Brucellosis - new aspects of an old disease

... Clinical conditions synonymous with brucellosis have been described since the time of Hippocrates. Indeed, it has been suggested that organisms resembling brucellae have been detected in carbonized cheese from the Roman era (Capasso 2002). These observations highlight how both man and animals have lived with this disease since the days of early record keeping. Despite the numerous biotechnological improvements we now have, brucellosis remains a major worldwide zoonosis. Some countries have been successful in eradication of disease, while others, especially in the developing world still live with a huge disease burden. This review outlines some of the early significant historical milestones then brings the reader to the current challenges that face us in detection, microbial typing, taxonomy, vaccine development, understanding the host–microbial interactions and virulence mechanisms of these enigmatic bacteria. Brucellosis is a major bacterial zoonosis of global importance. The causative organisms are Gram‐negative facultative intracellular pathogens that may affect a range of different mammals including man, cattle, sheep, goats, swine, rodents and marine mammals. In most host species, the disease primarily affects the reproductive system with concomitant loss in productivity of animals affected. In man, infection is associated with protean manifestations and characteristically recurrent febrile episodes that led to the description of this disease as 'undulant fever'. The disease is severely debilitating and protracted with several documented cases with signs associated with the disease lasting for over 30 years. It is believed that one such individual was Florence Nightingale, who endured over 25 years of ill health, personality changes (neurobrucellosis) and spondylitis which left her bedridden for 6 years of her life (Young 1995; Baly 1996; Dossey 1998).