Brucellosis in the UK: a risk to laboratory workers? Recommendations for prevention and management of laboratory exposure: Table 1

Abstract

Brucella spp is an uncommon class 3 pathogen isolated in laboratories serving non-endemic areas. This is a report of four recent cases of brucellosis diagnosed at five different London laboratories, and it highlights the need to maintain a high index of suspicion for brucellosis in patients with a history of travel to and/or consumption of unpasteurized foods from endemic areas. A protocol for risk categorisation is proposed, and there is a description of the strategy adopted for serological follow-up of exposed staff and use of postexposure prophylaxis.

Laboratory exposures to brucella in the UK and Ireland

“…An earlier UK report of LAB, involving 29 laboratory staff, also documented no seroconversions with only 20 staff (69%) accepting PEPs. 5 Staff compliance in the UK with the current recommended serological follow-up protocol appears to be poor; guidance on the management of laboratory exposures to brucella therefore needs to be reviewed. Information leaflets for laboratory staff, exploring the varied clinical presentations of brucellosis, could also be helpful.…”

Health and safety of health care workers

“…Amerikan Ulusal Mesleki Sağlık ve Güvenlik Enstitüsü (National Institute for Occupational Safety and Health -NIOSH), hastanelerde 29 çeşit fiziksel, 25 çeşit kimyasal, 24 çeşit biyolojik, 6 çeşit ergonomik ve 10 çeşit psiko-sosyal tehlike ve risk olduğunu bildirmiştir 5 . Sağlık çalışanlarının maruz kaldığı risk grupları: Biyolojik tehlikeler: Biyolojik tehlikeler tüm sağlık bakım alanlarında vardır ve hastaların kan veya kanla kontamine vücut sıvılarıyla teması sonucu HIV (Human Immunodeficiency Virus), Hepatit B Virüsü (HBV), Hepatit C Virüsü (HCV) gibi önemli patojenlere 6 , tüberküloz, barsak infeksiyonları ve Brucella, Salmonella gibi diğer infeksiyonlara sağlık çalışanlarında sıklıkla rastlanmaktadır 7,8,9 . Kimyasal tehlikeler: Sağlık çalışanları dermatit ve işe bağlı astıma neden olan kimyasal tehlikelere maruz kalmaktadır 9 .…”

Undifferentiated febrile illnesses in military personnel

“…The diagnosis is usually made by serology, but the Brucella bacteria may also grow from conventional blood cultures. Where clinical suspicion exists, laboratory personnel should be alerted because laboratory-associated infections can occur 20. Treatment requires a combination of antibiotics (eg, doxycycline and rifampicin) for at least 6 weeks and, hence, requires medical evacuation to Role 4.…”