An analysis for brucellosis in a person is taken. Brucellosis: what is it, how does brucellosis manifest itself in humans (photo), causes, symptoms and treatment. However, patients present such main complaints

Brucellosis is a disease characterized by damage to the musculoskeletal system, nervous, reproductive and other systems.

Brucella are stable in the external environment. They remain in water for more than 2 months, in milk - 40 days, in cheese - 2 months, in raw meat - 3 months, in salted meat - up to 30 days, in wool - up to 4 months. Brucella die when heated and under the influence of many disinfectants. Brucella is not transmitted from a sick person to a healthy person. The reservoir and source of infection are domestic animals (sheep, goats, cows, pigs, less often dogs).

Infection with brucellosis from sick animals occurs by contact, food and air routes. Infection by contact occurs especially often when amniotic fluid gets on the skin (help with calving, lambing, when caring for newborn calves, lambs). Veterinarians, calves, shepherds, etc. are often infected. Infection can also occur through contact with the meat of infected animals, with manure.

Brucella penetrate through the slightest damage to the skin. Food contamination often occurs through raw milk, as well as through the use of dairy products (feta cheese, cheese, butter). Airborne infection can occur when dust containing brucella enters the respiratory tract (in grazing areas and in sheep pens), as well as in laboratories in violation of safety regulations. This route of infection is relatively rare. People of working age (18~50 years) get sick more often. In most cases, this is an occupational disease.

What is this disease?

Brucellosis is a disease that is a zoonotic bacterial infection with a high potential for chronicity, characterized by a variety of symptoms, but most often there is a lesion of the musculoskeletal system and peripheral nervous system, and proceeding against the background of a general intoxication and feverish state.

Initially, one of the scientists (Martson in 1856) observed an unknown fever with accompanying symptoms on the island of Malta, and therefore gave it the name "Maltese fever", the same scientist established that the main source of the disease are sheep and goats, and infection occurs when using raw milk. Later there were those who discovered this same fever later, and called this fever by its name - either out of a thirst for vanity, or because of ignorance (scientist Bruce 1887 and others). But there were also such scientists who supplemented the data on the "Maltese fever":

Wright and Semple found that sera from patients with brucellosis gave an agglutination reaction, since then this observation has been used for diagnostic purposes as a serological test. Other scientists have recorded infectious abortions due to this disease.

The causative agent of brucellosis

Pathogens - aerobic and microaerophilic immobile gram-negative bacteria of the genus Brucella. According to the international classification, the genus Brucella consists of 6 independent species, which are divided into a number of biovars.

After penetration into the body of the pathogen that causes brucellosis, symptoms in humans appear after 5-30 days (on average, 2-3 weeks), with latent carriage it can be extended up to 3 months.

Brucella can survive:

• In water - up to 2 months.
• In raw meat - up to 3 months.
• In animal hair - up to 4 months.
• At a temperature of 60 degrees - up to 30 minutes.

When boiled, these microorganisms die almost instantly, as well as when exposed to various disinfectant solutions (0.2 - 1% bleach solution, chloramine, and so on).

Causes

The disease is caused by specific bacteria that belong to a separate genus Brucella, it has 7 species. In humans, 3 species cause disease - B. melitetnsis (also often causes disease in goats), B. suis (may develop in the body of pigs) and B. abortus (found in cattle). These bacteria are small in size, have polymorphism - there are rod-shaped, spherical (cocci) and convoluted forms. Spores and capsules do not form.

These features (aggression factors) of Brucella determine the course of the disease and the mechanism of its development (pathogenesis). The most virulent (the ability to cause a severe course of the disease) is the type of bacterium - B. melitetnsis. All brucellosis-causing bacteria that are sufficiently stable in the environment, in food (meat, milk), skin and animal hair, they can remain viable for a long time (from several months to six months or longer). Boiling in water kills them instantly, they are also sensitive to antiseptic solutions (hydrogen peroxide, alcohol, furatsilin, bleach, chloramine).

How infection occurs

As already mentioned, the infection enters through the wound surface during contact of a person with infected objects. Brucella enters the body both through damaged skin and through mucous membranes. Macrophage cells rise to fight the pathogen, but they only capture the infection and bring it to the lymph nodes. On the way, the bacteria actively multiply, and getting into the lymph flow, they lead to local inflammation of the lymph nodes.

The next stage of the spread of the infection is associated with its entry into the bloodstream, which contributes to further progress throughout the body. There are practically no organs and systems where brucella would not visit.

Symptoms

The incubation period for brucellosis in humans is 1-2 weeks. The disease develops, as a rule, gradually and has no specific symptoms. But patients usually present four main complaints:

• intermittent pain in the joints, mainly in the lower extremities, sometimes very strong and painful.
• an increase in body temperature in the form of prolonged subfebrile condition (up to 38 ° C) or a wave-like type with sharp rises and falls.
• increased sweating, perspiration, sometimes night sweats.
• severe weakness and loss of strength.

