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Brucellosis
is a relatively rare, but epidemiologically important zoonotic
disease caused by the Brucella bacteria. The most common species
of Brucella isolated from Florida patients is B. suis, which is
endemic in Florida feral hogs. Brucella melitensis and B.
abortus are not found in Florida. However these species may
cause infections in Florida residents with travel to developing
countries where these species are still endemic in domestic
goats, sheep and cattle.
Due to the naturally occurring infection in feral hogs, hog
hunters are at increased risk of developing brucellosis. Of the
10 reported cases of brucellosis in 2008, seven were associated
with wild pig hunting or preparation of wild pig meat. Feral hog
data collected by USDA indicate seroprevalences as high as 50%
in some feral swine herds in central Florida, and statewide
prevalence is estimated to be 10-20%. In 2008 (and 2009), a
majority of cases of Brucella acquired in Florida were in
residents of central Florida, but were also identified in other
parts of the state. Persons can become infected with Brucella
when open cuts or mucous membranes come in contact with pig
blood, raw meat or organs during the butchering process. Though
rare, hunters' family members have also acquired Brucella,
presumably from preparing wild hog meat, through other contact
with hog's blood, or through ingestion of undercooked meat.
The symptoms of brucellosis are non-specific and may wax and
wane. The most consistent symptom of brucellosis is intermittent
or constant fever. Other common symptoms include headaches,
chills, arthralgia (joint pain), and weight loss. Chronic
infection can lead to localized disease such as osteomyelitis or
endocarditis. Heymann's Control of Communicable Disease Manual
states: "The disease is often unrecognized and underreported."
If a patient has unexplained recurring fever, it is important to
assess whether or not they hunt or handle meat from feral hogs
or have other possible exposures to Brucella such as
international travel with consumption of unpasteurized milk
products. Relapse in infection is common if patients have
incomplete or inappropriate treatment (monotherapy), or have
underlying medical conditions.
Brucella melitensis, B. suis and B. abortus are considered
select bioterrorism agents, in part because of the low
infectious dose required to cause illness (only 10-100
bacteria). Amplification of bacteria in culture increases
bacteria numbers and also the likelihood of aerosolization,
putting laboratory workers at risk. Each year in Florida,
multiple laboratory workers are exposed to Brucella, most often
because they were not advised that a sample might contain
Brucella. In 2009, more than 90 Florida laboratory workers were
exposed to Brucella and one Florida specimen likely caused
brucellosis in a laboratory worker in another state. If Brucella
is suspected, please notify the laboratory in advance so that
they can take additional precautions to prevent unnecessary
staff exposures. In addition, please notify the health
department immediately upon suspicion or laboratory test order
for Brucella, 24/7 by phone per Florida Rule 64-D3.
For more information on Brucella please visit::
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/brucellosis_g.htm
Sources:
Heymann, David. (2008). Control of communicable diseases manual.
Amer Public Health Assn.
Florida Morbidity Statistics Report, 2008. (2009). Florida
Department of Health.
Perspectives for the Treatment of Brucellosis in the 21st
Century: The Ioannina Recommendations:
http://www.plosmedicine.org/article/info:doi%2F10.1371%2Fjournal.pmed.0040317
False positive Brucella EIA MMWR:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5722a3.htm
Brucellosis in Feral Swine Hunters MMWR:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5822a3.htm
Information for Feral or Free-Ranging Swine
and Hunters
Practice good sanitation
when handling feral swine or raw feral swine meat, they can
carry a number of infectious organisms including bacteria and
parasites such as Brucella and Trichinella. To protect against
these and other agents (including viruses):
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Avoid eating, drinking or using tobacco
when field-dressing or handling carcasses.
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Use latex or rubber gloves when handling
the carcass or raw meat.
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Avoid direct contact with blood,
reproductive organs and fecal matter. Wearing long sleeves,
eye protection and covering any scratches, open wounds or
lesions will help provide protection.
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Clean and disinfect knives, cleaning
area, clothing and any other exposed surfaces when finished.
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Wash hands frequently with soap and
water.
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Cook meat from these animals to 160ยบ F or
until juices run clear
Contact your
county health department for more information about Brucella and
other diseases hunters can be exposed to through pigs.
CDC Brochure on Wild Hog Hunting Safety
(PDF 2.3 MB)
Laboratory
Exposures to Brucellosis
Information for public health officials and health care
providers
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