Laboratory Exposures to Brucellae and Implications for Bioterrorism

Pablo Yagupsky,Ellen Jo Baron

doi:10.3201/eid1108.041197

Abstract

Brucellae are class 3 organisms and potential agents of bioterrorism. Because of effective public health measures, brucellosis has become a rare disease in industrialized countries, and clinical microbiology laboratories are frequently unfamiliar with the genus. A low index of suspicion by physicians or failure to notify the laboratory, equivocal Gram-stain results, misidentification of the organism by commercial systems, unsafe laboratory practices, and laboratory accidents have been responsible for numerous cases of exposure to the organism and laboratory-acquired disease in recent years. Discovery of a laboratory exposure to brucellae should prompt an exhaustive investigation of the event and its circumstances, definition of the population at risk, enforcement of safe laboratory practices, and antimicrobial drug prophylaxis for exposed persons. Inadvertent exposures to brucellae in the clinical laboratory indicate a widespread lack of preparedness to cope with eventual biologic threats involving use of the organism.

Highlights

Tion of the organism through organ transplantation, sexual contact, breastfeeding, or the transplacental route have been reported (1)
Patients involved in laboratory outbreaks of brucellosis have shown almost the entire range of clinical manifestations of the disease, ranging from the common prolonged febrile syndrome (14) and a flulike disease (25,27), to focal signs and symptoms, such as hepatitis (17,33), lymphadenopathy (17,25), uveitis (14), breast abscess (28) epididymitis (29), arthritis (17), discitis (29,34), pneumonitis (17), deep vein thrombosis (29), and meningitis (31)
Laboratory Exposure to Brucella Organisms Because of effective control measures in animals and animal products, brucellosis has been almost eradicated from most industrialized countries, where the disease is usually limited to persons who have traveled to developing countries or ingested imported contaminated food (14)

Summary

Introduction

Tion of the organism through organ transplantation, sexual contact, breastfeeding, or the transplacental route have been reported (1). The concentration of Brucella organisms in the blood (11,12) and synovial fluid (13) of patients with brucellosis is usually low, and these clinical specimens probably pose a low risk for contagion for laboratory personnel.

Results

Conclusion