Systemic lesions are diverse and affect almost all organs. Meet:

1. Musculoskeletal system: septic monoarthritis, asymmetric polyarthritis of the knee, hip, shoulder sacroiliac and sternoclavicular joints, osteomyelitis of the spine, myalgia.
2. Heart: endocarditis, myocarditis, pericarditis, aortic root abscess, thrombophlebitis, and endocarditis can develop on previously unchanged valves.
3. Respiratory system: bronchitis and pneumonia.
4. Digestive system: anicteric hepatitis, anorexia and weight loss.
5. genitourinary system: epididymitis, orchitis, prostatitis, tubo-ovarian abscess, salpingitis, cervicitis, acute pyelonephritis.
6. central nervous system: meningitis, encephalitis, meningoencephalitis, myelitis, cerebral abscesses, Guillain-Barré syndrome, optic nerve atrophy, lesions of III, IV and VI pairs.
7. Lymph nodes, spleen: lymphadenitis, enlarged spleen
8. Eyes: keratitis, corneal ulcers, uveitis, endophthalmitis.

Approximate frequency of history data and some symptoms/complaints in patients with brucellosis (in %)

N. I. Ragoza distinguishes 4 phases: the phase of compensated infection (primary-latent), the phase of acute sepsis without local lesions (decompensation), the phase of subacute or chronic recurrent disease with the formation of local lesions (decompensation or subcompensation) and the phase of restoration of compensation with residual effects or without them.

Clinical forms of brucellosis:

• the form is primary-latent;
• acute septic form;
• form primary chronic metastatic;
• form secondary chronic metastatic;
• secondary latent form.

Primary-latent state of practical health. With the weakening of the protective forces, it can turn into either an acute septic or a primary chronic metastatic form. Sometimes microsymptoms: a slight increase in peripheral lymph nodes, sometimes the body temperature rises to subfebrile, increased sweating during physical exertion. They consider themselves healthy and keep working.

Acute septic form with fever (39-40 ° C), the temperature curve is wavy, irregular (septic) type with large daily ranges, repeated chills and sweats. The state of health remains good (at a temperature of 39 ° C and above, he can read books, play chess, watch TV). There are no other signs of general intoxication. Does not threaten the life of the patient, even without etiotropic treatment, it ends in recovery. All groups of lymph nodes are moderately enlarged, some are sensitive. By the end of the first week - an increase in the liver and spleen. In the study of blood leukopenia, ESR is not increased. The main difference is the absence of focal changes (metastases). Without antibiotic therapy, the duration of fever is 3-4 weeks or more.

Chronic forms sometimes they develop immediately, bypassing the acute form, sometimes after a while after the acute septic form. According to the clinic, primary chronic metastatic and secondary chronic metastatic forms do not differ. The difference is the presence or absence of an acute septic form in history. Clinic: prolonged subfebrile temperature, weakness, increased irritability, poor sleep, impaired appetite, decreased performance. Generalized lymphadenopathy is soft, sensitive or painful on palpation, there are small, very dense, painless, sclerotic lymph nodes (0.5-0.7 cm in diameter). Enlargement of the liver and spleen. Against this background, organ lesions are detected, most often on the part of the musculoskeletal system, followed by the nervous and reproductive systems. Pain in muscles and joints, mainly in large ones, polyarthritis, with a new exacerbation, metastases of other localization appear. Periarthritis, paraarthritis, bursitis, exostoses, osteoporosis is not observed. The joints swell, mobility in them is limited, the skin over them is of normal color. Violation of mobility and deformation are caused by the growth of bone tissue. The spine is affected, more often in the lumbar region. Typical sacroiliitis (Eriksen's symptom: on the table on the back or on the side and put pressure on the crest of the superior iliac bone when positioned on the side or squeeze with both hands the anterior superior iliac crests in the supine position. With unilateral sacroiliitis pain on the affected side, with bilateral - pain in the sacrum on both sides). Symptom of Nahlas, lay on the table face down and bend the legs at the knee joints. When lifting a limb, pain in the affected sacroiliac joint. Symptom of Larrey on the table on the back, the doctor takes both hands on the protrusions of the wings of the iliac bones and stretches them to the sides, while pain appears in the affected side (with unilateral sacroiliitis). Symptom of John-Beer: the patient is in the supine position, with pressure on the pubic joint perpendicularly down, pain in the sacroiliac joint.

Myositis pain in the affected muscles. The pains are dull, prolonged, their intensity is associated with changes in the weather. On palpation, more painful areas are determined, and painful seals of various shapes and sizes are felt in the thickness of the muscles. Fibrositis (cellulitis) in the subcutaneous tissue on the legs, forearms, back and lower back. Sizes from 5-10 mm to 3-4 cm soft oval formations, painful or sensitive. In the future, they decrease, can completely resolve or sclerosis and remain for a long time in the form of small dense formations, painless.

Damage to the nervous system: neuritis, polyneuritis, radiculitis. Damage to the central nervous system (myelitis, meningitis, encephalitis, meningoencephalitis) is rare, it is long and difficult.

Changes in the reproductive system in men - orchitis, epididymitis, decreased sexual function. In women, salpingitis, metritis, endometritis. Amenorrhea occurs, infertility may develop. Pregnant women often experience abortions, stillbirths, premature births, congenital brucellosis in children.

The secondary chronic form proceeds in the same way. The secondary-latent form differs from the primary-latent one in that it more often passes into manifest forms (relapses).

