A Foodborne Outbreak of Brucellosis at a Police Station Cafeteria, Lima, Peru.
ABSTRACT Brucella melitensis is highly infectious for humans and can be transmitted to humans in a number of epidemiological contexts. Within the context of an ongoing brucellosis surveillance project, an outbreak at a Peruvian police officer cafeteria was discovered, which led to active surveillance (serology, blood culture) for additional cases among 49 police officers who had also eaten there. The cohort was followed up to 18 months regardless of treatment or symptoms. Active surveillance estimated the attack rate at 26.5% (13 of 49). Blood cultures from four cases were positive; these isolates were indistinguishable using multiple locus variable number tandem repeat analysis. This investigation indicates the importance of case tracking and active surveillance for brucellosis in the context of potential common source exposure. These results provide rationale for public health investigations of brucellosis index cases including the bioterrorism-related dissemination of Brucella.
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ABSTRACT: Members of the genus Brucella are pathogenic bacteria exceedingly well adapted to their hosts. The bacterium is transmitted by direct contact within the same host species or accidentally to secondary hosts, such as humans. Human brucellosis is strongly linked to the management of domesticated animals and ingestion of their products. Since the domestication of ungulates and dogs in the Fertile Crescent and Asia in 12000 and 33000 ya, respectively, a steady supply of well adapted emergent Brucella pathogens causing zoonotic disease has been provided. Likewise, anthropogenic modification of wild life may have also impacted host susceptibility and Brucella selection. Domestication and human influence on wild life animals are not neutral phenomena. Consequently, Brucella organisms have followed their hosts' fate and have been selected under conditions that favor high transmission rate. The "arm race" between Brucella and their preferred hosts has been driven by genetic adaptation of the bacterium confronted with the evolving immune defenses of the host. Management conditions, such as clustering, selection, culling, and vaccination of Brucella preferred hosts have profound influences in the outcome of brucellosis and in the selection of Brucella organisms. Countries that have controlled brucellosis systematically used reliable smooth live vaccines, consistent immunization protocols, adequate diagnostic tests, broad vaccination coverage and sustained removal of the infected animals. To ignore and misuse tools and strategies already available for the control of brucellosis may promote the emergence of new Brucella variants. The unrestricted use of low-efficacy vaccines may promote a "false sense of security" and works towards selection of Brucella with higher virulence and transmission potential.Frontiers in Microbiology 05/2014; 5:213. DOI:10.3389/fmicb.2014.00213 · 3.94 Impact Factor
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ABSTRACT: Background: The first case of human brucellosis was reported in 2002 in South Korea, and followed by the incidence, it has been nationally increasing. However, bovine brucellosis, through the management of Animal and Plant Quarantine Agency, has not been discovered from 2003 to date on Jeju Island. Despite Jeju Island previously considered a clean area for bovine brucellosis, we experienced an outbreak of human brucellosis between 2012 and 2013. Methods: We detected patients with human brucellosis between 2012 and 2013 on Jeju Island. The epidemiological, clinical, and microbiological data were collected. We tested for specimens in tissue from wound and blood using nested polymerase chain reaction (PCR) amplification of 16S ribosomal RNA (rRNA) and omp2. Serologic screening with standard tube agglutination (STA) test was performed on those who had a history of a contact with cattles. Results: Between January 2012 and September 2013, 5 cases were identified on Jeju Island. Herein, the cases with Brucella abortus infection after ingested raw fetal materials of cattle at a folk restaurant are reported. All patients were male and immunocompetent. They were infected with brucella by a folk remedy that a raw fetal material would restore general conditions. Four cases were confirmed the isolation of brucella from blood. We investigated folk restaurants and detected a illegal distribution channel of raw fetal materials of cattle. Conclusion: Because all patients developed zoonosis by a wrong folk remedy, we emphasize to enhance an educational program for awareness of zoonosis, active surveillance, detection and a control of illegal distribution channel for brucella infected animals in other areas.IDWeek 2014 Meeting of the Infectious Diseases Society of America; 10/2014