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{{Brucellosis}}
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==Overview==
==Overview==
Effective measures for the [[primary prevention]] of brucellosis include not consuming unpasteurized [[Dairy product|dairy]] or undercooked meat, and having safe occupational practices. There are no available [[vaccines]] for [[Human|humans]] against brucellosis.<ref name="j">Brucellosis. CDC. http://www.cdc.gov/brucellosis/prevention/index.html. Accessed on February 5, 2016</ref><ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 5, 2016</ref>
Effective measures for the [[primary prevention]] of brucellosis include not consuming [[Unpasteurized milk|unpasteurized]] dairy or undercooked meat, and having safe occupational practices.<ref name="j">Brucellosis. CDC. http://www.cdc.gov/brucellosis/prevention/index.html. Accessed on February 5, 2016</ref><ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 5, 2016</ref>


==Prevention==
==Prevention==
*The best way to [[Prevention (medical)|prevent]] brucellosis infection is to be sure you '''do not consume:'''
**Undercooked meat
**Unpasteurized [[Dairy product|dairy products]], including:
***Milk
***Cheese
***Ice cream
***[[Pasteurization]] is when raw milk is heated to a high [[temperature]] for a short period of time. This heating process destroys harmful [[bacteria]] that may make the milk unsafe to consume.
*If you are not sure that the [[dairy product]] is [[Pasteurize|pasteurized]], do not eat it.


*'''People who handle animal tissues''' (such as hunters and animal herdsman) should protect themselves by using:
{| class="wikitable"
**Rubber gloves
! colspan="2" |[https://www.cdc.gov/brucellosis/prevention/index.html Recommendations for prevention of Brucellosis by] [[Centers for Disease Control and Prevention|CDC]]
**[[Goggles]]
|-
**Gowns or aprons
|People who consume dairy and meat products
**This will help ensure that [[bacteria]] from potentially [[infected]] [[animals]] do not get into [[eyes]] or inside a cut or [[abrasion]] on the [[skin]].
|shouldn't consume the following:
 
*Undercooked meat
*Recommendations for '''Safe Laboratory Practices''':
*[[Unpasteurized milk|Unpasteurized]] dairy products, including:
**When brucellosis is suspected in a [[patient]], clinicians should not "suspect or rule out brucellosis" on the [[laboratory]] submission.
**Milk
**Review [[laboratory]] containment methods and [[microbiological]] procedures to ensure compliance with recommendations in the Biosafety in [[Microbiological]] and Biomedical Laboratories (BMBL) 5th Edition
**Cheese
**Use primary barriers: use safety [[centrifuge]] cups, personal protective equipment, and class II or higher Biological Safety Cabinets (BSCs) for procedures with a high likelihood of producing [[droplet]] splashes or [[aerosols]].
**Ice cream
**Use secondary barriers: restrict access to the [[laboratory]] when work is being performed and maintain the integrity of the [[laboratory]]'s air handling system by keeping external doors and windows closed.
*If you are not sure that the dairy product is pasteurized, do not eat it.
**Perform all procedures on unidentified [[isolates]] carefully to minimize the creation of splashes or [[aerosols]].
|-
**Prohibit sniffing of opened [[Culture medium|culture plates]] to assist in the identification of isolates. Manipulate isolates of small [[gram-negative]] or gram-variable rods within a BSC.
|People who handle animal tissues (such as hunters and animal herdsman''')'''
 
|
*'''USA''':
* Use clean, sharp knives for field dressing and butchering.
**Dairy herds in the USA to be certified brucellosis-free are tested at least once a year with the [[Brucella|''Brucella'']] milk ring test.
* Wear [[eye]] protection and rubber or latex gloves (disposable or reusable) when handling carcasses.
**Cows confirmed to be infected are often killed.
* Avoid direct (bare [[skin]]) contact with [[fluid]] or [[organs]] from the animal.
**In the United States, [[Veterinarian|veterinarians]] are required to [[Vaccination|vaccinate]] all young stock, thereby further reducing the chance of zoonotic transmission.
* Avoid direct (bare skin) contact with hunting dogs that may have come into contact with hunted animals.
**This [[vaccination]] is usually referred to as a "calfhood" vaccination.
* After butchering, burn or bury disposable gloves and parts of the carcass that will not be eaten.
**Most cattle receive a tattoo in one of their ears, serving as proof of their [[vaccination]] status.
* Don't feed dogs with [[raw]] meat or other parts of the carcass.
**The first state–federal cooperative efforts towards eradication of brucellosis caused by [[Brucella abortus|''Brucella abortus'']] in the U.S. began in 1934.
* Wash hands as soon as possible with soap and warm water for 20 seconds or more. Dry hands with a clean cloth.
**Wild bison and elk in the greater Yellowstone area are the last remaining reservoir of [[Brucella abortus|''B. abortus'']] in the US.
* Clean all tools and reusable gloves with a disinfectant, like dilute [[bleach]]. ''(Follow the safety instructions on the product label).''
***The recent [[transmission]] of brucellosis from elk back to cattle in Idaho and Wyoming illustrates how the area, as the last remaining reservoir in the United States, may adversely affect the livestock industry.
* Thoroughly cook meat from any animal that is known to be a possible carrier of [[brucellosis]] (see the list above).
***Eliminating brucellosis from this area is a challenge, as many viewpoints exist on how to manage diseased [[wildlife]].
* Be aware that freezing, smoking, drying and pickling do not kill [[Bacteria|the bacteria]] that cause [[brucellosis]].
***Purebred bison in the Henry Mountains of southern Utah are free of brucellosis.<ref name=""j">Brucellosis. CDC. http://www.cdc.gov/brucellosis/prevention/index.html. Accessed on February 5, 2016</ref><ref name="a">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 5, 2016</ref>
|-
|Safe Laboratory Practices:
|
*When brucellosis is suspected in a patient, clinicians should not "suspect or rule out brucellosis" on the laboratory submission.
*Review [[laboratory]] containment methods and [[microbiological]] procedures to ensure compliance with recommendations in the Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition
*''Use primary barriers:'' use safety centrifuge cups, personal protective equipment, and class II or higher Biological Safety Cabinets (BSCs) for procedures with a high likelihood of producing droplet splashes or aerosols.
*''Use secondary barriers:'' restrict access to the laboratory when work is being performed and maintain the integrity of the laboratory's air handling system by keeping external doors and windows closed.
*Perform all procedures on unidentified isolates carefully to minimize the creation of splashes or [[aerosols]].
*Prohibit sniffing of opened culture plates to assist in the identification of isolates. Manipulate isolates of small gram-negative or gram-variable rods within a BSC.
|}