Consequences

Brucellosis can affect almost any part of the patient's body, including the organs of the reproductive system, liver, heart, and central nervous system. Possible complications include:

1. Endocarditis. This is one of the most serious conditions that can lead to malfunction of the heart valves. Endocarditis is the main cause of death in patients with brucellosis;
2. Arthritis. Infectious joint inflammation is characterized by pain, stiffness, and swelling in the affected area (usually in the knees, ankles, hips, wrists, and spine);
3. Infectious inflammation of the testicles (epididymo-orchitis). Brucella can invade the epididymis, the tube that connects the vas deferens and the testicles. From there, the infection can spread further into the testicles, causing swelling and pain;
4. Infectious inflammation of the liver and spleen. With the development of this complication, the patient has an increase in these organs in size and pain appears in the epigastric region;
5. Infections of the central nervous system: meningitis (inflammation of the membranes surrounding the brain) and encephalitis (actual inflammation of the brain).

Brucellosis in pregnant women can cause miscarriage, fetal abnormalities.

Death from brucellosis is rare. Most of them are the result of a malfunction of the heart after the development of endocarditis.

Diagnostics

How to diagnose brucellosis? This is a complex process if the person is not at risk for the disease. In the correct diagnosis, epidemic data, the association of symptoms and the place of work of a person play a role.

Where does the diagnosis begin?

1. To begin with, they collect an anamnesis, find out whether similar outbreaks of brucellosis have previously occurred at the enterprise in which the patient works, or at his place of residence.
2. Isolation of cell culture from a sick person is an important fundamental diagnostic method. To do this, take blood for brucellosis and other biological fluids. Special media are used for cell culture growth. The difficulty lies in the fact that cultures germinate for a long time - a column of bacteria grows for at least a month.
3. What tests to take for brucellosis? Almost any biological fluid is used to determine the presence of bacteria in the blood. But first of all, they take blood, especially for serological research methods, from which RSK, RNGA, Coombs' reaction are prescribed. These research methods are more sensitive, they can even determine the L-forms of bacteria, but these are expensive procedures.
4. For the diagnosis of brucellosis in humans, a special Wright serological method is also used. A titer of 1:200 is considered positive. An obvious advantage is a quick diagnosis - no later than 10 days you can get reliable data on the presence of brucellosis.
5. The modern method of DNA detection - PCR diagnostics, is used in very rare cases due to the high cost.
6. Use the Berne skin test or an allergic diagnostic method. It is based on the presence of a brucellosis antigen in the blood of a sick person - when brucellin is introduced, swelling and redness appear at the injection site.

Treatment of brucellosis in humans

In humans, the treatment of acute and chronic forms of brucellosis is different. In the acute form, the use of antibiotics comes first, in the chronic form - vaccines and antiallergic drugs.

All drug names are for informational purposes only. Self-medication is unacceptable, as it can lead to negative consequences. This information is not a recommendation, the patient himself is responsible for the consequences of using drugs without a doctor's prescription.

Treatment of chronic brucellosis

Antibiotics in chronic forms of brucellosis were ineffective. The main role in these forms is played by the appointment of drugs with nonspecific and specific desensitizing effects. In chronic forms, vaccine therapy is most effective, which is not only a desensitizing measure, but also stimulates the immune system.

Diet and nutrition

There is no specific diet specifically for brucellosis. At the same time, brucellosis is an infectious disease, the acute course of which leads to a significant expenditure of energy and other resources of the patient's body. That is why the brucellosis diet should be as high-calorie and easily digestible as possible (so that the body spends as little energy as possible on food processing).

During an exacerbation of fever (that is, during the period when there is a massive intake of Brucella and their toxins into the bloodstream), patients are advised to take as much fluid as possible in its pure form (up to 2-4 liters per day). This helps to dilute the blood and reduce the concentration of toxins in it, and also accelerates the excretion of toxic substances through the kidneys with urine.

Forecast

After the complete disappearance of all symptoms in 20-30% of patients, symptoms of the disease may reappear.

Previously, the main cause of death in brucellosis was heart damage. Today, with the advent of new effective antibacterial drugs, the prognosis for life is favorable. But the level of health, working capacity and quality of life after an illness always decrease to one degree or another.

Prevention

There is no specific effective vaccine against brucellosis for humans. The main recommendations for preventing infection are:

• Avoid consumption of unpasteurized dairy products;
• Compliance with hygiene rules and wearing gloves by agricultural workers;
• Vaccination of pets. Thanks to the mass vaccination of livestock, the problem of brucellosis in the United States has been almost completely eliminated.

Since vaccination is carried out with live weakened bacteria, getting the vaccine into the human body can cause disease.

After contact with an animal infected with Brucella bacteria, even in the absence of symptoms, close monitoring of the patient's condition is necessary for 6 months.

Brucellosis is a fairly common infectious disease. can affect both animals and humans. It should be noted that brucellosis in humans causes damage to many body systems and, if left untreated, can become chronic, which is extremely dangerous.

Brucellosis in humans and its causes

It should be noted that brucella is very resistant - they are able to tolerate both high and low temperatures. Most often, human infection occurs when eating meat and some waste products of sick animals. For example, in meat, bacteria can survive for about five months, and in milk for up to eight weeks.

In addition, a household route of transmission is also possible, for example, through scratches and cracks in the skin. This infection is most susceptible to people working with animals, in particular, veterinarians, milkmaids, etc.

photos and symptoms

Most often appear 1-5 weeks after infection. During this time, they manage to spread throughout the body along with the flow of lymph and blood. Brucellosis in humans primarily affects the musculoskeletal system, central nervous system, liver, lymph nodes, reproductive organs, and spleen.

