BRUCELLOSIS

Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)

I. IDENTIFICATION

A. CLINICAL DESCRIPTION: An illness characterized by acute or insidious onset of fever, night sweats, fatigue, anorexia, weight loss, headache, and arthralgia. The infection can also cause osteoarticular complications, endocarditis, and orchitis.

B. REPORTING CRITERIA: Clinical diagnosis with laboratory confirmation.

C. LABORATORY CRITERIA FOR CONFIRMATION:

• Isolation of Brucella sp. from a clinical specimen, OR
• Fourfold or greater rise in Brucella agglutination titer between acute- and convalescent-phase serum specimens obtained ³ 2 weeks apart and studied at the same laboratory, OR
• Demonstration of Brucella sp. in a clinical specimen by immunofluorescence.

D. WISCONSIN CASE DEFINITION:

A clinically compatible illness that is laboratory confirmed.

II. ACTIONS REQUIRED / PREVENTION MEASURES

A. WISCONSIN DISEASE SURVEILLANCE CATEGORY II: Report to the patient's local health officer on an Acute and Communicable Disease Case Report (DPH 4151) or other means within 72 hours of the identification of a case or suspected case.

B. EPIDEMIOLOGY REPORTS REQUESTED: Acute and Communicable Diseases Case Report (DPH 4151).

C. PUBLIC HEALTH INTERVENTIONS:

• Source investigation by LHD. Search for history of exposure to infected animals or animal products (especially unpasteurized milk and cheese) and trace to place of origin. Ask about exposure to microbiology laboratory settings, because multiple cases have been traced to clinical laboratory exposures. Additionally, check for history of exposure to the brucellosis vaccine used in livestock, since this is a live vaccine. Infection with this vaccine strain (B. abortus RB51) typically does not produce a detectable antibody response, and, although it can be cultured using standard microbiological methods, the speciation of this strain is difficult. Consultation with the State Public Health Veterinarian is advised if a vaccine-acquired infection is suspected.
  

III. CONTACTS FOR CONSULTATION

 A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-7321.

B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.

C. WSLH /

1. BACTERIAL SEROLOGY: (608) 262-3217.
2. CULTURE: (608) 263-3421.

IV. RELATED REFERENCES

1. “Brucellosis” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets

2. Heymann DL, ed. BRUCELLOSIS. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004: 75-78.

3. Human Exposure to Brucella abortus Strain RB51 – Kansas . 1997 MMWR 1998;47(9):172-5.

4. Brucellosis Outbreak at a Pork Processing Plant – North Carolina . 1992 MMWR 1994;43(7):113-6.

V. DISEASE TRENDS

Between 1999 and 2003 there were only 5 cases of brucellosis reported in Wisconsin .