==Vaccines==
==Vaccines==
*There are no available [[vaccines]] for [[Human|humans]] against brucellosis.
* [[Attenuated|Live attenuated]] Brucella strains, such as B. abortus strain 19BA or 104M, have been used in some countries to protect high-risk populations.<ref>Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 9th, 2017</ref>
*[[Brucella abortus|''B. abortus'']] RB51 is a strain of this [[bacterium]] developed specifically for [[Immunization (medicine)|immunization]] of cattle against brucellosis to allow [[serological]] differentiation between naturally [[infected]] and [[vaccinated]] animals.
* Vaccination as displayed short-term [[efficacy]] and high reactogencity.
**Accidental [[human]] exposure to RB51, though uncommon, has resulted in development of [[symptoms]] consistent with brucellosis.
**Exposures have included needle sticks, [[eye]] and wound splashes, and contact with [[infected]] material.
*Other [[vaccines]], such as [[Brucella abortus|''Brucella abortus'']] S19 for cattle and ''[[Brucella melitensis|B. melitensis]]'' Rev-1 for sheep and goats, can also cause [[infection]] in [[humans]].<ref name="k">Brucellosis. CDC. http://www.cdc.gov/brucellosis/veterinarians/cattle.html. Accessed on February 5, 2016</ref>


==Reference==
==Reference==
{{reflist|2}}
{{reflist|2}}
[[Category:Bacterial diseases]]
 
[[Category:Occupational diseases]]
[[Category:Disease]]
[[Category:Zoonoses]]
[[Category:Up-To-Date]]
[[Category:Pulmonology]]
[[Category:Hepatology]]
[[Category:Rheumatology]]
[[Category:Nephrology]]
[[Category:Emergency medicine]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Biological weapons]]
[[Category:Disease]]
{{WH}}
{{WS}}

Latest revision as of 20:45, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Danitza Lukac Vishal Devarkonda, M.B.B.S[2]

Overview

Effective measures for the primary prevention of brucellosis include not consuming unpasteurized dairy or undercooked meat, and having safe occupational practices.[1][2]

Prevention

Recommendations for prevention of Brucellosis by CDC
People who consume dairy and meat products shouldn't consume the following:
  • Undercooked meat
  • Unpasteurized dairy products, including:
    • Milk
    • Cheese
    • Ice cream
  • If you are not sure that the dairy product is pasteurized, do not eat it.
People who handle animal tissues (such as hunters and animal herdsman)
  • Use clean, sharp knives for field dressing and butchering.
  • Wear eye protection and rubber or latex gloves (disposable or reusable) when handling carcasses.
  • Avoid direct (bare skin) contact with fluid or organs from the animal.
  • Avoid direct (bare skin) contact with hunting dogs that may have come into contact with hunted animals.
  • After butchering, burn or bury disposable gloves and parts of the carcass that will not be eaten.
  • Don't feed dogs with raw meat or other parts of the carcass.
  • Wash hands as soon as possible with soap and warm water for 20 seconds or more. Dry hands with a clean cloth.
  • Clean all tools and reusable gloves with a disinfectant, like dilute bleach. (Follow the safety instructions on the product label).
  • Thoroughly cook meat from any animal that is known to be a possible carrier of brucellosis (see the list above).
  • Be aware that freezing, smoking, drying and pickling do not kill the bacteria that cause brucellosis.
Safe Laboratory Practices:
  • When brucellosis is suspected in a patient, clinicians should not "suspect or rule out brucellosis" on the laboratory submission.
  • Review laboratory containment methods and microbiological procedures to ensure compliance with recommendations in the Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition
  • Use primary barriers: use safety centrifuge cups, personal protective equipment, and class II or higher Biological Safety Cabinets (BSCs) for procedures with a high likelihood of producing droplet splashes or aerosols.
  • Use secondary barriers: restrict access to the laboratory when work is being performed and maintain the integrity of the laboratory's air handling system by keeping external doors and windows closed.
  • Perform all procedures on unidentified isolates carefully to minimize the creation of splashes or aerosols.
  • Prohibit sniffing of opened culture plates to assist in the identification of isolates. Manipulate isolates of small gram-negative or gram-variable rods within a BSC.

Vaccines

  • Live attenuated Brucella strains, such as B. abortus strain 19BA or 104M, have been used in some countries to protect high-risk populations.[3]
  • Vaccination as displayed short-term efficacy and high reactogencity.

Reference

  1. ↑ Brucellosis. CDC. http://www.cdc.gov/brucellosis/prevention/index.html. Accessed on February 5, 2016
  2. ↑ Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 5, 2016
  3. ↑ Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 9th, 2017
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