If left untreated, the disease becomes chronic, which is fraught with dangerous complications. Brucellosis in humans primarily affects the joints, leading to severe pain and limited mobility. Complications can also include meningitis, hepatitis, neuritis, radiculitis, diseases of the cardiovascular system, disruption of the hearing and visual apparatus.

Brucellosis in humans: treatment

Of course, you will first have to take some tests to confirm the diagnosis. A blood test helps to determine the presence of specific antibodies, and a laboratory culture allows you to isolate the pathogen itself and check its sensitivity to a particular group of drugs.

As for therapy, in this case, tetracycline antibiotics are used, including Levomycetin and Streptomycin. Most often, 3-4 weeks of therapy is enough to completely free the body from pathogenic microorganisms. After that, doctors can prescribe a vaccination that will protect against re-infection.

Brucellosis is a disease of bacterial origin caused by microorganisms of the genus Brucella.

Circulating in the blood, this pathogen causes multiple lesions of the nervous, cardiovascular, musculoskeletal and reproductive systems of a person, so treatment should be started as early as possible.

Ways of infection

Brucellosis can be contracted from infected pigs, as well as small and large cattle. Dogs, camels and other animals are rarely the source of infection.

The same applies to the likelihood of transmission of infection from a sick person to a healthy one. It should be noted that not every entry of Brucella into the body leads to the development of the disease, but infection of people occurs through direct contact with meat, blood, saliva, feces, amniotic fluid of a sick animal.

This explains why brucellosis occurs predominantly in milkmaids, veterinarians, shepherds and other professionals working in the livestock sector. The penetration of a pathogen into the human blood causes damage to the skin, mucous membranes, while 10 Brucella are enough for infection.

Bacteria can enter the body through food - if you use products made from the milk or meat of an infected animal.

Airborne brucellosis is also transmitted, but this occurs infrequently. Brucella can enter the respiratory system during laboratory work, which indicates a low probability of infection.

The disease occurs mainly in persons aged 18-55 years, and is often professional for rural workers. A person who has had brucellosis develops temporary immunity against the disease, which lasts no more than 5 years.

How to identify the disease

The manifestations of the disease are associated with the work of the patient's immune system. Therefore, one can transfer it easily, while someone begins to develop a difficult process. In an organism with weak immunity, even a live vaccine leads to a violent response.

The incubation period of the disease lasts from 3 weeks to several months.

The development of the disease and its consequences is directly related to the type of pathogen:

1. So, B. abortus, entail the development of a mild disease, but most often it becomes chronic.
2. Due to bacterial activity B. Suis abscesses develop.
3. Pathogenic activity B. melitensis causes severe brucellosis. The latter form of the disease leads to disability.

Diagnosis is complicated by the fact that the first manifestations of the disease are similar to those of the flu.

For the initial stage of the disease, the following manifestations are characteristic:

Acute brucellosis in young people develops abruptly, in the elderly - gradually, this form is characterized by the following symptoms:

Muscle atrophy and other similar diseases develop, including those requiring surgical intervention. Chronic brucellosis affects the state of the reproductive system, regardless of gender.

Residual brucellosis is also distinguished, implying a condition in which the consequences of infection are delayed, pathological reactions occur after a while. As a result, there are pathological changes in the functioning of the joints, a deterioration in the psychological state of the patient. The considered form of the disease differs only in subfebrile temperature.

Diagnosis of the disease

Diagnosis of brucellosis is carried out by compiling a detailed anamnesis, analyzing the clinical manifestations of the disease.

An infected person is sent for laboratory tests, which involve bacteriological cultures of the contents of the lymph nodes, bone marrow and blood, for which a biopsy is performed earlier. Serological diagnostics helps to identify specific antibodies in the blood.

At different stages of the course of the disease, reactions are checked using:

1. Coombs' samples- allows you to identify incomplete antibodies in the chronic form.
2. Wright's samples- in the presence of an acute form of the disease on the 10th day will give a positive result.
3. Burne samples- allergic, carried out intradermally to determine the sensitivity of body tissues to bacteria of the type.

Medical therapy

Antibiotics are used to treat brucellosis in humans. The most effective among them are Streptomycin and Gentamicin.

If the disease is mild, it is enough to take only one antibiotic - Doxycycline, and if there is no effect, Rifampicin is additionally prescribed.

Treatment of children under 8 years of age involves the use of Rifampicin and Trimethoprim.

In the treatment of a disease in pregnant women, Rifampicin is used not only as an independent agent, but also in combination with Trimethoprim.

It should be remembered that the use of Trimethoprim after the sixth month of pregnancy creates a risk of kernicterus in the unborn child.

The resulting endocarditis should be treated with more aggressive antibiotic therapy, which includes the use of doxycycline, rifampicin and trimethoprim, provided that aminoglycosides are used. In a severe case, it is necessary to replace the heart valve with an artificial analogue.

The chronic form of the disease is treated with the same drugs, as well as vaccination.

If the disease is complicated, corticosteroids should be used. Additionally, in the event of concomitant diseases, the patient is prescribed anti-inflammatory drugs, analgesics.

