Laboratory-Acquired Meningitis Caused by Brucella abortus Strain 19

Montes, Javier Velasco; Rodríguez, Mónica; Martin, T. Ferris; Martin, F.

doi:10.1093/infdis/154.5.915

Cited by 18 publications

(7 citation statements)

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“…Some workers experienced more severe signs, including soft tissue abscesses (some of which involved implants or prostheses) (35,37), spondylitis or sacroiliitis (26,33,35), and neurologic brucellosis (45). Chronic fatigue (34) and permanent hearing loss (46) were also reported.…”

Section: Resultsmentioning

confidence: 99%

A Literature Review of Laboratory-Acquired Brucellosis

et al. 2013

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bBrucellosis is a bacterial zoonotic disease which has been associated with laboratory-acquired infections. No recent reviews have addressed the characteristics of laboratory-acquired brucellosis (LAB). English-language literature was reviewed to identify reports of laboratory exposures to Brucella spp. and LAB cases between 1982 and 2007. Evaluation of 28 case reports identified 167 potentially exposed laboratory workers, of whom 71 had LAB. Nine reports were identified that summarized an additional 186 cases of LAB. Only 18 (11%) exposures were due to laboratory accidents, 147 (88%) exposures were due to aerosolization of organisms during routine identification activities, and the circumstances of 2 (1%) exposures were unknown. Brucella melitensis was the causative agent in 80% (135/167) of the exposures. Workers with high-risk exposures were 9.3 times more likely to develop LAB than workers with low-risk exposures (95% confidence interval [CI], 3.0 to 38.6; P < 0.0001); they were also 0.009 times likelier to develop LAB if they took antimicrobial PEP than if they did not (95% CI, 0 to 0.042; P < 0.0001). The median incubation period in case and summary reports was 8 weeks (range 1 to 40 weeks). Antimicrobial PEP is effective in preventing LAB. The incubation period may be used to identify appropriate serological and symptom surveillance time frames for exposed laboratory workers.

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Section: Resultsmentioning

confidence: 99%

A Literature Review of Laboratory-Acquired Brucellosis

et al. 2013

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“…Due to the induction of a persistent cross-reacting immune response, the use of S19 was discontinued during the latter stages of the brucellosis eradication program in favor of a serologically non-reactive vaccine in the late 1990s [56]. In addition to elevated antibody titers, S19 can cause abortion in some vaccinated animals, and is pathogenic to humans in its current state [19, 20, 57–60]. S19 displays a clearance profile in mice that when compared to wild-type strains indicates attenuation that compromises the establishment of chronic, not acute, infection [61–64].…”

Section: Candidate Selectionmentioning

confidence: 99%

Brucellosis: The case for live, attenuated vaccines

Ficht

Kahl-McDonagh

Arenas-Gamboa

et al. 2009

Vaccine

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The successful control of animal brucellosis and associated reduction in human exposure has limited the development of human brucellosis vaccines. However, the potential use of Brucella in bioterrorism or biowarfare suggests that direct intervention strategies are warranted. Although the dominant approach has explored the use of live attenuated vaccines, side-effects associated with their use has prevented widespread use in humans. Development of live, attenuated Brucella vaccines that are safe for use in humans has focused on the deletion of important genes required for survival. However, the enhanced safety of deletion mutants is most often associated with reduced efficacy. For this reason recent efforts have sought to combine the optimal features of a attenuated live vaccine that is safe, free of side effects and efficacious in humans with enhanced immune stimulation through microencapsulation. The competitive advantages and innovations of this approach are: (1) use of a highly attenuated, safe, gene knockout, live Brucella mutants; (2) manufacturing with unique disposable closed system technologies, and (3) oral/intranasal delivery in a novel microencapsulation-mediated controlled release formula to optimally provide the long term mucosal immunostimulation required for protective immunity. Based upon preliminary data, it is postulated that such vaccine delivery systems can be storage stable, administered orally or intranasally, and generally applicable to a number of agents.

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“…B. suis (4,6), B. abortus (3,6,8), and B. canis (30) have also been implicated, and transmission of the attenuated B. abortus 19 and B. melitensis Rev-1 vaccine strains has also been reported (31,32). …”

Section: The Organismmentioning

confidence: 99%

“…Patients involved in laboratory outbreaks of brucellosis have shown almost the entire range of clinical manifestations of the disease, ranging from the common prolonged febrile syndrome (undulant fever) (14) and a flulike disease (25,27), to focal signs and symptoms, such as hepatitis (17,33), lymphadenopathy (17,25), uveitis (14), breast abscess (28) epididymitis (29), arthritis (17), discitis (29,34), pneumonitis (17), deep vein thrombosis (29), and meningitis (31). Deaths are rare (<5%) even among untreated patients with brucellosis, but 5 fatal cases occurred among the 426 persons with laboratory-acquired disease summarized by Pike in 1978 (5).…”

Section: The Organismmentioning

confidence: 99%