Patients with Suspected Infection

The diagnosis of human brucellosis cannot be made solely on clinical symptoms, since:

• there are varying clinical manifestations
• initial symptoms are non-specific

However, physicians caring for febrile patients who live in – or have recently traveled to – an endemic country should consider that the patient could be infected with brucellosis.

Symptoms of brucellosis may occur anytime from 5 days to 5 months after initial exposure to Brucella species; symptoms may also disappear for weeks or motnhs only to return at a later date.

When taking a patient history, inquiring about activities related to risk factors can assist in more precisely assessing the risk of exposure.

Questions about risk factors may include:

• Do you work in a slaughterhouse or meat-packing environment?
• Have you recently traveled overseas? If so, where?
• While traveling, did you consume any undercooked meat or unpasteurized dairy products?
• Do you hunt? If so, have you come into contact with moose, elk, caribou, bison or wild hogs (feral swine)?
• Have you assisted animals giving birth?
• Do you work in a laboratory? If so, does the lab handle Brucella specimens?

Precautions

Brucella organisms are easily killed by common disinfectants and heat. Standard hospital approved disinfectants are adequate for cleaning patient rooms.

Since person-to-person transmission is rare, patients do not have to be held in isolation rooms. Healthcare workers should exercise standard precautions. Laboratory workers should take necessary precautions when working with Brucella species.