The use of surgical treatment is performed when brucellosis is complicated by purulent-septic or other phenomena.

Patients are prescribed vitamin complexes, hematopoietic stimulants are used, such as Metacil, Pentoxyl. In winter, patients are exposed to ultraviolet radiation.

With the manifestation of allergic reactions, antihistamines are used (Suprastin, Ksizal).

During the period of remission of the chronic form of brucellosis, the patient is prescribed physiotherapy, physiotherapy exercises, and is given referrals to sanatoriums.

Impact on all human organs and systems

The appointment of treatment in the first month of detection of signs of the disease guarantees the achievement of a favorable result. However, you should be prepared for the fact that the recovery period will be long.

The number of deaths from brucellosis is relatively small, but this pathology affects almost all parts of the body, disrupting the body's systems. Complications relate to joints, tissues, nerve cells, organs, and are expressed by the appearance of disorders in the activity of the heart, brain, and reproductive system. Often there is infection of the liver, spleen, testicles.

The musculoskeletal system is most often affected in chronic brucellosis. The course of the disease is accompanied by muscular and joint pains. Predominantly large joints suffer, which swell and become inactive. The skin over them does not change its color. The lumbar spine often suffers.

Brucellosis affects the nervous system, which is expressed in the development of neuritis and sciatica. The severe course of the disease, accompanied by a violation of the central nervous system, causes a destructive effect on the body of an infected person.

Lesions of the reproductive system disrupt the functioning of the reproductive organs, affecting the development of complex diseases, including infertility.

The functioning of the cardiovascular system is also impaired under the influence of infection, and is manifested by inflammation of the heart muscle and other similar diseases.

The transfer of brucellosis during pregnancy is fraught with complications in the development of the fetus.

Effective disease prevention

Preventive measures aimed at preventing the development of brucellosis include the following:

• avoiding the consumption of unprocessed dairy products and meat;
• compliance with safety rules by rural workers, in particular, the use of disposable gloves cannot be ignored;
• timely vaccination of pets.

In addition, a person in contact with an animal that is infected with brucellosis must be observed by medical workers for six months.

Bang and Traum's disease, Bruce's septicemia, Maltese, Neapolitan, modulating fever - under what terms does not hide the infectious disease brucellosis. A little over 200 years ago, scientists started talking about it. Many facts are known about this infection, one of which is the chronic course of the disease and extensive damage to organs and systems.

What is brucellosis and what is the causative agent of this infection? For what reasons can a person become infected with brucellosis and what kind of symptoms will the acute and chronic course of the disease have? How often do people get infected today? What is the treatment and prevention measures? All these questions will be answered below.

What is brucellosis

In 1859, on the island of Malta, the Englishman J. Marston first described diseases that resembled brucellosis along the way. Since then, this disease has been called Maltese fever. A little later, in 1886, a scientist from London, David Bruce, isolated bacteria from the spleen of a deceased person, resembling Maltese in structure. Bacteria were subsequently named after the English scientist.

After that, it turned out that not only people can get an infection - throughout the last century, many works have been written on the detection of the causative agent of brucellosis in animals.

The causative agent of the infection

The causative agent of brucellosis is bacteria of the genus Brucella. Nowadays, 6 types of microorganisms are known to cause this disease. And only 4 of them are extremely dangerous for humans:

• brucella melitensis, carried by sheep and goats;
• brucella abortus suis - cause disease in humans and pigs;
• brucellosis in humans can be caused by the bacterium brucella abortus bovis, which is carried by cows;
• brucella canis - transmitted through dogs.

But there are suggestions that several more species of Brucella are pathogenic for humans.

What can be said about the causative agent of infection?

1. These are ordinary gram-negative bacteria, almost all of their species are similar to each other.
2. Grows easily on simple nutrient media.
3. At what temperature does the causative agent of brucellosis die? - bacteria do not like high temperatures - in just 30 minutes they die at 60 ° C, and instantly when boiled.
4. To low degrees, the causative agent of brucellosis, on the contrary, is resistant.
5. The difference between the bacteria is the ability to secrete endotoxin, and under the influence of antibiotics, they turn into the L-form, which can exist for a long time in the human body.
6. At the moment of direct sunlight, bacteria die, as well as under the influence of all available disinfectants.

Brucellosis is an acute infectious-allergic disease caused by bacteria. Both people and animals can get sick. Due to the peculiarities of the structure and behavior of the pathogen at the time of exposure to drugs, brucellosis often becomes chronic, and the number of complications can only increase over time.

Causes of human infection

Brucellosis is transmitted in several ways. An important part of the disease is that it belongs to the professional category. That is, mass cases of infection of livestock workers and farm workers or large enterprises processing animal hair are known. Although in our time the disease is becoming less common.

Ways of transmission of brucellosis are as follows.

1. The main way is alimentary or contact, while working with infected animals on the farm. Moreover, bacteria can be found in absolutely everything: bedding, feed, wool, and drinking water are contaminated with secretions from sick cattle.
2. The causative agent is often found in products: in meat up to 20 days, in dairy up to 60.
3. An aerogenic mechanism of infection transmission is possible during the inhalation of particles of dust, wool, and earth.
4. Brucella transplacentally penetrate into the amniotic fluid, they are found in large quantities in the placenta and in all tissues of the baby.

