Brucellosis – Exposure Management

The World Health Organization (WHO) describes Brucellosis as a bacterial disease caused by various Brucella species. It is a zoonotic infection, meaning the disease is transmitted from animals to humans via consuming contaminated animal products (such as unpasteurized milk or cheese), or inhaling airborne agents.

In Ontario, Brucellosis is a reportable infectious disease, meaning that cases must be reported to the local public health unit. Public Health Ontario also does active surveillance of Brucellosis cases in the province. Brucellosis is also an occupational illness and can affect occupations such as farmers, butchers, veterinarians and laboratory personnel.

Brucellosis causes flu-like symptoms such as fever, weakness, malaise and weight loss. According to the US Centre for Disease Control (US CDC), the incubation period of this infection ranges between 5 days to 6 months but is typically around 2-4 weeks. The CDC also reports that Brucellosis is the most commonly reported laboratory bacterial infection and has published guidance on risk stratification based on the exposure scenario in the laboratory setting.

According to the US CDC, in laboratory settings, risk stratification depends on the type of specimen being handled, if a Class II Biosafety Cabinet was used, if personal protective equipment (PPE) was used, and if the specimen was manipulated. The CDC then further recommends a variety of possible actions ranging from no action, to symptom monitoring, to serological follow up, and possible administration of post-exposure prophylaxis (PEP) to prevent infection.

The CDC also provides exposure guidance in other occupational scenarios such as other clinical exposure, surgical exposure and veterinary exposures.

Employers of at-risk workers may benefit from having procedures and policies in place to handle Brucella exposure.