Acute Brucellosis Following Accidental Exposure to Brucella melitensis Rev-1 Vaccine

Abstract

Brucellosis is mainly transmitted to humans by direct contact with infected animals, consumption of non-pasteurized dairy products or through inhalation of aerosols. However, the disease may also be transmitted by exposure to vaccination that is used in veterinary medicine. In the literature, there were a few case reports of persons who developed brucellosis after unintentional inoculation or conjunctival exposure to the live Brucella vaccine. Here, we describe a sheep farmer with acute brucellosis that occurred as a result of unintentional percutaneous exposure to Rev 1 animal vaccine while vaccinating lambs.

Modelling Human Brucellosis Based on Infection Rate and Vaccination Coverage of Sheep and Goats

“…The live attenuated B. melitensis vaccine (Rev. 1) may cause disease to humans indistinguishable from the one caused by the wild strains [17,18]. The inadequate use of personal protective equipment and the negligence to implement safe practices during high-risk activities such as vaccination, attending parturitions, handling aborted fetuses, and other obstetric procedures, increase the chance of infection [14].…”

Occupational infection to Brucella abortus B19 vaccine despite antimicrobial prophylaxis

“…In the medical literature there are few studies describing the outcome of accidental exposure to brucellosis vaccine. In a series of 26 cases exposed to Brucella abortus (strain RB51) vaccine, 81% were associated with needlestick injury, 15% with conjunctival spray exposure and 4% reported direct contact with an open wound, and at least one systemic symptom was reported by 73% of the exposed workers 12 .…”

The The first report of Brucella melitensis Rev.1 human brucellosis in Bosnia and Herzegovina

“…Ashford et al clearly showed the possibility of infections by the live attenuated B. abortus vaccinal strain RB51 after an accidental inoculation or conjunctival splashing [21]. According to the intrinsic resistance of Rev.1 strain to streptomycin [5], the therapeutic regime should be started with combination of doxycycline and rifampicin for at least six weeks [10][11][12]. An antibiogram was not performed for the patient presented in this report, and the therapy was started with a standard combination of doxycycline 100 mg BID p.o.…”

“…Nevertheless, the virulence of the Rev.1 strain for humans is still uncertain, since a small number of publications support possible transmission of Rev.1 strain to humans. They argue that the infection is only possible after accidental inoculation and that aerogenic transmission or other contact is only possible under very specific conditions [9][10][11][12][13].…”