years, followed by those younger than 13 years and slightly lower numbers aged 40-60, with even fewer above 60 years of age. This is mostly from cases of Brucella melitensis.
Individuals in the 13-40 age range appear more susceptible to illness from B. melitensis.

Higher incidence in males than females worldwide.
This is potentially due to occupation-related exposure to animals.

Clinical Manifestation

Common symptoms include fever, night sweats, malaise, anorexia, fatigue, weight loss, and depression.
Bone and joint involvement are frequent complications.
Possible complications include sacroiliitis, spondylitis, peripheral arthritis, osteomyelitis, bursitis, and tenosynovitis.
Genito-urinary involvement (orchitis, epididymitis) occurs in 2-20% of cases.
Neuro-brucellosis is rarer but can be severe.
Relapse is possible.

Key Points on the Disease in Humans

Usually presents as an acute febrile illness.
Primarily caused by B. melitensis.
All age groups affected.
Complications can affect any organ system.
May persist as relapse, chronic localized infection, or delayed convalescence.

Mode of Transmission

Contact with infected animal fluids (blood, urine, vaginal discharges, aborted fetuses, placentas).
Ingestion of raw milk, dairy products, or undercooked meat from infected animals.
Airborne transmission in laboratory or slaughterhouse settings.
Accidental inoculation of animal vaccines.
Possible rare person-to-person or sexual transmission.
Transmission from mother to infant via breastfeeding or ingestion of raw milk.

Key Points on the Epidemiology of Brucellosis in Humans

Cattle, sheep, goats, and pigs are the primary animal reservoirs.
Transmission often occurs via occupational or environmental contact with infected animals or products.
Foodborne transmission (e.g., raw milk, cheese) is a significant risk factor.
Brucellosis can be a travel-associated illness.
Blood or organ/tissue transfer is a possible mode of infection, but not common.
Person-to-person transmission is rare.

Reservoir

Cattle, swine, goats, and sheep are main reservoirs.
Dogs can be a reservoir for B. canis.

Incubation Period

Variable, typically 1-3 weeks, but can extend to 6 months or more.

Period of Communicability

Rare person-to-person transmission; risk for medical personnel in areas with limited resources.

Susceptibility

Severity and duration of illness vary.
Duration of acquired immunity uncertain.

Diagnosis

Isolation of the infectious agent from blood, bone marrow, or other tissues.
PCR
Serological tests, such as Rose Bengal, seroagglutination, or ELISA (95% accurate).

Key Points on the Diagnosis of Brucellosis in Humans

Culture often negative, especially with long-standing disease.
Serology is the most useful diagnostic tool.
Different serological tests (RBT, tube agglutination, ELISA) can be used.
Key to differentiate active vs. past infection using IgM & IgG analysis.

Case Scenario

81-year-old man presented with flu-like symptoms, back pain, and arthralgia.
High CRP, low Hb, mild liver enzyme elevation, and positive blood culture for Brucella melitensis.
Confirmed brucellosis diagnosis.

Methods of Control - Preventive Measures

Public awareness, especially for tourists, about the risk of consuming unpasteurized milk products.
Education for farmers, workers in slaughterhouses, and butcher shops about disease prevention and safe practices when handling animals and products.
Education for hunters handling feral animals to use appropriate protective clothing.

Methods of Control - Other Preventive Measures

Testing and culling/isolation of infected animals.
Pasteurization of milk and dairy products; avoidance of raw products.
Proper handling and disposal of aborted animals or contaminated products (like placentas); proper disinfection.

Methods of Control - Patient, Contacts, and Environment

Reporting to local health authorities.
Isolation precautions if sores/draining lesions are present.
Disinfection of purulent discharges.
Tracing contacts and infection sources (e.g., animals, milk products).

Methods of Control - Treatment

Recommended treatment (for adults and children >8 years): a. Doxycycline 100mg PO twice daily plus Rifampin 600-900 mg/day PO for 6 weeks. b. Doxycycline 100mg PO twice daily for 6 weeks and Streptomycin 1g IM for 2-3 weeks. (considered more effective against relapse)
Ciprofloxacin-based regimens have shown equal treatment efficacy as Doxycycline regimens.

Key Points on Prevention of Brucellosis in Humans

Occupational and food hygiene are central to prevention.
Vaccination not routinely recommended.
Heat-treated milk and dairy products are safer.
Avoid raw milk and products from potentially infected animals.
Cooked meat is safer.

Key Points on Prevention, Control, and Eradication of Animal Brucellosis

Careful herd management and hygiene are critical.
Vaccination (especially B. abortus 19 and RB 51) is often helpful but is not always sufficient by itself; appropriate use is very important.
Effective control requires collaboration between communities.
Prevention & control must be planned, coordinated, and resourced.
Education & information campaigns.
Eradication programs must include testing, culling, and controlling animal movement.

Epidemic and International Measures

Identify sources of infection (e.g., raw milk, infected animals).
Stop production/distribution of contaminated products (unless pasteurization is done)
International control of animal trade and transport.

KEY POINTS ON SURVEILLANCE BRUCELLOSIS IN HUMANS AND ANIMALS

Continued surveillance is key to monitoring the presence/absence of brucellosis and controlling outbreaks.
Case definitions, reporting systems, data analysis, and disseminating information for action are essential components.
Design the surveillance program based on the existing control strategies.
Human cases can indicate potential animal infections.

Summary

Brucellosis is a reportable disease globally.
Similar to flu-like symptoms (fever, weakness, malaise, weight loss).
Rare person-to-person transmission
Caused by Brucella species (mainly cattle, swine, goats, sheep, and dogs).

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on Brucellosis, a significant zoonotic disease. This quiz covers various aspects including pathogenicity, transmission modes, endemic regions, and affected demographics. Perfect for students and professionals in veterinary medicine and infectious diseases.