brucellosis - saudi

7/30/2019 Brucellosis - Saudi

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BRUCELLOSIS

COMMUNITY MEDICINE


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INTRODUCTION

Brucellosis, Undulant fever, Malta fever or

Mediterranean fever is primarily a zoonotic disease.

The disease manifests itself in man by an intermittent

or irregular fever, splenomegaly, hepatomegaly, heavy

night sweats and tenderness over spine.

Brucellosis is both a severe human disease and adisease of animals with serious economic

consequences.


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GEOGRAPHIC DISTRIBUTION

Brucellosis is a recognized public health

problem with a world wide distribution.

Its growing prevalence is a matter of

international concern.

Brucellosis is well- known to occur in the

mediterranean region.


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AGENT

All species of brucella:

Brucella melitensis

Brucella abortus

Brucella Suis

Are widely distributed geographically.

These organisms are fairly resistant in theenvironment, but readily killed by heat and

chemicals.


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RESERVOIR

Brucellosis can affect sheep, goats and pigs.

Cross infections often occur between species.

urine, milk,The infected animals excrete Brucella in the

particularly,placenta, uterine and vaginal discharges

during a birth or an abortion.

The animals may remains infected for life.

Cattle and goats generally remain infected for life.


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HOST FACTORS

Brucellosis is predominantly a disease of adult

males, suggesting a connection with

occupation.

Farmers, Shepherds, veterinarians, abattoir

and laboratory workers are at special risk

because of occupational exposure.


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ENVIRONMENTAL FACTORS

Brucellosis is most prevalent under conditions of absence of advanced

standards of hygiene.

Overcrowding of herds, high rainfall, lack of exposure to sunlight,

unhygienic practices in milk and meat production all favour the spread of

brucellosis.

They can travel long distances in milk and dust.

The environment of a cow shed may be heavily infected.

The organisms can survive for weeks or months in favourable conditions in

water, urine, faeces, damp soil, and manure.


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MODE OF TRANSMISION

Human brucellosis is almost invariablycaused by infection from animals.

Spread from man to man is rare.The routes of spread are:

infectioncommonly,Most:Inoculation-1

occur by direct contact) muco- cutaneousroute) with sick animals, handling infectedtissues or discharges. This type of exposure is

largely occupational.


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MODE OF TRANSMISION

takemayInfection:Ingestion-2place by ingestion of infected milkand milk products, especially fresh

cheese.Fresh vegetables can also carry

infections if grown on soil

containing manure from infectedfarms.


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MODE OF TRANSMISION

:Inhalation)3

The environment of a cow shed may beheavily infected.

Few people living in such anenvironment can escape infection.

Transmission takes place through

respiratory route by inhalation ofinfected dust.


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CLINICAL PICTURE: Onset may be abrupt with sudden chillsAcute attack-Aand rigors, Generalized aches and pains, often

sweating.

The most striking aspect of the clinical picture is theseverity of the illness and the absence of clinical signs.

The acute attack subsides within 2 to 3 weeks.

If the patient is treated with antibiotics, symptomsmay disappear more quickly, but the infection may

persist giving rise to relapses.


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CLINICAL PICTURE

B- Chronic disease: This may follow an acute

attack or apear insidiously.The course of the disease may be prolonged and

long- drawn for months or years with low grade

or no fever, malaise, prostration, arthralgia, andswelling of joints.

Diagnosis may be established by blood culture

and by serological tests.


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CONTROLIn the animals: The control of brucellosis is based on a combination of measures:

complementThe.availablearetestsSkin.surveymassBy:findingCase-1

fixation test is also recommended.

theprovidesanimalsinfectedtheofElimination:eliminationandSegregation-2

only satisfactory solution aimed at eradication of the disease.

allinwidespreadbemustIt.animalsofinfectionprevents:Immunization-3

or20/45killedtheandcalvesyounginvaccine19Bliveusingareasaffected

.animalsotherinvaccine38H

In each subsequent year, the new generation of animals must be vaccinated.


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CONTROL

4- Hygienic measures: These comprise

provision of a clean sanitary environment for

animals, sanitary disposal of urine and faeces,

veterinary care of animals and healtheducation of all those who are occupationally

involved, especially precautions with aborted

cattle.


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In the human

1- Early diagnosis and treatment: The antibiotic of choice istetracycline. For adults in acute stage, the dose is 2 to 3 g daily by

mouth for 21 days.

2- Pasteurization or boiling of milk and milk products.

3- Protective measures: Persons at risk should observe highstandards of personal hygiene.

They should wear protective clothing when handling carcasses.

Exposed areas of skin should be washed and soiled clothing

renewed4- Vaccination by live vaccine (strain B 19) are known to be

effective.

Brucellosis would disappear if it were eradicated among animals.


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The End

brucellosis - saudi

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