Medicines for Brucellosis

What it is

Brucellosis is an infection caused by Brucella bacteria, which are spread from animals to people. It is rare in the UK (which is largely free of the infection in animals), but is more common in some other parts of the world, so it is often related to travel or to consuming certain products from areas where it occurs. People usually catch brucellosis by: consuming unpasteurised (raw) milk or dairy products (such as certain cheeses) from infected animals (a common route); close contact with infected animals or their tissues (relevant to certain occupations, such as farming or veterinary work, in affected areas); and, less commonly, other routes. It is not usually spread from person to person. The symptoms of brucellosis can be varied and non-specific, and may come and go, which can make it difficult to recognise; they can include: fever (which may be recurrent or fluctuating — the old name "undulant fever" reflects this), sweats (often drenching night sweats), tiredness and weakness, muscle and joint aches and pains, headache, loss of appetite, and feeling generally unwell. The symptoms may develop gradually and can persist or recur if not treated. Brucellosis can also, in some cases, affect specific parts of the body (such as the joints, bones, or, less commonly, other organs), causing more specific problems. Because the symptoms are non-specific and it is rare in the UK, the diagnosis may not be immediately obvious, and it is important to mention relevant travel or exposure (such as consuming unpasteurised dairy products abroad) to the doctor, as this helps point to the diagnosis; it is confirmed with blood tests. The reassuring point is that brucellosis is treatable, usually with a course of antibiotics (often a combination, given for a number of weeks) to clear the infection and prevent it recurring. Preventing brucellosis involves avoiding unpasteurised dairy products (particularly when travelling in affected areas) and appropriate precautions for those with occupational animal exposure. The key messages are that brucellosis is a rare (in the UK) bacterial infection caught from infected animals or unpasteurised dairy products, causing fever, sweats, and aches, and that it is treatable with antibiotics.

How it is treated

Brucellosis is treated with a course of antibiotics (often a combination, for several weeks) to clear the infection and prevent recurrence; recognising it depends on considering relevant exposure. Because brucellosis is rare in the UK and its symptoms are non-specific (fever, sweats, aches, and feeling unwell), the diagnosis may not be immediately obvious, so it is important to mention any relevant exposure to a doctor — such as recent travel to an area where brucellosis occurs, consuming unpasteurised (raw) milk or dairy products, or contact with animals (particularly in relevant occupations) — as this helps point to the diagnosis. It is confirmed with tests, particularly blood tests (which can detect the infection or the body’s response to it), and sometimes samples from affected sites. Once diagnosed, treatment is with antibiotics: because Brucella bacteria can be difficult to fully clear and the infection can recur if not treated adequately, treatment usually involves a combination of antibiotics given for a prolonged period (typically a number of weeks), and it is important to complete the full course as directed to clear the infection and reduce the risk of it coming back. Where brucellosis has affected specific parts of the body (such as the joints or bones, or other organs), treatment may be adjusted and prolonged, and specialist input may be involved. With appropriate, complete treatment, most people recover well, though it is important to complete the treatment and attend follow-up, as inadequate treatment can lead to recurrence or complications. Preventing brucellosis is worthwhile, particularly for travellers and those with animal exposure: avoiding unpasteurised (raw) milk and dairy products, especially when travelling in areas where brucellosis occurs (choosing pasteurised products); and, for people with occupational contact with animals in affected areas, taking appropriate precautions. The reassuring messages are that brucellosis, although a rare (in the UK) infection with non-specific symptoms, is treatable and usually cured with a course of antibiotics (completing the full treatment is important to prevent recurrence), and that it can be prevented by avoiding unpasteurised dairy products (particularly abroad) and taking precautions with animal exposure; so mentioning relevant travel or exposure to a doctor when unwell with fever and aches, and completing treatment, are the keys to managing it.