| disease | Brucellosis |
Brucellosis, also known as undulant fever, is a zoonotic pestilence caused by Brucella. Its clinical features include prolonged fever, profuse sweating, arthralgia, orchitis, hepatosplenomegaly, and more. The pathogen is a Gram-negative short coccobacillus, classified into Brucella melitensis (goat type), Brucella abortus (cattle type), and Brucella suis (pig type) based on generation and transformation as well as serological reactions. Additionally, there are forest rodent type, sheep epididymis type, and canine type. The main types infecting humans are goat, cattle, and pig. In terms of pathogenicity, the goat type is the strongest, followed by the pig type, with the cattle type being the weakest. The pestilence sources are infected sheep, cattle, and pigs, with the pathogen present in the tissues, urine, milk, reproductive tract secretions, amniotic fluid, placenta, and fetal membranes of sick animals. Transmission occurs through contact, as well as via digestive and respiratory pestilence. The general population is susceptible and may experience reinfection or chronic progression.
bubble_chart Diagnosis
1. Acute phase
(1) The onset is insidious. The prominent manifestations are shiver, fever, and profuse sweating. The fever typically lasts for an average of 2–3 weeks, with recurrent episodes occurring from a few days to 2 weeks later, presenting a wavelike pattern. The fever type is mostly remittent but can also be irregular. Profuse sweating often soaks clothes and bedding, accompanying fever reduction, which is another distinctive feature of this disease.
(2) Arthralgia. It mainly affects large joints and is migratory; a few cases may present with joint redness and swelling or muscle pain.
(3) Lymphadenopathy and hepatosplenomegaly. Lymphadenopathy is primarily observed in the neck and armpits.(4) Others. Males may develop orchitis or epididymitis, females may suffer from oophoritis, and pregnant women may experience late abortion. Lumbosacral nerve lesions leading to sciatica are also relatively common.
2. Chronic phase
It may develop from the acute phase or occur without a history of acute sexually transmitted disease. Common symptoms include fatigue, sweating, headache, low-grade fever, depression, dysphoria, and muscle and joint pain.
Epidemiology: The incidence is higher in spring and summer, with a higher prevalence in pastoral areas. Understanding the patient's region, occupation, and exposure history aids in diagnosis.
bubble_chart Treatment Measures
1. General Treatment
During the acute phase, patients should rest in bed, drink plenty of fluids, consume easily digestible food, and ensure adequate caloric intake. Antipyretics, analgesics, and sedatives may be administered if necessary.
2. Etiological Treatment
Antibacterial drugs are primarily used for patients in the acute phase or those with chronic recurrence. Commonly used medications are as follows.
⑴ Combination of streptomycin and tetracycline: Streptomycin 1g/day, divided into 2 intramuscular injections; tetracycline 2g/day, divided into 4 oral doses. The treatment course lasts 3 weeks.
⑵ Combination of compound formula sulfamethoxazole and streptomycin: The former is taken as 2 tablets each time, 3 times/day; the latter dose is the same as above. The treatment course lasts 3 weeks.
3. Treatment for Chronic Phase
Etiological treatment should be combined with specific desensitization therapy. The etiological treatment is the same as above. Specific desensitization therapies include:
⑵ Hydrolysate and lysate therapy: The initial dose for both is 1% 1ml/day, gradually increasing to 2ml/day, with a treatment course of 10–15 days. This can also be used for acute-phase patients. Reactions such as shivering, fever, sweating, headache, and general discomfort may occur after vaccine, hydrolysate, or lysate injections. In severe cases, respiration and blood pressure may be affected.
4. Others
Corticosteroids should be administered to patients with severe conditions, testicular swelling and pain, severe joint, muscle, or nerve pain, or complications involving the heart or brain. Physical therapies such as heat therapy, diathermy, and hydrotherapy may also be used during the chronic phase.
1. Management of pestilence sources
Strengthen the management of diseased livestock. Affected animals should be isolated in designated pastures. Late abortion fetuses should be buried deeply with quicklime. Infected individuals should be promptly isolated until symptoms disappear, and blood and urine cultures test negative. Patients' excreta and contaminants must be disinfected.
2. Cutting off transmission routes
Dairy products, meat, and skin and hair from epidemic areas must undergo strict disinfection and sterilization before being transported out. Protect water sources.
3. Protecting susceptible humans and livestock
All individuals at risk of infection should be vaccinated. Currently, the M-104 freeze-dried live vaccine is widely used, administered via scarification, providing immunity for 1 year. Additionally, all personnel engaged in livestock-related work should take personal protective measures. Livestock in pastoral areas should also be vaccinated.
