188 Where There Is No Doctor 2011
BRUCELLOSIS (UNDULANT FEVER, MALTA FEVER)
This is a disease that comes from drinking fresh milk from infected cows or goats.
It may also enter the body through scrapes or wounds in the skin of persons who work
with sick cattle, goats, or pigs, or by breathing it into the lungs.
PREVENT BRUCELLOSIS:
NEVER DRINK
UNBOILED MILK
Signs:
• Brucellosis may start with fever and chills, but it often begins very gradually with
increasing tiredness, weakness, loss of appetite, headache, stomach ache, and
sometimes joint pains.
• The fevers may be mild or severe. Typically, these begin with afternoon chills
and end with sweating in the early morning. In chronic brucellosis, the fevers
may stop for several days and then return. Without treatment, brucellosis may
last for years.
• There may be swollen lymph nodes in the neck, armpits, and groin (p. 88).
Treatment:
♦ If you suspect brucellosis, get medical advice, because it is easy to confuse this
disease with others, and the treatment is long and expensive.
♦ Treat with tetracycline, adults: two 250 mg. capsules 4 times a day for 3
weeks. For precautions, see page 356. Or use cotrimoxazole. (For dosage and
precautions, see p. 357.)
Prevention:
♦ Drink only cow’s or goat’s milk that has been boiled or pasteurized. In areas
where brucellosis is a problem, it is safer not to eat cheese made from unboiled
milk.
♦ Be careful when handling cattle, goats, and pigs, especially if you have any cuts
or scrapes.
♦ Cooperate with livestock inspectors who check to be sure your animals are
healthy.
TYPHOID FEVER
Typhoid is an infection of the gut that affects the whole body. It is spread from
feces‑to‑mouth in contaminated food and water and often comes in epidemics
(many people sick at once). Of the different infections sometimes called ‘the fever’
(see p. 26), typhoid is one of the most dangerous.