Is brucellosis transmitted from person to person? - No, this way of infection is completely excluded.

Infection of people occurs at the time of contact with contaminated objects through the wound surface (scratch, abrasion, cut) or during the use of products. Workers of livestock farms in 100% of cases become infected when cutting meat, an increase in the incidence is also associated with calving of livestock.

The source of brucellosis for humans are the following animals:

• pigs;
• dogs;
• sheep and goats;
• cows;
• in some places - reindeer.

How infection occurs

As already mentioned, the infection enters through the wound surface during contact of a person with infected objects. Brucella enters the body both through damaged skin and through mucous membranes.

Macrophage cells rise to fight the pathogen, but they only capture the infection and bring it to the lymph nodes. On the way, the bacteria actively multiply, and getting into the lymph flow, they lead to local inflammation of the lymph nodes.

The next stage of the spread of the infection is associated with its entry into the bloodstream, which contributes to further progress throughout the body. There are practically no organs and systems where brucella would not visit.

Symptoms of brucellosis in humans

When the first signs of brucellosis appear in a person depends on the amount of the microorganism that has got inside. In rare cases, the infection does not pass further defense systems and remains in the lymph nodes for a long time. If a person's immunity is not weakened, bacteria in his body remain for a long time, even if in an inactive state. The incubation period of the disease is 7 to 30 days.

How does brucellosis manifest itself in humans?

These are the so-called early signs of an infectious disease. In later periods, brucellosis manifests itself differently and affects more and more organs.

Symptoms of chronic brucellosis

This disease may have a long course, in which the causative agent of brucellosis is in the human body, and manifests itself at the time of a sharp weakening of the immune system. Relapse often occurs 1–2 months after the first signs of the disease have subsided.

An exacerbation of a chronic infection is slightly different from an acute one:

• intoxication is poorly expressed;
• in the first place is not general symptoms with weakness, fever, but damage to internal organs and the musculoskeletal system;
• brucellosis arthritis is often noted;
• sometimes, against the background of an aggravation of the disease, more severe infections join: tuberculosis, malaria.

How does the infection worsen and what organs are most often affected?

Can brucellosis cause diarrhea? - neither acute nor chronic course of the disease is characterized by such a symptom. But with a pronounced violation of the functions of the liver, sometimes there is a loosening of the stool.

Protracted or chronic brucellosis is dangerous because more organs and systems are involved in the painful process.

Complications of brucellosis

Why is brucellosis dangerous for humans? - the fact that this disease is unpredictable. It proceeds for a long time, for several weeks the patient is disturbed by various symptoms. But, in addition to the chronic course of the disease, there are other unpleasant moments.

Diagnostics

How to diagnose brucellosis? This is a complex process if the person is not at risk for the disease. In the correct diagnosis, epidemic data, the association of symptoms and the place of work of a person play a role.

Where does the diagnosis begin?

Treatment of brucellosis

To treat an infection, four main tasks must be performed:

• the fight against the pathogen;
• ridding a person of a painful syndrome;
• prevention of complications or work with existing ones;
• rehabilitation of the patient.

Treatment of brucellosis in humans begins with the appointment of antibacterial drugs. The selection of drugs is carried out according to the stage of development of the infection, the presence of complications and the degree of compensation of the process.

Prevention

Prevention of brucellosis is a complex multi-stage process, the main role in which belongs to the state and enterprises.

boiling milk

To eradicate the pathogen, carry out:

• treatment of infection in farm animals;
• milk disinfection;
• pasteurization and boiling of dairy products;
• apply special methods of keeping ready-made dairy and meat products;
• regular examination of workers of farms and collective farms for brucellosis;
• people in special protective clothing are allowed to animals;
• regularly carry out sanitary-educational work among the population.

Individual prophylaxis of brucellosis consists in compliance with hygiene standards, food processing, regular ongoing cleaning in the habitats of agricultural and domestic animals.

Specific prophylaxis of brucellosis

A past infection does not guarantee full protection against brucellosis for the rest of your life - immunity lasts only for a year. At best, a person will be lucky and the disease will not bother him for the next three years. Therefore, it is necessary to use more effective methods of protection.

Until recently, animals were vaccinated against brucellosis, but this did not bring a positive result, since the disease can also occur in vaccinated people, even if in a very mild form.

Currently, a live dry brucellosis vaccine is used. It is prescribed to people with a high risk of morbidity. These include:

• workers of collective farms and farms;
• veterinarians of private enterprises;
• all people who care for farm animals and live in areas with frequent outbreaks of brucellosis.

In such cases, a person is vaccinated against brucellosis every 1–2 years. This is the maximum period of protection, since immune cells in the body remain only for a short time. A feature of the vaccine is intravenous administration, but intradermal administration is also allowed. One dose of 0.1 ml contains 25 million microbial attenuated antibodies.

The vaccine is one of the reactogenic vaccines, its introduction may lead to the development of allergic reactions, pain in the joints and weakness. In this regard, before immunization against brucellosis, a skin test is performed.

Vaccination of people against brucellosis is carried out in a planned manner. The same drug is also used for treatment, but in this case the doses of the drug are different, since for the therapeutic purpose the vaccine has to be administered to the patient up to 10 times, and the interval between injections is 2-3 days.

