'Continue fight against COVID-19, but be alert about Brucellosis too'

While the nation continues to fight the COVID19 pandemic and the socioeconomic problems that have come along with it health experts and scientists are now worried about a new zoonotic bacterial disease Brucellosis that surfaced in China in December last year and has already infected more than 3000 people While some feel that as the disease is already present in India it wont be as severe as COVID19 others are of the opinion that it might snowball into a pandemic and become more severe than the current oneAuthorities of Lanzhou city in Gansu province have confirmed that 3245 people have tested positive for Brucellosis ndash a zoonotic disease ndash which is usually spread through contact with infected farm animals such as cows goats and pigs The outbreak started with a leak at the Lanzhou Veterinary Research Institute in central China which infected 96 laboratory staff on December 7 2019Speaking to midday Dr Seyed E Hasnain professor of Molecular Medicine vice chancellor of Jamia Hamdarad and Hon professor at IITDelhi said ldquoThis disease is caused by Brucella bacterium Recent evidence suggests that Brucellosis is now getting more associated with returning travellers and is a serious concern in countries with low and middle income It is transmitted to humans from animal reservoirs such as cattle sheep goats and pigs either through direct contact with the animals or using unpasteurised animal products Therefore we have to be careful as there could overlap between Covid 19 similarities and Burcuellosis and therefore health experts need to be extra alertrdquoNo associationDr Hasnain addedldquoSo far there has been no association of Brucellosis with COVID19 but similarities include a Spread due to inhalation of air containing the bacteria as happened recently in China b initial infection due to movement of travellers c disease symptoms such as fever chills headache body ache general weakness fatigue etc d infection can affect most parts of the body including liver inflammation of the testicles leading to infertility in men inflammation of the meninges and CVDs and e about 2 percent of infected persons die but so far no deaths have been reported from China Brucellosis can be treated by administration of antibiotics namely rifampin doxycycline and streptomycinrdquoSwab samples being collected at an antigen testing camp at Chunabhatti Dahisar PicSatej ShindeProfessor Dr Sarman Singh director of All India Institute of Medical Sciences AIIMS Bhopal and an expert in clinical microbiology and molecular medicine said ldquoThe outbreak of Brucellosis in China is a matter of concern and both CDC and WHO are closely monitoring the situation An advisory on Brucellosis amidst covid pandemic is welcome but we must understand that Brucellosis is still treatable but not Covid 19rdquoDr Singh added ldquoWe must understand that the consequences or sequels of so called cured Covid 19 cases go for a long time which we seeing is having wider areas of concerns as it adversely impacts multiple organs ndash brain to heart to intensive or even general condition post recovery covid 19 so called recovered patients do complain of weight loss fatigue neurological and psychological issues etc which is not the case with BrucellosisrdquoldquoMoreover we must understand that there is significant difference between the two ndash viruses like SARSCoV2 can cause pandemics whereas bacteriarsquos do not usually cause pandemic And even if it does we can easily make molecular modifications to treat such a bacterial attack At this moment while the entire health machinery is focusing on Covid 19 pandemic globally and in India we should continue our fight against the same though keeping our eyes and ears open for other future likely possible outbreaks for lsquoBrucellosisrdquo said Dr SinghAlready present in IndiaDr Wiqar Shaikh senior allergy and asthma specialist saidldquoIs the World looking at the beginning of a new pandemic The recent episodes of Brucellosis cases multiplying in North West China cannot be taken sitting low because like Covid 19 this may result in a spread to the neighbouring countries and then result in a pandemic if not controlled in timerdquoDr Shaikh further saidldquoUnlike Covid 19 which was a new disease the incidences of Brucellorsquos in India is approximately 1 lakh cases per year with a mortality of approximately of 2 percent Unfortunately in a disease which already exist in our country a pandemic situation will be faster and more severe than Covid 19 It is therefore extremely important for medical practitioners doctors in government and civic hospitals to have a high index of suspicion for Brucelloorsquos in the near future in patients presenting with fever In such cases it would be mandatory to not only test the patient with a swab for Covid 19 but also to do the blood culture and IgM antibodies against Brucella This would be imperative to formulate a strategy for adequate and effective treatment against both the ailments Currently no effective vaccine is available for Brucella as is also the case with Covid 19rdquoDr Shaikh is concerned that a given patient may have a dual infection with both Brucella bacterium and Covid 19 virus which would spell disasterEchoing similar concerns Dr Subhash Hira professor of Global Health at the University of WashingtonSeattle USA saidldquoWhile brucellosis watch is yet to start globally it sends out a strong message to all countries to scaleup vigilance at their apex Centres for Disease Control Scientists have been talking about 21st century as the ldquoCentury of pandemicsrdquo and while the world is still struggling to deal with health and socioeconomic effects of COVID19 a new zoonotic bacterial disease called lsquoBrucellosisrsquo outbreak has been reported in northwest China this weekrdquoDr Hira addedldquoBrucellosis in humans occurs when a person comes into contact with an animal or animal product infected with the Brucella bacteria It then spreads from person to person only under exceptional conditions Breastfeeding moms with brucellosis may pass the bacteria on to their baby Brucella may also be spread through sexual contact It can enter the human body through a cut or scratch in the skin breathing contaminated air through aerosol or eating or drinking something contaminated with the bacteria such as unpasteurized milk or undercooked meat Four types of Brucella bacteria cause the majority of brucellosis infections in humans namely B melitensis from goat and cow B suis from pig B canis from dog B abortus from cattlerdquoDr Shaikh addedldquoAlthough Brucellosis is a bacterial infection caused by the bacteria called as lsquoBrucellarsquo unlike the covid 19 disease which is caused by SARSCoV2 