Brucellosis primary prevention: Difference between revisions

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Revision as of 20:16, 4 January 2017

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

Overview

Effective measures for the primary prevention of brucellosis include not consuming unpasteurized dairy or undercooked meat, and having safe occupational practices. There are no available vaccines for humans against brucellosis.^[1]^[2]

Prevention

Prevention of Brucellosis
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

There are no available vaccines for humans against brucellosis.
B. abortus RB51 is a strain of this bacterium developed specifically for immunization of cattle against brucellosis to allow serological differentiation between naturally infected and vaccinated animals.
- 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 S19 for cattle and B. melitensis Rev-1 for sheep and goats, can also cause infection in humans.^[3]

Reference

↑ Brucellosis. CDC. http://www.cdc.gov/brucellosis/prevention/index.html. Accessed on February 5, 2016
↑ Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 5, 2016
↑ Brucellosis. CDC. http://www.cdc.gov/brucellosis/veterinarians/cattle.html. Accessed on February 5, 2016

[j-1] Brucellosis. CDC. http://www.cdc.gov/brucellosis/prevention/index.html. Accessed on February 5, 2016

[a-2] Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 5, 2016

[k-3] Brucellosis. CDC. http://www.cdc.gov/brucellosis/veterinarians/cattle.html. Accessed on February 5, 2016

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[2]

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@@ Line 7: / Line 7: @@
 ==Prevention==
-*The most adequate way to prevent brucellosis infection is to be sure '''not to consume:'''
-**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) should protect themselves by using:
+{| class="wikitable"
-**Rubber gloves
+! colspan="2" |Prevention of Brucellosis
-**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 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 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, veterinarians are required to 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 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==