Brucellosis in cattle & farm workers – a story from the field

brucellosis-poster_reduced

brochure-brucellosis_reduced

Brucellosis is not something they teach you about in school.  Nope, I had to go to vet school to hear about Brucellosis.  To be honest, it was not a particularly inspiring disease to have to cram before the Large Animals exam. It wasn’t like cows were blowing up and rolling over about to explode or oozing blood all over the place or running at you madly, water starved and stark raving nutters.

Brucellosis happens because of a rather sleepy old gram negative bacterium that wakes in the last trimester of a cow’s pregnancy and causes abortions in cows.  Sometimes it didn’t even do that.  Sometimes cows might get hygromas – a fancy word for knobbly knees.  But that too was just sometimes.  Nothing outstanding about Brucellosis in cattle. Pretty mundane. At the end of the notes, it was mentioned that it can be transmitted to people through infected milk or infected birth material of the cow.  Ok…so what does it do in humans?  Well, also, no blowing up and rolling over about to explode or oozing blood all over the place or running madly.  Nope, it just sort of looks a lot like other common diseases.  Headache, fever, sweating, muscle pain, joint pain…  Panado and orange juice stuff.

 

symptoms
Brucellosis symptoms in humans (http://almostadoctor.co.uk)

Progress a few years, and I am working for government.  I meet Brucellosis again, because a good proportion of my job as a state veterinarian is involved in controlling this disease in cattle.  In fact, it is such a big deal, that government wants to ERADICATE it and has already spent billions trying to annihilate it…to little effect.  So began my personal relationship with Bovine Brucellosis.  It’s been two years, and I have to admit that what I thought was a sleepy, old, morose bacterium is actually quite a profound character, with some stupendous survivor skills!  Farmers shed tears over this tiny bugger!  Veterinarians are humbled by this little creature.

 

So, we set out to figure out if people who were working with the positive cattle, were getting infected.  We don’t know because doctors don’t routinely test for it.  We had no idea.  So off we went: veterinarian, medical doctor and field worker to collect blood from humans who work on positive cattle farms in the province.

No, we didn’t put the humans in a crush.  We made them sit on a nice chair that we brought along with us.  It was a strange experience to be working with people instead of animals. I just focused on trying not to faint when the doctor was taking blood from a person.

Somewhere along this process of our field visits, the penny dropped.  These people who we were chatting to, who were trusting us with their blood and who were all so uniquely different in their expressions and mannerisms…could have been infected with brucellosis…

I’m not sure how it happens – that single moment, when one’s understanding expands beyond it’s comfortable bounds.  I am a veterinarian. My mandate is to take care of animals.  But, actually, out there, sweating and squinting under the midday South African sunlight, with a white plastic chair in the middle of a flat field splattered with yellow flowers and fat bonsmara cattle, it becomes lucid and clear…the mandate to take care of animals falls on the shoulders of the person handling the animal.  If that person is feeling sick and is unwell…who will be there to look after the animals?  And in that moment of clarity, I wondered two things,

“Does this person have any idea of how important he is?”

and

“Has he any idea that he might get really sick for a long long time by working with the cattle?”

Of course we did ask them what they knew about Brucellosis and possible exposures they may have had in the past.  Those results with the results of the study is still to be published.  Suffice to say, we found that, yes indeed, some farm workers did have antibodies to Brucellosis.  How many?  🙂  To be published.  I will add the link when it is 🙂

Life for Gauteng veterinary services changed slightly during the process of this study.  We as veterinarians have  had to grow our vision and take up the baton of responsibility toward the public we serve.  GDARD decided to support and sponsor the student zoonotic disease awareness day to be held on the 11th November 2016.  Not a light decision given our current economic slump and cost cutting measures…

The farm workers that we tested inspired the design of our zoonotic disease material.  Many cannot read and many do not understand English.  So we decided to use a lot of friendly easy pictures and minimal words.  I attached our poster and brochure on the top of this page.

And so, our zoonotic awareness day this year is dedicated to the ones that inspired us veterinarians to grow and change from a discipline focused profession, to something more whole and healthy, something more within the culture of One Health: it is dedicated to farm workers all over the world…