John M. Sauret, MD, Natalia Vilissova, MD


J Am Board Fam Med. 2002;15(5) 

In This Article

Abstract and Introduction

Background: Human brucellosis has a serious medical impact worldwide, and its eradication poses major difficulties. Although human brucellosis is relatively rare in the United States (approximately 100 cases per year), there is concern that this disease is largely underdiagnosed and underreported. Additionally, immigrants from endemic areas are arriving to this country, and Brucella species are considered to be biologic agents for terrorism. Human brucellosis affects all age-groups, and family physicians are not well versed in recognizing and treating this potentially life-threatening condition.
Methods: A literature review from 1975 to 2001 was performed using the key words "human brucellosis," "zoonosis," and "bioterrorism."
Results and Conclusions: Appropriate antimicrobial therapy and duration of treatment of human brucellosis will reduce morbidity, prevent complications, and diminish relapses. Because of the nonspecific symptoms and rarity of human brucellosis in the United States, family physicians must acquire a detailed dietary and occupational history to diagnose the disease promptly. Family physicians must assume a responsible role in reporting this disease, as well as be aware of persons at high-risk for this disease and the potential sources of infection.

Human brucellosis is a potentially life-threatening multisystem disease. Rarely reported in the United States, human brucellosis is a zoonotic disease of bacterial origin. The first case was reported in the United States in 1898 by Musser and Sailer, and reported cases reached a maximum of 6,321 in 1947.[1] Since that time, there has been a steady decline. The Centers for Disease Control and Prevention (CDC) reported approximately 100 cases each year during the past 10 years, with most cases in the southwest region.[2] The decline in disease incidence is mainly due to compulsory pasteurization of milk and to the control of the disease in dairy cattle.[3] Worldwide, this disease has a major presence in the Middle East, southern Europe, and South America (ie, Brazil, Columbia). Studies have shown that in the United States human brucellosis is underdiagnosed and underreported. The reporting rate in some states, ie, California, has been as low as 10%.[1]