BRUCELLOSIS (MEDITERRANEAN FEVER, MALTA FEVER, UNDULANT
FEVER, BANG'S DISEASE)
a. General. Brucellosis is a widespread infectious, febrile disease affecting
principally ruminants, cattle, swine, and goats, but sometimes affecting other animals
(dogs, raccoons, opossums), including man. Brucellosis occurs worldwide and in
particular, the Mediterranean countries of Europe and North Africa, Mexico, Central Asia
and South America. It, too, is an occupational disease and occurs principally among
males who are farm workers, abattoir workers, or veterinarians. These people work
with infected animals or their tissues; therefore, they are more prone to the disease than
others. Occasionally, the disease occurs among users of unpasteurized milk, or other
milk products such as cheese. In the US, approximately 170 cases are reported
annually. It is most prevalent in rural areas. Airborne infection may occur among
animals in pens and stables. The incubation period is highly variable and difficult to
ascertain, but it is usually 50 to 21 days (sometimes several months).
b. Signs and Symptoms. This systemic disease has an acute or insidious
onset that may be very sudden. The patient experiences chills and fever, a severe
headache, profuse sweating, generalized aching, malaise, arthralgia, weakness, and
depression. His temperature increases as the disease progresses (104F-106F).
Uncommon but characteristic features are orchitis and vertebral osteomyelitis. Although
recovery is usual, there are pronounced disabilities, and the syndrome may reappear as
c. Treatment. The drug of choice in the treatment of brucellosis is tetracycline
HCl (Tetracyn); however, for the seriously ill victim or those with abscesses, administer
streptomycin. Steroids may be given to decrease systemic toxicity. Activity should be
restricted in chronic cases and enforced bed rest during febrile periods.
(1) It is necessary that farmers and workers be educated as to the nature of
the disease and shown ways of handling products or carcasses of potentially infected
(2) Use serological testing to search for and eliminate infected animals. In
cases of high prevalence in areas, immunize calves and sometimes adult animals.
(3) Ensure that milk and dairy products are pasteurized. If this is not
possible, boil the milk.
Caution the public not to partake of untreated milk and milk products.