Brucellosis is not one of the most dangerous diseases, millions of people do not get sick with it every year, and the number of deaths can be counted on the fingers. But this is a long-term infection with numerous lesions, leading to disability. Therefore, if a person belongs to the risk group for the development of brucellosis, then the most reliable protection is vaccination.

In which fever occurs, bones, muscles, heart, blood vessels, nervous system, kidneys are affected. The infection comes from animals. Brucellosis is classified as a particularly dangerous infection.

For the first time, researcher J. Marston took up the study of brucellosis on the island of Malta in the 19th century. Local residents and quartered English soldiers contracted the disease when they drank raw goat's milk. In 1886, the bacterium was first discovered in the spleen of a deceased patient (this was done by the scientist D. Bruce - the pathogen was named after him brucella), and since 1897, the analysis of the serum of infected people has been successfully used.

In Russia, the first cases of the disease were registered in 1912 in Ashgabat.

How many people in the world have brucellosis?

In some countries, brucellosis does not occur at all: in Denmark, Sweden, Iceland, Finland, Switzerland, Slovakia, the Czech Republic, Romania, the Netherlands, the UK (including the Channel Islands), Japan, Bulgaria, Luxembourg, the Virgin Islands and Cyprus.

The following professions are most susceptible to infection with brucellosis:

• farmers;
• employees of meat processing enterprises;
• veterinarians;
• employees of bacteriological laboratories.

Causes of brucellosis

Animals from which infection may occur:

• goats and sheep;
• cattle;
• pigs;
• reindeer.

Brucella persist in the environment for a long time:

• in soil - up to 6 months;
• in dairy products - up to 2 months;
• in meat - up to 20 days;
• in cheeses from contaminated milk - up to 3-4 months;
• in frozen or salted meat - up to 1.5-2 months.

Brucella- a bacterium that can live and multiply inside the cells of the human body, where it is inaccessible to the immune system. The body's defense systems cannot cope with the pathogen, and the disease proceeds in a chronic form.

Brucellosis cannot be transmitted from humans. Although, there is some evidence of the possibility of infection of the fetus from a pregnant mother, a child through breast milk, a partner during intercourse.

Ways of infection with brucellosis:

• when eating infected milk, dairy products, meat;
• by inhalation of dust from wool, manure, bedding, earth;
• direct contact, cutting meat, if there are damages, abrasions and small scratches on the skin.

Signs of brucellosis

Signs of brucellosis in the defeat of various organs

Lesions of the musculoskeletal system in brucellosis

Brucella Arthritis Symptoms:

• sharp pain in the joint;
• swelling, redness in the area of ​​the affected joint;
• movement disorder.

Less common is the involvement of the small joints of the hands and feet.

Arthritis of the intervertebral joints is characterized by a persistent course, often recurs. With brucellosis, joint damage can be combined with inflammatory processes in the tendon sheaths (tendovaginitis), synovial bags (bursitis), pain along the adjacent nerves.

With a long course of the inflammatory process around the joint, an overgrowth of bone tissue is formed, as a result of which movements are disturbed.

Brucella myositis - inflammation of muscle tissue. The muscles of the lower back, arms and legs are most commonly affected.

Symptoms of brucellosis myositis:

• Pain in the muscles. They continue for a long time, have a dull character, and intensify during changes in the weather.
• Painful seals appear in the thickness of the muscles, which can be felt.
• Over time, the pain goes away, the seals disappear, but then they appear in other muscles.

The defeat of the cardiovascular system in brucellosis

1. Endocarditis- inflammation of the inner lining of the heart, which lines its chambers from the inside. The main manifestations of the disease:
   • fever;
   • weakness, sweating, increased fatigue;
   • pain in the bones and muscles;
   • swelling in the legs, especially in the evening;
   • bluish or purple hue of fingertips, nose, earlobes.
2. Pericarditis- Inflammation of the outer lining of the heart. The main symptoms of the disease:
   • increase in body temperature;
   • general weakness, malaise;
   • chest pains - occur on the left or in the lower part of the sternum, intensify during frequent deep breathing, pass in a sitting position when the body is tilted forward.
3. Thrombophlebitis - inflammation of the vein wall and the formation of blood clots on it. The main symptoms of the disease:
   • fever, malaise;
   • pain along the inflamed vein;
   • painful bumps under the skin;
   • swelling of the affected limb, pain, numbness.

Usually, brucellosis is suspected when the patient has symptoms of infective endocarditis or pericarditis, the doctor prescribes tests to identify common pathogens, and their result is negative. After that, specific tests for brucellosis are prescribed.

Respiratory damage in brucellosis

Types of damage to the respiratory system:

• Brucella sore throat- tonsillitis. They increase in size, there is a sore throat, which intensifies during swallowing. Swallowing becomes difficult.
• Brucella pharyngitis- inflammation of the mucous membrane of the pharynx. At the same time, pain in the throat, cough are noted.
• Brucella bronchitis and brucellosis pneumonia (pneumonia). They present with classic symptoms. The patient is worried about frequent coughing, sputum leaves, in which there may be blood impurities.

The defeat of the digestive system in brucellosis

• Anicteric hepatitis- inflammation in the liver. Enlargement of the liver and spleen is noted even in the acute stage of the disease, when the pathogen circulates in the blood. Brucella hepatitis manifests itself in the form of aching pains under the right rib. Sometimes there is a slight jaundice.
• Lack of appetite and weight loss.