virus unfortunately the presenting symptoms of both ailments are fairly similar Fever vomiting diarrhoea loss of appetite body aches and headaches are symptoms which are common to both Brucella and Covid 19 besides liver damage damage to the heart are also common for both Brucella and Covid 19rdquoDr Shaikh further said ldquoAlthough there are differences between the two such as arthritis joint swelling spondylitis swelling of back bone and swelling of the testicles which are commonly seen in Brucellorsquos The other common feature between Covid 19 and Burcellosis is that both could be transmitted through close contact between animals and human beings and human to human transmission because of infected secretion coughing sneezing etc either through animals or affected human beingsrdquoThe difference between ailments however that Brucella could be caused by ingestion of unpasteurised milk or under cook meat from infected animals whereas covid 19 has not been proved yet to be transmitted through food The other major difference is that although no current treatment is specifically available for covid 19 there are multiple antibiotics available for treating Brucellorsquos Also the diagnosis of Brucellosis is through either blood culture or identification of antibodies against Brucella whereas immunology ndash the science of defence system of the body clearly knows that antibodies have a poor role in a viral infection such as Covid 19 in which memory T lymphosites have exclusive role in defence against the virus explained Dr ShaikhDr Ketan Vagholkar professor of surgery DY Patil medical college saidldquoThe Covid 19 pandemic should serve as an eyeopener for health authorities all over the world Research laboratories from countries in the far East are involved in biological engineering of Zoonotic organisms Covid 19 is a concrete example of such engineered virus Most of these laboratories are involved in researching organism in animals especially like Bat There attempt is to modify the organism which do not cause disease in bat and similar animal and ensure that they can be transmitted to human being and further spread by infected human beings The focus therefore should be on identifying all possible organisms both viruses and bacteriarsquos which otherwise are seen in animals of various species and can be transmitted to human beingsrdquoDr Vagholkar addedldquoA rough strategy to identify and treat such potential organisms should be developed well in advance or knowing breakouts of otherwise uncommon diseases such as brucellosis All health care workers should be trained in order to create awareness about such potential modified organisms which can lead to not only epidemics but a serious pandemic which the world is struggling to treatrdquoDifferent viewDr T Jacob John known globally for his extensive work in the fields of virology and paediatrics who headed the ICMR Centre of Advanced Research in Virology and the National HIVAIDS Reference Centre at the Christian Medical College Vellore where he set up the countrys first diagnostic virology laboratory has a different view He says Brucellosis is a most unlikely candidate for a pandemic as it is already prevalent in many countries and in India too Its original names were Malta fever and Mediterranean fever In this case humantohuman transmission is extremely rare and not a problem It can be easily diagnosed and treated with antibiotics Also the mortality rate is very lowWhen asked if our health experts need to be alert Dr Jacob stated We often miss brucellosis when it comes to diagnosis and antibiotics are given without a specificproperlabbased diagnosis but patients recoverCOVID19 has longterm effects as it affects multiple organs Recovered patients do complain of weight loss fatigue neurological and psychological issues etc which is not the case with Brucellosis Moreover there is a significant difference between the two ndash viruses like SARSCoV2 can cause pandemics whereas bacteria do not usually lead to the same ndash Dr Sarman Singh director of AIIMS BhopalUnlike COVID19 which was a new disease for this country the incidence of Brucellosis in India is approximately 1 lakh cases per year with a mortality of approximately of 2 per cent Unfortunately a disease that already exists in the country can turn into a pandemic faster and become more severe So doctors should test patients with high fever both for COVID19 and Brucellosis ndash Dr Wiqar Shaikh senior allergy and asthma specialistRecent evidence suggests that Brucellosis is getting associated with returning travellers and is a serious concern in countries with low and middleincome group people It is transmitted to humans from farm animals either through direct contact or by using unpasteurised animal products We have to be careful as symptoms of COVID19 and Brucellosis might overlap ndash Dr Seyed E Hasnain professor of Molecular Medicine3245No of people who have been infected in Chinas Lanzhou cityExpert Virologist differs in his viewDr T Jacob John known globally for his extensive work in the fields of virology and paediatrics who headed the ICMR Centre of Advanced Research in Virology and the National HIVAIDS Reference Centre at the Christian Medical College Vellore where he set up the countrys first diagnostic virology laboratory tells has a different view Brucellosis is a most unlikely candidate for a pandemic as it is already prevalent in many countries and in India in almost all States Its original names were Malta fever and Mediterranean feverCattle sheep goats and pigs are the natural hosts Man is accidental victim but humantohuman transmission is extremely rare and not a problem It is easily diagnosed by laboratory once it is suspected and easily treated with antibioticsLaboratory staff getting infected is sad and bad that indicates sloppy lab disciplineAll over India farm animals have infection and a lot of people get infected many without major symptoms some with fever and fatigue Death rate is very lowWhen asked if our health experts need to be alert so that they do not miss out on signs of Brucellosis while they are in the midst of treating Covid 19 pandemic Dr Jacob stated Yes Brucellosis if often a missed diagnosis and missed when antibiotics are given without a specificproperlabbased diagnosis patients recover Typhoid malaria dengue chikungunya and leptospirosis are remembered by doctors in Fever Cases but brucellosis often forgottenKeep scrolling to read more newsCatch up on all the latest Mumbai news crime news current affairs and a complete guide from food to things to do and events across Mumbai Also download the new midday Android and iOS apps to get latest updates MidDay is now on Telegram Click here to join our channel middayinfomedialtd and stay updated with the latest news