Brucellosis

Question 1

Is Brucellosis nationally notifiable?

Answer 1

Yes - routine, labs and doctors

Question 2

What is the organism that causes human disease in Australia related to Brucellosis?

Answer 2

Brucella suis

Only species causing human disease in Australia.
Many species cause disease in different animals

Question 3

What animals are primary reservoirs for Brucellosis?

Answer 3

Cattle, swine, goats
Feral pigs in Queensland cause most infections in Australia.

Dogs can be infected from pigs.

Can survive in dust / soil.

Question 4

How is Brucellosis transmitted?

Answer 4

Contact with infected tissues and secretions - blood, urine, vaginal discharges, aborted animal foetuses, and especially placentae

Transmission via:
* broken skin
* mucous membranes
* ingestion (raw milk and milk products)
* inhalation
* fomites

Question 5

What are common clinical features of Brucellosis?

Answer 5

Non-specific flu-like symptoms, hepatitis, orchitis, osteoarticular disease, endocarditis

Most recover in 2-4 weeks but may relapse intermittently.

Question 6

Who are considered high-risk groups for Brucellosis?

Answer 6

• People who handle infected animals or their products e.g. feral pig hunters and biosecurity officers
• Animal contact in endemic countries.

Question 7

What defines a confirmed case of Brucellosis?

Answer 7

Isolation/PCR from blood or seroconversion

A probable case may involve a single high titre/PCR from another site along with clinical symptoms.

Question 8

What is the primary diagnostic method for Brucellosis?

Answer 8

• Culture of blood, bone marrow, other fluids or tissues
• PCR
• Serology

The National Brucella Reference Laboratory is at the Australian Animal Health Lab.

Question 9

Where should samples be sent?

Answer 9

National Brucella Reference Laboratory - Australian Animal Health Lab

Question 10

What is the typical incubation period for Brucellosis?

Answer 10

Usually 1-2 months; range 5-60 days

Question 11

True / False: Brucellosis has been eradicated in Australia.

Answer 11

False. Eradicated from Australian cattle herds and domestic pigs but still present in feral pigs in northern Australia.

Question 12

Where is Brucellosis still present in Australia?

Answer 12

Feral pigs in northern Australia

It is a risk to those who hunt or butcher feral pigs.

Question 13

What preventive measures can be taken against Brucellosis?

Answer 13

Education:
* Avoid unpasteurized milk, boil milk, use PPE, and hand washing
* Farmers and handlers of potentially infected animals / products to reduce exposure
* PPE - overalls, gloves, masks
* Cover wounds

Question 14

What is the treatment approach for a Brucellosis case?

Answer 14

Clinician responsibility includes ID referral and antibiotic treatment for at least 6 weeks

Exposure investigation includes travel history, hunting, and contact with feral pig carcasses.

Question 15

How are brucellosis cases managed from a public health perspective?

Answer 15

• Interview - DRSVECTA - esp travel hx, hunting, contact with feral pigs, unpasteurised dairy, illness in pigs/dogs, undercooked pig meat
• T - ID; ABx 6 weeks
• I - NA
• E - reduce exposure e.g. PPE, avoid unpasteurised dairy products

Question 16

How should contacts / co-exposed be managed?

Answer 16

Interview - DRSVECTA; exposures same as cases
T - NA
I - NA
E - sx, transmission, test if symptomatic, consider chemoprophylaxis if lab exposure

Question 17

What environmental management should occur?

Answer 17

Notify Office of the Chief Vet (NRE) - animal investigation and control measures; recall implicated milk products

Question 18

What actions should be taken if there is an environmental exposure to Brucellosis?

Answer 18

Notify DEECA for animal investigations and control measures

Also involves recalling implicated milk products.