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==Overview==
==Overview==
== Primary Prevention ==
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>
To prevent brucellosis, unpasteurized milk, cheese, or ice cream should be avoided while traveling. IHunters and animal herdsman should use rubber gloves when handling viscera of animals. There is no vaccine available for humans.
===Biological warfare===
In 1954, ''B. suis'' became the first agent [[biological warfare|weaponized]] by the U.S. at its Pine Bluff Arsenal in Arkansas. ''Brucella'' species survive well in aerosols and resist drying. ''Brucella'' and all other remaining biological weapons in the US arsenal were destroyed in 1971-72 when the U.S. offensive biological weapons (BW) program was discontinued. <ref >{{cite book|author=Woods, Lt Col Jon B. (ed.)|title=[http://www.usamriid.army.mil/education/bluebookpdf/USAMRIID%20BlueBook%206th%20Edition%20-%20Sep%202006.pdf ''USAMRIID’s Medical Management of Biological Casualties Handbook'']|edition=6th ed.|publisher=[[USAMRIID|U.S. Army Medical Institute of Infectious Diseases]], Fort Detrick, Maryland|year=April 2005|pages = 53}}</ref>


The United States BW program focused on three agents of the ''Brucella'' group:
==Prevention==


* Porcine Brucellosis (Agent US)
{| class="wikitable"
* Bovine Brucellosis (Agent AB)
! colspan="2" |[https://www.cdc.gov/brucellosis/prevention/index.html Recommendations for prevention of Brucellosis by] [[Centers for Disease Control and Prevention|CDC]]
* Caprina Brucellosis (Agent AM)
|-
|People who consume dairy and meat products
|shouldn't consume the following:
*Undercooked meat
*[[Unpasteurized milk|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 [[Bacteria|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.
|}


Agent US was in advanced development by the end of the Second World War.  When the USAF wanted a biological warfare capability, the Chemical Corps offered agent US in the M114 bomblet, based after the 4-pound bursting bomblet developed for [[anthrax]] in the Second World War. Though the capability was developed, operational testing indicated that the weapon was less than desirable, and the USAF termed it an interim capability until replaced by a more effective biological weapon. The main drawbacks of the M114 with agent US was that it was incapacitating (the USAF wanted "killer" agents), the storage stability was too low to allow for storing at forward air bases, and the logistical requirements to neutralize a target were far higher than originally anticipated, requiring unreasonable logistical air support.
==Vaccines==
* [[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>
* Vaccination as displayed short-term [[efficacy]] and high reactogencity.


Agents US and AB had a median infective dose of 500 org/person, and AM was 300 org/person.  The rate-of-action was believed to be 2 weeks, with a duration of action of several months.  The lethality estimate was based on epidemiological information at 1 - 2%.  AM was always believed to be a more virulent disease, and a 3% fatality rate was expected.
==Reference==
==Reference==
{{reflist|2}}
{{reflist|2}}
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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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