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==Overview==
==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 human vaccines against brucellosis.<ref name="a">Brucellosis. CDC. http://www.cdc.gov/brucellosis/. Accessed on February 5, 2016</ref><ref name="b">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 prevent brucellosis infection is to be sure you do not consume:
 
**Undercooked meat
{| class="wikitable"
**Unpasteurized dairy products, including:
! colspan="2" |[https://www.cdc.gov/brucellosis/prevention/index.html Recommendations for prevention of Brucellosis by] [[Centers for Disease Control and Prevention|CDC]]
***Milk
|-
***Cheese
|People who consume dairy and meat products
***Ice cream
|shouldn't consume the following:
***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.
*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.
*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:
|People who handle animal tissues (such as hunters and animal herdsman''')'''
**Rubber gloves
|
**Goggles
* Use clean, sharp knives for field dressing and butchering.
**Gowns or aprons
* Wear [[eye]] protection and rubber or latex gloves (disposable or reusable) when handling carcasses.
**This will help ensure that bacteria from potentially infected animals do not get into eyes or inside a cut or abrasion on the skin.
* 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.
*Recommendations for Safe Laboratory Practices:
* After butchering, burn or bury disposable gloves and parts of the carcass that will not be eaten.
**When brucellosis is suspected in a patient, clinicians should not "suspect or rule out brucellosis" on the laboratory submission.
* Don't feed dogs with [[raw]] meat or other parts of the carcass.
**Review laboratory containment methods and microbiological procedures to ensure compliance with recommendations in the Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition
* Wash hands as soon as possible with soap and warm water for 20 seconds or more. Dry hands with a clean cloth.
**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.
* Clean all tools and reusable gloves with a disinfectant, like dilute [[bleach]]. ''(Follow the safety instructions on the product label).''
**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.
* Thoroughly cook meat from any animal that is known to be a possible carrier of [[brucellosis]] (see the list above).
**Perform all procedures on unidentified isolates carefully to minimize the creation of splashes or aerosols.
* Be aware that freezing, smoking, drying and pickling do not kill [[Bacteria|the bacteria]] that cause [[brucellosis]].
**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.
|-
 
|Safe Laboratory Practices:
*USA:
|
**Dairy herds in the USA to be certified brucellosis-free are tested at least once a year with the Brucella milk ring test.
*When brucellosis is suspected in a patient, clinicians should not "suspect or rule out brucellosis" on the laboratory submission.
**Cows confirmed to be infected are often killed.
*Review [[laboratory]] containment methods and [[microbiological]] procedures to ensure compliance with recommendations in the Biosafety in Microbiological and Biomedical Laboratories (BMBL) 5th Edition
**In the United States, veterinarians are requireD to vaccinate all young stock, thereby further reducing the chance of zoonotic transmission.
*''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.
**This vaccination is usually referred to as a "calfhood" vaccination.
*''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.
**Most cattle receive a tattoo in one of their ears, serving as proof of their vaccination status.
*Perform all procedures on unidentified isolates carefully to minimize the creation of splashes or [[aerosols]].
**The first state–federal cooperative efforts towards eradication of brucellosis caused by Brucella abortus in the U.S. began in 1934.
*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.
**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.<ref name="a">Brucellosis. CDC. http://www.cdc.gov/brucellosis/. Accessed on February 5, 2016</ref><ref name="b">Brucellosis. Wikipedia. https://en.wikipedia.org/wiki/Brucellosis. Accessed on February 5, 2016</ref>


==Vaccines==
==Vaccines==
*There are no available human vaccines 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>
*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.
* 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 S19 for cattle and B. melitensis Rev-1 for sheep and goats, can also cause infection in humans.<ref name="f">Brucellosis. CDC. http://www.cdc.gov/brucellosis/veterinarians/cattle.html. Accessed on February 5, 2016</ref>


==Reference==
==Reference==
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[[Category:Needs content]]
 
[[Category:Bacterial diseases]]
[[Category:Disease]]
[[Category:Occupational diseases]]
[[Category:Up-To-Date]]
[[Category:Zoonoses]]
[[Category:Pulmonology]]
[[Category:Hepatology]]
[[Category:Rheumatology]]
[[Category:Nephrology]]
[[Category:Emergency medicine]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Biological weapons]]
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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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