Archive | September 21, 2013

Brucellosis: My New Bacterial Tenant

Brucellosis hotspot?

Brucellosis hotspot?

Though the tests aren’t back yet, I am certain that I have been infected with one (or more) species of a bacteria in the genus Brucella. In humans, Brucella is usually transmitted by drinking unpasteurized milk, or through contact with the saliva, nasal excretions, urine of fecal matter of infected livestock. There are only 100-200 cases a year in the US, but it’s common in developing countries.

For those keeping up, you may remember that I spent the summer in Kenya, working with a team extracting blood samples from camels, cows, goats and sheep. We were in contact with all of these animals on almost a daily basis. We weren’t wearing any protection at all, but it’s inconceivable to wear a full hazmat suit while taking blood from goats in a Maasai community. You’d get laughed out of town.

My days right now are running in a fairly predictable pattern. I wake up, feel pretty good, eat breakfast and drink some coffee. At about 10-11 a.m. I begin to feel dizzy, sweat somewhat, a low grade fever kicks in and a horrible taste develops in my mouth. My peripheral vision is limited and I have trouble focusing on distant objects. It gets progressively worse throughout the day, but improves before dinner. After dinner, I feel worse than before. I’m positive that the brunt of the physical symptoms are associated with anemia. It’s like a low grade malaria.

The psychological effects are fascinating. Again, in the morning, I feel fine. As the day progresses, I am less and less able to string coherent sentences together (not that I’m good at it in the best of times), lose thoughts in mid sentence and can’t remember important vocabulary words. I’m stuck in an existential funk where the thought of tomorrow is dark, I’ve forgotten the past and the present isn’t all that meaningful. I often find myself staring into space and time passes quickly.

Though I have no other negative physical effects and am able to leave the house and move around, I’m finding this incredibly debilitating. Even writing this blog post is a challenge.

From the pathogen’s standpoint, this situation is ideal. It doesn’t immediately kill the host, and the bacteria tends to incubate in cells so that it can avoid the body’s immune response. If I were a herd animal, eating and defecating in the same space, I would be able to transmit for, conceivably, the rest of my life. The low grade anemia keeps the animal mobile, yet impedes its ability to evade predators, allowing transmission to occur from herbivorous ungulates to carnivorous animals.

Again, because the bacteria hides out in cells, it’s a bear to kill. I have two months of two types of antibiotics to look forward to, both with different schedules and dietary requirements. One causes awful nightmares (doxycycline).

If left untreated brucellosis can include abscesses in the joints, spinal problems, blindness and inflammation of the testicles. It is anecdotally associated with elevated rates of suicide in veterinarians. I’m wondering how much chronic brucellosis there is in pastoralist communities in Sub-Saharan Africa. The burden must be quite severe.

This is going to be rough, but it’s better than a lifetime of these symptoms. I’m certainly finding this scientifically interesting, though I will be happy to have it gone for good.

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