Investigation of Animal Care Workers Exposed to Marine Mammal Brucella Species
IAAAM 2013
Deborah A. Fauquier1*; Marta A. Guerra2; Kathryn Arden3; Caroline Banis3; Michelle M. Barbieri1; Michelle Berman4; Catherine Brown5; Kathleen M. Colegrove6; Barun K. De2; Joe L. Elm Jr.7; Ruth Y. Ewing8; Julie A. Gabel9; R. Clay George10; Frances Gulland11; Craig Harms12; Marilyn Haskell13; Grishma A. Kharod2; Margaret Lynott14; Wayne McFee15; William McLellan16; Jael Miller17; Demetrius L. Mathis2; Michael Moore18,20; Meredith G. Morrow2; Julia Murphy19; Misty Neimeyer20; Ann Pabst16; Sarah Y. Park7; Christine R. Quance21; Michael W. Rikard22; Keith A. Rittmaster23; Susan Rollo17; David S. Rotstein24; Danielle Stanek25; Robyn A. Stoddard2; Larry D. Stover26; Karen A. Terio6; Vicky G. Thayer27; Rebekah V. Tiller2; Kristi West28; Heidi Whitehead29; Carl Williams13; Qingzhong Wu30; and Teresa K. Rowles1
1Marine Mammal Health and Stranding Response Program, National Marine Fisheries Service, National Oceanic Atmospheric Administration, Silver Spring, Maryland, 20910, USA; 2Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, 30333, USA; 3South Carolina Department of Health and Environmental Control, North Charleston, South Carolina, 29405, USA; 4Santa Barbara Museum of Natural History, Santa Barbara, California, 93105, USA; 5Massachusetts Department of Public Health, Jamaica Plain, Massachusetts, 02130, USA; 6Zoological Pathology Program, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, 61802, USA; 7Hawaii Department of Health, Honolulu, Hawaii, 96813, USA; 8Southeast Fisheries Science Center, National Marine Fisheries Service, National Oceanic Atmospheric Administration, Miami, Florida, 33149, USA; 9Georgia Department of Public Health, Atlanta, Georgia, 30303, USA; 10Georgia Department of Natural Resources, Brunswick, Georgia, 31520, USA; 11The Marine Mammal Center, Sausalito, California, 94965, USA; 12College of Veterinary Medicine, North Carolina State University, Morehead City, North Carolina, 28557, USA; 13North Carolina Division of Public Health, Raleigh, North Carolina, 27699, USA; 14Virginia Aquarium, Virginia Beach, Virginia, 23451, USA; 15Center for Coastal Environmental Health and Biomolecular Research, National Centers for Coastal Ocean Science, National Ocean Service, National Oceanic Atmospheric Administration, Charleston, South Carolina, 29412, USA Science Serving Coastal Communities; 16University of North Carolina Wilmington, Wilmington, North Carolina, 28403, USA; 17Texas Department of State Health Services, Houston, Texas, 77023, USA; 18Biology Department, Woods Hole Oceanographic Institution, Woods Hole, Massachusetts, 02543, USA; 19Virginia Department of Health, Richmond, Virginia, 23219, USA; 20International Fund for Animal Welfare, Falmouth, Massachusetts, 02675, USA; 21National Veterinary Services Laboratories, Animal and Plant Health Inspection Service, United States Department of Agriculture, Ames, Iowa, 50010, USA; 22Cape Lookout National Seashore, Harkers Island, North Carolina, 28531, USA; 23North Carolina Maritime Museum, Beaufort, North Carolina, 28516, USA; 24Marine Mammal Pathology Services, Olney, Maryland, 20832,USA; 25Florida Department of Health, Tallahassee, Florida 32399, USA; 26Fort Macon State Park, Atlantic Beach, North Carolina, 28512, USA; 27North Carolina Division of Marine Fisheries, Morehead City, North Carolina, 28557, USA; 28Hawaii Pacific University, Kaneohe, Hawaii, 96744, USA; 29Texas Marine Mammal Stranding Network, Galveston, Texas, 77551, USA; 30Hollings Marine Laboratory, National Ocean Service, National Oceanic Atmospheric Administration, Charleston, South Carolina, 29412, USA
Abstract
Brucella bacteria species have been documented in the marine environment since the mid-1990s, and exposure to Brucella has been documented globally in numerous marine mammal species.4 Sporadic cases of brucellosis have been reported in cetaceans housed in display or rehabilitation facilities and in the wild.3,4 Manifestations of infection in cetaceans include late-term abortions, meningoencephalitis, pneumonia, orchitis, and osteomyelitis. The impact of Brucella on marine mammal populations is currently unknown.
Since late 2011, the National Marine Fisheries Service (NMFS), in cooperation with the National Marine Mammal Stranding Network, have tested numerous samples from coastal US populations of cetaceans and have identified 33 animals positive for marine Brucella (by culture and/or PCR), some with clinical signs of brucellosis. These positive animals, found in the Pacific and Atlantic Oceans as well as the Gulf of Mexico, consisted of four different small cetacean species, including bottlenose dolphins (Tursiops truncatus), common dolphins (Delphinus delphis), harbor porpoises (Phocoena phocoena), and striped dolphins (Stenella coeruleoalba). Bottlenose dolphins were the most commonly affected species of this group.
Marine-associated brucellosis in humans has not been documented in the US but has been found in four human cases worldwide.1,2,6 One individual was exposed in a laboratory while handling samples from an infected dolphin.1 The other three individuals reported no contact with marine mammals but consumed raw fish or shellfish.2,6 Recently, marine mammal workers were exposed to a Brucella positive porpoise at necropsy but no subsequent illness was reported.5
Due to the unknown risk that marine Brucella poses to marine mammal workers, the NMFS Marine Mammal Health and Stranding Response Program (MMHSRP) is currently working with the Centers for Disease Control and Prevention (CDC) and state public health officials to assess the exposure of stranding network personnel to positive Brucella animals throughout the US. The CDC is also working with the state and local health departments in eight states to contact workers and veterinarians potentially exposed to marine Brucella species while rescuing, rehabilitating, treating, and performing necropsies on infected marine mammals. Persons at risk were interviewed to obtain information on dates of exposure, work performed with marine mammals, and types of personal protective equipment worn. Individuals classified as being exposed submitted serum samples for testing using the Brucella microagglutination test (BMAT), performed at the CDC. Persons classified as high-risk took recommended antibiotic post-exposure prophylaxis (PEP) treatment consisting of a 3-week course of doxycycline and rifampicin.
Currently, over 60 questionnaires have been administered, 43 persons have submitted serum samples for BMAT testing, and 19 persons have received PEP treatment. Although the investigation is still proceeding, to date there is a lack of seropositivity among marine mammal workers who have been tested, and no evidence of illness with symptoms compatible with brucellosis has emerged. Preliminary findings suggest that personal protective equipment (PPE) as laid out in the MMHSRP guidelines and Sears et al. (2012)5 may be appropriate to protect against exposure to marine Brucella. Additionally, marine mammal Brucella species may not be readily transmissible to marine mammal workers in non-laboratory settings.
* Presenting author
Literature Cited
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