Brucellosis in India: A Silent Occupational Threat in Veterinary Practice

Brucellosis continues to rank among the most neglected zoonotic diseases globally, with an estimated 5 to 12.5 million cases annually. While largely controlled in high-income countries, it remains endemic and underreported in low-resource settings, including India. In the Indian context, the disease presents a dual burden, impacting both livestock productivity and human health, especially among those engaged in veterinary and animal husbandry activities¹. 

The economic consequences are staggering. Brucellosis causes an estimated US$ 3.43 billion loss in livestock, with over 95% attributed to the bovine sector. Human brucellosis further contributes to economic and health losses, accounting for 177,601 DALYs annually¹. These figures underscore the urgent need for veterinarians to recognize their frontline role not just in treatment, but in prevention. 

Veterinary Workforce: Structure and Risk Exposure 

India’s veterinary service system comprises three primary tiers, qualified veterinarians, para-veterinarians, and animal handlers. While veterinarians and para-veterinarians receive formal training, animal handlers often learn through experience without structured education. 

This stratification directly influences exposure risk. Routine veterinary tasks such as pregnancy diagnosis, artificial insemination, and handling of abortions significantly increase the likelihood of contact with infected tissues. As a result, veterinary professionals consistently fall into a high-risk occupational category for Brucella infection^1,2. 

Clinical Manifestations in Humans 

Veterinary professionals should be aware of the clinical presentation of human brucellosis, which often includes: 

• Undulating fever  

• Joint pain  

• Night sweats  

• Chronic fatigue  

If untreated, the disease may progress to debilitating chronic stages with multisystem complications¹. Early recognition is critical, especially in endemic regions where symptoms may be overlooked or misdiagnosed. 

Disparities in Infection Risk Across Veterinary Roles 

A key insight from recent studies is the variation in infection prevalence across occupational groups. Animal handlers were found to have a significantly higher seropositivity rate (31.25%) compared to para-veterinarians (11.11%) and veterinarians (7.5%)¹. 

This disparity is not incidental. Animal handlers often: 

• Perform high-risk procedures more frequently  

• Use minimal or no personal protective equipment (PPE)  

• Have limited awareness of zoonotic transmission  

Additionally, their lower likelihood of seeking diagnostic testing further complicates disease surveillance and control¹. 

High-Risk Veterinary Interventions 

Certain procedures significantly elevate exposure risk and should be approached with strict biosecurity protocols: 

• Handling aborted fetuses  

• Retained placenta removal  

• Assisting parturition (dystocia cases)  

• Artificial insemination  

• Contact with sick animals  

Animal handlers, in particular, reported higher frequencies of such exposures, often without adequate protection¹. This combination of high exposure and low protection creates a critical vulnerability. 

The PPE Paradox in Veterinary Practice 

One of the more unexpected findings is that individuals reporting PPE use were sometimes more likely to be seropositive. While counterintuitive, this likely reflects: 

• Inconsistent or incorrect PPE usage  

• Use of inadequate protective gear  

• Higher exposure among those who attempt PPE use  

Importantly, overall PPE adherence was found to be grossly inadequate across all groups¹. This highlights that availability alone is insufficient—training and compliance are equally essential. 

Vaccination and Occupational Hazards¹ 

Vaccination remains the cornerstone of brucellosis control in India due to limitations in treatment and socio-cultural constraints such as bans on cattle slaughter. However, vaccination campaigns introduce their own risks. 

Needlestick injuries during vaccination procedures can lead to accidental inoculation. Though reported in only 4.1% of respondents, such incidents can have serious consequences, including long-term adverse reactions. 

Veterinarians must strictly adhere to needle-stick injury prevention protocols, especially during mass vaccination drives. 

The One Health Imperative 

Brucellosis exemplifies the interconnectedness of animal and human health. Effective control requires a One Health approach, integrating veterinary services, public health systems, and community awareness. 

In resource-limited settings like India, strategies must demonstrate benefits across both sectors to ensure sustainability. This includes: 

• Strengthening surveillance systems  

• Promoting vaccination programs  

• Enhancing occupational safety  

Conclusion: Bridging the Gap Between Knowledge and Practice 

Brucellosis remains a persistent occupational hazard for veterinary professionals in India. While awareness exists among trained personnel, gaps in practice, especially PPE adherence, continue to drive transmission. 

Targeted interventions, particularly for animal handlers, along with structured training, improved access to protective gear, and stronger surveillance, are essential to reducing disease burden. 

Veterinarians are not just clinicians in this battle; they are educators, implementers, and the first line of defense against a disease that continues to thrive in silence. 

Reference 

1. Tiwari HK, Proch V, Singh BB, Schemann K, Ward M, Singh J, Gill JP, Dhand NK. Brucellosis in India: Comparing exposure amongst veterinarians, para-veterinarians and animal handlers. One Health. 2022 Jun 1;14:100367. https://www.sciencedirect.com/science/article/pii/S2352771421001579 

2. Singh J, Singh BB, Tiwari HK, Josan HS, Jaswal N, Kaur M, Kostoulas P, Khatkar MS, Aulakh RS, Gill JP, Dhand NK. Using dairy value chains to identify production constraints and biosecurity risks. Animals. 2020 Dec 8;10(12):2332. https://www.mdpi.com/2076-2615/10/12/2332