I found the following about Brucellosis at the CDC website (www.cdc.gov). It
contains much epidemiological and medical terminology, but maybe it will be helpful:
Brucellosis (also termed undulant, Mediterranean, or Malta fever) is a febrile
illness caused by several species of bacteria of the genus Brucella ****. The
incubation period is
typically more than 30 days but can range from 5 days to several months. Symptoms
are
nonspecific and include fever, chills, sweats, headache, myalgia/arthralgia,
anorexia, fatigue, and
weight loss. The most common physical findings (other than fever) are
lymphadenopathy and
splenomegaly. Subclinical Brucella infection occurs commonly, and the ratio of
subclinical to
clinical infection varies from 1:1 to 12:1 (1). The antibiotic regimen recommended
by the World
Health Organization is a 6-week course of doxycycline (100 mg every 12 hours orally)
and
rifampin (15 mg/kg of body weight per day {maximum: 600 mg} in a single morning
dose) (2 ).
Even with treatment and clinical improvement, fatigability may persist for a month
or more and be
accompanied by pronounced disability; relapsing illness occurs in approximately
2%-10% of
patients treated with recommended antibiotic regimens (3).
Definitive diagnosis requires isolation of the causative organism in cultures of
blood or bone
marrow. However, brucellosis is more commonly diagnosed serologically, either by a
fourfold rise
in STA titer over several weeks or a single titer greater than or equal to 160:1 in
a person with
compatible clinical manifestations (4).
In the United States, human brucellosis is a reportable disease in every state
except Nevada. In
1992, 105 cases were reported to CDC by state health departments (5), compared with
a peak
of approximately 6300 in 1947 (6). However, because of the variable clinical
manifestations of
brucellosis, only an estimated 4%-10% of cases are recognized and reported in the
United States
(7). The findings in this report indicate that occupational transmission of
brucellosis remains a
public health hazard, particularly among persons exposed to swine.
Person-to-person transmission of brucellosis is rare (8), and a substantial
proportion of reported
cases are associated with ingestion of unpasteurized dairy products contaminated
with B.
melitensis that have been imported from Mediterranean countries or Mexico (6).
Occupational
transmission of brucellosis occurs primarily among packing plant workers,
veterinarians, livestock
producers, and laboratory workers. Among packing plant workers, transmission of
brucellosis
occurs from infected swine to workers through breaks in the workers' skin,
inhalation, and
conjunctival contact (9). The primary strategy for prevention of brucellosis in
workers is to reduce
exposure to infected animals by eliminating commercial slaughter of such animals.
Although
personal protective equipment is often recommended, the efficacy of personal
protective
equipment in preventing the occupational transmission of Brucella requires further
assessment.
A unified national program to eradicate swine brucellosis was initiated in 1961. The
Cooperative
USDA Animal and Plant Health Inspection Service-State Animal Health Swine
Brucellosis
Eradication Program, in which all states participate, has established surveillance
and procedures
necessary for locating infected herds, controlling infected and exposed swine, and
eliminating
infected swine (10). In addition, specific provisions exist to designate entire
states or individual
swine herds as brucellosis-free. As of December 31, 1993, 34 swine herds nationwide
were
under quarantine for brucellosis in seven states (Florida, Georgia, Hawaii,
Oklahoma, South
Carolina, Tennessee, and Texas). These brucellosis-infected herds can be moved for
slaughter
only under permit issued by USDA. In general, processing plants that receive
brucellosis-infected
herds do not employ special precautions to prevent occupational exposure to the
infected swine,
potentially placing workers at increased risk for infection. USDA is evaluating its
swine brucellosis
control/eradication program, including the disposition of known brucellosis-infected
herds.
(end CDC part)
Brucellosis is considered zoonotic because of transmission from animals to humans,
from cattle, swine, dogs (though rare), even marine mammals. Epidemiology of each
type of brucellosis is unique, making detection and treatment difficult. It's
mainly a problem in underdeveloped nations, but the above CDC extraction came from a
report about occupational exposure to Brucella suis in a swine production facility
in North Carolina
To Unsubscribe: Email majordomo@ces.ncsu.edu with the command
"unsubscribe sanet-mg". If you receive the digest format, use the command
"unsubscribe sanet-mg-digest".
To Subscribe to Digest: Email majordomo@ces.ncsu.edu with the command
"subscribe sanet-mg-digest".
All messages to sanet-mg are archived at:
http://www.sare.org/htdocs/hypermail
This archive was generated by hypermail 2b29 : Sun Feb 06 2000 - 12:00:24 EST