BRUCELLOSIS

Brucellosis is an infectious disease of people and animals, characterized by chronic course, defeat of the musculoskeletal system, nervous and reproductive system. It is widespread everywhere.

The causative agents are brucellae. For humans, the most pathogenic Brucella melitensis, affecting mainly goats and sheep. Brucella have the form of short rods 0.3-3 microns in size, sometimes they are spherical or ovoid. They are stable in the environment, they tolerate low temperatures well. In raw milk and dairy products remain viable for 20 to 70 days. Boiling and pasteurization kill Brucella.

The source of the causative agent of infection are agricultural animals - small and large cattle, swine, etc. Signs of brucellosis in animals can be abortion (stillborn fetus), metroendometritis, mastitis , arthritis, males - orchitis , etc. In the stillborn fetus, its membranes, amniotic Fluid, the milk of a sick female contains a huge number of pathogens of brucellosis.

In the human body brucella penetrate through the mucous membranes of the digestive tract and respiratory tract, damaged skin. Human infection occurs both in direct contact with sick animals, and when processing raw meat, skin, wool, and when eating raw milk, curdled milk, butter, brynza, kumys, insufficiently boiled and roasted meat of animals infected with brucella. The most common diseases are milkmaids, calves, shepherds, veterinarians, zootechnicians, etc. Diseases can be registered throughout the year, but the incidence of the disease is observed in the winter-spring period, when domestic animals bring offspring.

Clinical picture. The incubation period varies from one to several weeks and even months, usually 1-3 weeks. The onset of the disease is more often gradual. Some patients note a general malaise, weakness, depression, sleep disturbance, loss of appetite. Others complain of headache, irritability, pain in the lumbar region, in various muscle groups and joints, chills. Subfebrile fever may be noted. Less often the disease begins acutely, without a prodromal period, and is characterized by a fever with chills and sweats, pains in the muscles and joints. Liver and spleen, lymph nodes increase. Fever can be undulating, improperly intermittent (intermittent), remitting (relieving) and subfebrile. In pregnant women in an acute period of the disease, spontaneous abortion is possible. Gradually, the fever subsides, and the damage to certain organs and systems of infectious and allergic origin comes to the fore. If the clinical manifestations persist more than (6 months from the onset of the disease, brucellosis is considered chronic.

In chronic brucellosis, changes in the musculoskeletal system, nervous and reproductive systems predominate. Heat is rare; For weeks and months there is a subfebrile and even normal temperature (remission). There are local severe joint lesions in. Form of destructive arthritis, changes and large joints. Possible osteomyelitis, spondylitis, ankylosis, tendoiaginpts, synovitis, bursitis fibrositis (painful condensation of connective tissue), etc. Defects of the nervous system, mainly peripheral (neuritis, plexitis, radiculitis), less often the CNS ( meningitis , encephalitis , arachnoiditis , etc.). Characteristic increase in the liver and spleen. In men, orchitis , epididymitis, in women - salpingitis, oophoritis, metroendometritis. Pregnancy often worsens the course of the illness, exacerbates it. Pregnancy , developed after 1.5 - 2 years from the onset of the disease, often proceeds normally, the child is born healthy. However, in this period, premature births and stillbirths are observed. There are often exacerbations and relapses of the disease.

With the so-called latent brucellosis, lymph node enlargement, mild changes in the musculoskeletal system, functional disorders of the nervous system are revealed. In such patients, positive reactions to brucellosis are found.

Part of the patients after the subsidence of the infectious process persist persistent residual phenomena: contractures, ankyloses, arthrosis, spondylosis, hormonal disorders.

The diagnosis is based on epidemiological history (occupation, contact with sick animals), the clinical picture and the results of laboratory studies. In everyday practice, serological reactions are used, in particular Wright's reaction. For mass surveys, Haddleson's accelerated reaction is used. The complement fixation reaction, opsonophagocytic reaction, passive hemagglutination reaction, determination of opsonins titer, immunofluorescence method, Coombs reaction, etc. are also used.

Widely used intradermal allergic diagnostic test Byrne, which is put with brucellin. The sample is considered positive for hyperemia of a skin area measuring 33.5 cm or more.

Treatment. Patients are hospitalized. In the acute period and with exacerbations of chronic brucellosis (in the presence of intoxication, fever) antibiotics of the tetracycline series are used for 3 to 6 weeks or biseptol for 4 weeks. Rifampicin is also effective . Prescribe symptomatic drugs (painkillers, anti-inflammatory). By stihanii signs of acute brucellosis are shown physiotherapy procedures, sanatorium treatment. Those who have been ill are subject to follow-up for 2 years.

Forecast. More often, recovery comes. Lethality in brucellosis is almost not observed. The prognosis of ability to work with lesions of the musculoskeletal system may be unfavorable.

Prevention consists of a complex of veterinary, medical and economic measures. Systematically identify animals with brucellosis. Sick animals are slaughtered in the so-called sanitary slaughterhouses or at the usual at the end of the working day, followed by disinfection of the slaughterhouse with a 10% solution of bleach. The skins of killed animals are salted and transferred to treatment after 3 months. You can not slaughter sick cattle earlier than 3 months after the abortion and in the second half of pregnancy. With forced slaughter of cattle in prohibited periods, meat is salted for 2 months. Tribal and thoroughbred cattle, brucellosis patients, are kept in insulators. Dairy products in brucellosis farms are prepared from pre-thermally processed milk. Finished cheese is aged for 2 months, hard cheeses - 3 months.

Personnel in brucellosis farms should be provided with overalls (boots, overalls, headgear), which after work is disinfected. Adolescents and pregnant women are not allowed to work in brucellosis farms. Persons working in the foci of brucellosis, annually 1-2 months before the onset of mass calving (lambing) of cattle are inoculated with a cutaneous dry live vaccine.