People have a high susceptibility to brucellosis, after the transfer of infection for 6-9 months, immunity is maintained. Re-infection with Brucella occurs in 2-7% of cases. Usually the disease is caused by one of 4 main types of pathogens.
The source is sheep and goats. Distributed in Spain, Greece, Latin America, the Middle East and India. Brucella Suis. The most common causative agent of brucellosis in the United States. The source is wild pigs. Brucella canis. The source of infection is usually dogs. Distributed in North, Central and South America, Japan and central Europe. Brucella abortus. The source of infection is cattle. Distributed everywhere. This species, as the primary causative agent of the disease, was completely destroyed in several European countries, Japan, Israel, Canada, Australia and New Zealand.
Dogs can become carriers of tinidazole pills. There are several confirmed cases of brucellosis-specific symptoms in owners of infected dogs, but the coursethe disease in these cases was not severe and patients were quickly cured without serious consequences.
- It is very difficult to get brucellosis from a dog, since the main route of infection is food. The only exception are veterinarians who are constantly in contact with animal biological fluids (blood, saliva).
- In the US, brucellosis is more common in men. Usually these are people who work or once worked in the field of animal husbandry. The disease is rare in children.
- Also at increased risk are veterinarians working with brucellosis vaccines and hunters.
- At an early stage, brucellosis in a person, whose symptoms are very similar to influenza or other viral infections, is very difficult to diagnose.
The initial manifestations of brucellosis include. 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. The severity of the course depends on the type of pathogen.
Protracted (chronic) course of brucellosis is manifested by constant, increasing weakness, apathy, pain in the joints. This character has a less favorable prognosis and can lead to underestimation of the condition and late seeking medical help. According to statistics, a chronic course is several times more likely to end in disability of patients.
In young and middle-aged people it develops rapidly, in older people it usually develops gradually.
- The patient's joints also suffer - bursitis, polyarthritis, tendovaginitis.
- In men, brucellosis can affect the testicles and their appendages; in women, endometritis and menstrual irregularities occur; during pregnancy, it can cause premature birth or miscarriage.
- With a severe course of the infection, there is a risk of developing an infectious-toxic shock, which is complicated by pericarditis - inflammation of the membranes of the heart.
- The duration of the disease increases with re-infection and reaches 2-3 years. In this form, the temperature is rarely higher than subfebrile, relapses occur after 1-2 months, when another infection or virus (flu, cold, etc.) is attached, the condition worsens significantly.
A feverish state alternates with periods of normal or subfebrile body temperature, at high temperatures, bradycardia may occur (a discrepancy between the heart rate and body temperature), weakness, goosebumps in various parts of the body, pain in muscles and joints. At normal temperatures, patients experience thirst, constipation, dry mouth, increased heart rate. Dense formations appear, the size of a pea or a chicken egg along the muscles and tendons, the so-called fibrositis and cellulitis. There are signs of allergic reactions - vascular disorders, dermatitis, rash.
Symptoms depend on which functional system of the body is more affected.
If the joints, then they often undergo deformation and destruction, if the spine, then spondylitis develops, limiting the patient's movements and causing severe pain. Fibrosis and cellulitis develop in the elbow joints and in the area of the sacrum and lower back. Neuritis often develops, such as neuritis of the facial nerve, auditory or optic nerve, sciatica, paresthesia, inflammation of the nerve plexuses, and even reactive neurosis. There are fertility disorders - impotence in men (see drugs to increase potency), infertility in women, allergic inflammation of the sex glands. The long course of the disease leads to irreversible changes in the joints and ligaments - muscle atrophy, spondylosis, ankylosis, which requires surgical intervention.
Residual brucellosis is the so-called delayed consequences of infection, when pathological reactivity is formed in the body. There is an immunological restructuring, which is accompanied by pathology of the joints, subfebrile temperature,psychological changes. The main goal of treating brucellosis is to control symptoms and prevent them from getting worse. The main principle of therapy is multicomponent antibacterial treatment, since in most cases there was no effect from the use of any one antibiotic.
Although many antibiotics show high activity against Brucella in the laboratory, only a few drugs are really effective when used in medical practice.
Treatment of brucellosis with a mild course of the disease can be started with the use of one antibiotic - doxycycline tablets 100 mg twice a day for 6 weeks. However, in this case, there is often no effect (40% of cases), so rifampicin is added to the treatment at a dosage of 600-900 mg / day. In regions with an increased frequency of pathogen resistance to rifampicin, it is preferable to use other combinations described below. WHO recommendations for the treatment of severe brucellosis in adults and children over 8 years of age include the following treatment regimens.