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Disease: Brucellosis Brucellosis
Category: Infectious diseases
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Disease Definition:

Also called undulant fever or Mediterranean fever, brucellosis is a serious bacterial disease that causes fever, joint pain and fatigue. The bacteria called brucella cause brucellosis, which spread from animals to people, usually through unpasteurized milk, cheese and other dairy products.

This disease affects hundreds of thousands of people and animals each year in Mediterranean countries and other areas.
The bacteria can spread through the air or through direct contact with infected animals.

Although treatment for this disease takes several weeks and relapses are common, brucellosis is successfully treated with antibiotics. Animals can be vaccinated against this disease, and in order to prevent this disease in humans, they should avoid unpasteurized dairy products and take precautions when working with animals or in a laboratory.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


Usually, the symptoms of brucellosis start showing either in a few days or a few months after being infected with brucella, the bacteria that cause brucellosis. Similar to the symptoms of the flu, the signs and symptoms of brucellosis may include:


  • Joint, muscle and back pain
  • Sweats
  • Weakness
  • Chills
  • Headache
  • Fatigue
  • Fever that often rises to 40 C (104 F) or more in the afternoon. One of the indicators of this disease is the rising and falling (undulating) of fever.

Brucellosis symptoms can return after disappearing for weeks or even months. Brucellosis could become chronic in some cases, with symptoms that persist for years, even after treatment. Fevers, fatigue, arthritis and spondylitis, which is an inflammatory arthritis that affects the spine and nearby joints, are some of the long-term signs and symptoms of brucellosis.

It is difficult to identify brucellosis in the early stages because it resembles the flu. A person should make an appointment to see the doctor in case they have:


  • Unusual weakness
  • A rapidly rising fever
  • A persistent fever
  • Muscle aches
  • Any risk factors for the disease.


Many wild and domestic animals are affected with brucellosis. Some of the animals that are especially susceptible to the disease are dogs, goats, pigs, cattle, wild boar, reindeer, camels and sheep. One form of this disease also affects certain whales, harbor seals and porpoises.
At least six species or strains of bacteria cause brucellosis in animals, but not all produce illness in humans.

There are three main ways in which the bacteria could spread from animals to people. These ways are:

Laboratory technicians, slaughterhouse workers and farmers could easily become infected with the bacteria, because brucella easily spreads in the air.

Raw dairy products:
Brucella bacteria can be transmitted to humans in raw or undercooked meat from infected animals. In case the bacteria were in the milk of infected animals, it can spread to humans in unpasteurized milk, butter, cheese and ice cream.

Direct contact:
Through a cut or other wound, the bacteria that are in the semen, placenta or blood of an infected animal could enter someone's bloodstream. People rarely get brucellosis from their pets because normal contact with animals such as touching, playing or brushing doesn’t cause infection. However, people should avoid handling dogs that are known to have the disease in case they have weakened immune systems.

Although in some cases women have spread the disease to their infants during birth or their breast milk, this bacterium usually doesn’t spread from one person to another. In some rare cases, brucellosis could spread through bone marrow transfusions, contaminated blood or sexual activity.



Any part of the body could be affected with brucellosis, including the liver, central nervous system, heart and reproductive system. Complications in just one organ or throughout the body could be caused by chronic brucellosis. Some of the complications of this disease are:

The common symptoms of osteoarthritis are pain, swelling and stiffness in the joints, particularly the spine, ankles, wrists, knees and hips. Inflammation of the joints between the bones (vertebrae) of the spine or between the spine and pelvis is a condition called spondylitis, which can cause lasting damage and can be particularly hard to treat.

This disease, which is the infection of the heart’s inner lining, is one of the most serious complications of brucellosis. Untreated endocarditis, which can damage or even destroy the heart valves, is the leading cause of brucellosis-related deaths.

Central nervous system infections:
Encephalitis, which is inflammation of the brain, and meningitis, which is inflammation of the membranes surrounding the brain and spinal cord are some of the potentially life-threatening illnesses included in central nervous system infections.

This is the inflammation and infection of the testicles. The epididymis, which is the coiled tube that connects the vas deferens and the testicle, could be infected with the bacteria that cause brucellosis. The infection could spread from there to the testicle, causing pain and swelling, which could be severe. The prostate gland and kidneys could also be affected by brucellosis.

These bacteria could also cause hepatitis, a serious liver disease. If left untreated, hepatitis could lead to cirrhosis (liver scarring) and ultimately to liver failure.

Skin rashes:
Some of the rare complications of brucellosis include skin rashes and other skin problems.

In some cases, early pregnancy loss could be caused by brucellosis.

Pale skin, shortness of breath and fatigue could be caused by anemia, a condition in which a person doesn't have enough healthy red blood cells.


Relieving symptoms, avoiding complications and preventing a relapse of the disease are the major goals of treating brucellosis. Patients' symptoms may not disappear completely for several months and they have to take medications for at least six weeks. However, this disease could return and become chronic.

A combination of two or three antibiotic medications, such as doxycycline combined with streptomycin (rifampin or gentamicin) is the standard treatment for brucellosis, which should be taken for six weeks or longer. Patients may also need to take three antibiotics for three months, in case brucellosis has affected their central nervous system. Treatment of children and pregnant women involves just one antibiotic or a different combination of drugs, because they can’t take certain antibiotics.


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