Brucellosis in children

Abstract

Brief details of 17 cases of brucellosis in children up to 15 years, admitted to hospital between 1940 and 1958, are discussed. The diagnosis in each of these cases is the final one arrived at in hospital and usually based on positive agglutination and the clinical picture; only one had a positive blood culture. Remittent or irregular pyrexia was seen in 14 and 'undulant' pyrexia in two. Attention is drawn to the continuing important role of infected raw milk in the aetiology of this disease in childhood; 13 cases appeared to be due to drinking raw milk, in four of these the milk was tuberculin-tested. The disease was mild in 11 cases, prolonged and debilitating in four cases, and was associated with cirrhosis in one case and a fatal issue in one other. The association of brucellosis with cirrhosis of the liver in a child does not appear to have been reported previously, though there is nothing surprising in such an event. The brucellosis diagnosis in both the latter cases depends on agglutination of 1/1,000 and 1/250 and not on culture of the organism, however. Children from 0 to 15 years account for approximately 30% of hospital admissions for brucellosis in the Oxford region. Reasons for this are discussed. Progressively improving recognition may be a factor in the higher percentage of children in the general series from which these 17 cases are drawn than is usual in series of brucellosis cases. It is well known that the disease is difficult to recognize in mild cases and general practitioners should be informed about infected sources. This is a task for public health departments working in liaison with their veterinary colleagues, but the absence of notification of human and animal brucellosis impedes this kind of progress.