Brucellosis primary prevention

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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.

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:
  • Rubber gloves
  • Goggles
  • Gowns or aprons
  • This will help ensure that bacteria from potentially infected animals do not get into eyes or inside a cut or abrasion on the skin.

• Recommendations for 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.

• USA:
  • Dairy herds in the USA to be certified brucellosis-free are tested at least once a year with the Brucella milk ring test.
  • Cows confirmed to be infected are often killed.
  • In the United States, veterinarians are required to vaccinate all young stock, thereby further reducing the chance of zoonotic transmission.
  • This vaccination is usually referred to as a "calfhood" vaccination.
  • Most cattle receive a tattoo in one of their ears, serving as proof of their vaccination status.
  • The first state–federal cooperative efforts towards eradication of brucellosis caused by Brucella abortus in the U.S. began in 1934.
  • Wild bison and elk in the greater Yellowstone area are the last remaining reservoir of B. abortus in the US.
    • 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.
    • Eliminating brucellosis from this area is a challenge, as many viewpoints exist on how to manage diseased wildlife.
    • Purebred bison in the Henry Mountains of southern Utah are free of brucellosis.

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.