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A Case-Study of Implementation of Improved Strategies for Prevention of Laboratory-acquired Brucellosis

  • Castrodale, Louisa J. (Alaska Department of Health and Social Services, Division of Public Health) ;
  • Raczniak, Gregory A. (Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Zoonotic and Emerging Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC)) ;
  • Rudolph, Karen M. (Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Zoonotic and Emerging Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC)) ;
  • Chikoyak, Lori (Yukon-Kuskokwim Delta Regional Hospital) ;
  • Cox, Russell S. (Yukon-Kuskokwim Delta Regional Hospital) ;
  • Franklin, Tricia L. (Alaska Department of Health and Social Services, Division of Public Health) ;
  • Traxler, Rita M. (Division of High-consequence Pathogens and Pathology, NCEZID, CDC) ;
  • Guerra, Marta (Division of High-consequence Pathogens and Pathology, NCEZID, CDC)
  • Received : 2015.05.19
  • Accepted : 2015.07.21
  • Published : 2015.12.30

Abstract

Background: In 2012, the Alaska Section of Epidemiology investigated personnel potentially exposed to a Brucella suis isolate as it transited through three laboratories. Methods: We summarize the first implementation of the United States Centers for Disease Control and Prevention 2013 revised recommendations for monitoring such exposures: (1) risk classification; (2) antimicrobial postexposure prophylaxis; (3) serologic monitoring; and (4) symptom surveillance. Results: Over 30 people were assessed for exposure and subsequently monitored for development of illness. No cases of laboratory-associated brucellosis occurred. Changes were made to gaps in laboratory biosafety practices that had been identified in the investigation. Conclusion: Achieving full compliance for the precise schedule of serologic monitoring was challenging and resource intensive for the laboratory performing testing. More refined exposure assessments could inform decision making for follow-up to maximize likelihood of detecting persons at risk while not overtaxing resources.

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