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 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