She kept working: Farmer's long and painful fight with brucellosis

Alice Silantoi, a 57-year-old Maasai woman from Narok County, embodies resilience as a farmer and mother of seven. Her voice carries the quiet authority of someone who has balanced family, livelihood, and a chronic illness for decades, speaking with measured calm rather than urgency.

Her battle with brucellosis, a zoonotic bacterial infection transmitted from animals to humans, began in 1988 with persistent pain in her left leg.

“It started small,” she recalls, “but it never left. Gradually, it spread: aches in my joints, back, head, and overwhelming fatigue that struck even on rest days.”

The exhaustion felt profound, as if her body rebelled against everyday demands. Diagnosed with brucellosis, Alice’s experience spanned over three decades.

It intertwined with her roles in farming, child-rearing, and community life, marked by recurring treatments, misconceptions, and unyielding daily responsibilities.

“I learned to live with it,” she says steadily. “Life doesn’t pause for illness.”

The World Health Organization (WHO) classifies brucellosis as a neglected zoonotic disease caused by Brucella bacteria, primarily infecting livestock like cattle, goats, sheep, pigs, and dogs. Humans contract it through contact with infected animals, consumption of unpasteurised dairy or undercooked meat, or inhalation of contaminated aerosols.

Globally, it affects around 500,000 people annually, though underreporting is common due to nonspecific symptoms. In humans, brucellosis mimics flu-like illnesses: intermittent fever, sweats, weakness, malaise, weight loss, headaches, and muscle and joint pain.

The incubation period varies from one week to months, typically two to four weeks. Untreated, it can become chronic, leading to complications like arthritis, endocarditis, or neurological issues. In Kenya, brucellosis remains endemic, especially in pastoralist regions.

Recent studies indicate national cattle seroprevalence around 6.8 per cent, higher in arid and semi-arid zones that record up to 8.5 per cent.

Human seroprevalence in pastoral communities can exceed 50 per cent in high-risk areas, with cultural practices like raw milk consumption elevating exposure.

Emmanuel Okunga, Senior Deputy Director of Medical Services and head of Kenya’s Zoonotic Disease Unit (ZDU), calls brucellosis a master imitator.

Its symptoms: fever, joint pain, fatigue overlap with malaria or typhoid, causing frequent misdiagnosis.

“Unlike malaria, which resolves quickly with treatment, brucellosis persists chronically, causing prolonged weight loss and severe aches,” Dr Okunga explains.

Accurate diagnosis requires a detailed history: livestock contact, raw milk and meat intake, or handling animal births.

“These clues distinguish it from common fevers,” Okunga notes.

Veterinary epidemiologist Khadija Chepkorir from the ZDU describes animal transmission as ingestion of contaminated pasture and water or venereal spread. Infected livestock often show no overt signs but suffer abortions, infertility, or swollen reproductive organs.

Humans risk infection via similar routes: raw dairy, undercooked meat (like reddish nyama choma), or unprotected handling of birth fluids and blood. Occupational groups such as farmers, veterinarians, and abattoir workers face heightened danger, especially when they work without gloves or gear.

In pastoral areas, where livestock define culture and economy, brucellosis spreads easily amid close human-animal bonds.

Misdiagnosis prolongs suffering, while treatment demands prolonged antibiotics.

WHO recommends doxycycline plus rifampicin or streptomycin for at least six weeks.

For Alice, therapy involved repeated injections and tablets.

Symptoms subsided temporarily, only to return. Side effects such as nausea and reflux tested her adherence, yet she persisted.

“The medicine upset my stomach, but I continued. No choice,” she says.

Despite pain, Alice farmed, raised children, and contributed to her community. Mornings brought stiff joints and fatigue before chores began. Animals needed tending; children, guidance.

“I couldn’t stay in bed,” she says. “With seven children depending on me, I had to push through weakness.”

Clinic visits disrupted routines. Pain radiated from the knees to the back, making short walks arduous. Silence prevailed.

Community myths compounded challenges: symptoms attributed to weight gain, or blamed on crop pesticides and animal vaccines.

“No one consumes unsafe food intentionally,” Alice counters firmly.

She advocates boiling milk and cooking meat thoroughly.

Treatment costs strained households: each injection costs between Sh3,000 and Sh4,000.

Alice urges affordable diagnostics and drugs.

“Early detection saves years of hardship.

This year, Alice reports feeling “okay,” cautiously.

After 37 years, she believes the disease is dormant or resolved, though vigilance remains.

“It doesn’t always kill, but it hides and resurfaces,” she says.