The defeat of the genitourinary system in brucellosis

• Orchitis- inflammation of the testicle. May threaten the development of infertility. There are pains in the scrotum, one half of it becomes edematous, slightly increases in size.
• Epididymitis- inflammation of the epididymis.
• Prostatitis- inflammation of the prostate gland. It is characterized by classic symptoms.
• Decreased sexual function, potency.

Types of lesions of the genitourinary system with brucellosis in women:

• Metritis- inflammation of the uterus. The most common inflammation of its mucous membrane - endometritis.
• Salpingitis- inflammation of the fallopian tube.
• Violation of menstruation. Amenorrhea is noted - the absence of menstruation for a long time, or they become more rare, scarce.
• Infertility.
• If a pregnant woman gets sick with brucellosis, then she usually has spontaneous abortion (miscarriage). A child with congenital brucellosis may be born.

Damage to the nervous system in brucellosis

1. Peripheral nerve damage:
   • mononeuritis - inflammation of one nerve;
   • polyneuritis - damage to a large number of small nerves;
   • plexitis - damage to the nerve plexus;
   • sciatica - damage to the nerve root.
   Damage to the peripheral nerves manifests itself in the form of pain, impaired sensitivity and movement. The severity of these symptoms depends on how large the nerve is affected, on the severity of the lesion.


2. Intercostal neuralgia- Pain in the chest with damage to the intercostal nerves. Arise sharply, unexpectedly, are stabbing in nature, quite intense. They can mimic pain in the heart.


3. Acoustic and/or optic neuritis- inflammatory changes in the nerve, which are accompanied by a decrease in hearing or vision.


4. Paresis- partial violation of movements in a certain muscle group.


5. Meningitis and meningoencephalitis- inflammation of the membranes and substance of the brain. Manifested by classic symptoms: deterioration in general condition, fever, severe headache, nausea, vomiting, photophobia, intolerance to loud sounds, impaired consciousness. Brucella meningitis is not as severe as meningococcal, but for a long time.


6. Neurosis, hypochondria, mental disorders- develop when bacteria of the large hemispheres of the brain are affected by toxins.

Damage to the lymph nodes and spleen in brucellosis

• Lymphadenitis- inflammation of the lymph node. It increases (usually to the size of a bean), becomes painful, and can be seen under the skin.
• Enlargement of the spleen. It is detected during palpation of the abdomen, an ultrasound examination. At the same time, a decrease in the number of leukocytes, erythrocytes and platelets is noted in the general blood test.

Eye damage in brucellosis

• iritis- inflammation of the iris of the eye;
• uveitis- inflammation of the choroid of the eyeball;
• chorioretinitis- inflammation of the choroid of the eyeball and retina;
• keratitis- inflammation of the cornea;
• optic nerve atrophy- as a result of violation of its function, visual acuity decreases.

Consequences and residual effects of brucellosis

• Increased sweating.
• Increased irritability, sudden mood swings.
• Pain in the joints. Occur during physical exertion, change of weather.
• Deformities and impaired mobility of the joints. Occur due to the growth of bone tissue around the joint. If the movements are severely limited, you have to resort to surgical treatment.

Which specialist to contact?

Brucellosis is a disease that can manifest itself in different ways, with a large number of symptoms. Therefore, it is very difficult to make a diagnosis only after the review. The doctor can only suspect the disease. Only laboratory tests help to definitively diagnose brucellosis.

What can the doctor ask?

• Where does the patient live? Where did he go during the last month?
• What foods did you eat? Did you buy milk and meat from unverified sellers?
• Have you eaten homemade cheeses and dairy products?
• When and how did the disease start? How did it proceed?

Examination by a doctor

A diagnostic complex is prescribed, which may include various studies, depending on the symptoms present:

• with joint damage: x-ray , ultrasound , computed tomography , arthroscopy;
• with heart failure: chest x-ray, ECG, ECHO-cardiography;
• with damage to the respiratory system: chest x-ray, sputum analysis;
• with damage to the digestive system: ultrasound of the abdomen, liver biopsy, hepatitis tests;
• with damage to the genitourinary system: Ultrasound of the small pelvis, colposcopy, hysteroscopy, analysis of smears from the vagina;
• with damage to the nervous system: skull radiography, computed tomography, magnetic resonance imaging, spinal puncture, electroencephalography;
• with damage to the lymph nodes and spleen: ultrasound, biopsy;
• with eye injury: examination by an ophthalmologist.

• symptoms of joint damage that bother for a long time and do not fit into the clinical picture of most common joint diseases;
• endocarditis and pericarditis, in which bacteriological tests show a negative result;
• pneumonia, bronchitis, or another inflammatory disease that cannot be treated with conventional antibiotics.

Laboratory diagnosis of brucellosis

Medical treatment of brucellosis

Treatment of acute brucellosis

Rehabilitation

Forecast

Prevention of brucellosis

• Eradication of the disease in cattle and small cattle.
• Careful observance of veterinary and sanitary standards on farms, meat processing enterprises.
• Careful sanitary control of meat and meat products. You should not buy meat in the markets or on the street from incomprehensible sellers. Appropriate documentation must be available, and carcasses must be branded.
• It is advisable to buy pasteurized milk in bags, and if bought fresh on the market, it must be boiled.