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A Foodborne Outbreak of Brucellosis at a Police Station Cafeteria, Lima, Peru
Karina Román
Karina Román
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Rosa Castillo
Rosa Castillo
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Robert H. Gilman
Robert H. Gilman
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Maritza Calderón
Maritza Calderón
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Aldo Vivar
Aldo Vivar
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Manuel Céspedes
Manuel Céspedes
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Henk L. Smits
Henk L. Smits
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Paolo Meléndez
Paolo Meléndez
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Eduardo Gotuzzo
Eduardo Gotuzzo
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Humberto Guerra
Humberto Guerra
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Ryan C. Maves
Ryan C. Maves
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Michael A. Matthias
Michael A. Matthias
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Joseph M. Vinetz
Joseph M. Vinetz
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Mayuko Saito
Mayuko Saito
Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California
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Brucella melitensis is highly infectious for humans and can be transmitted to humans in a number of epidemiological contexts. Within the context of an ongoing brucellosis surveillance project, an outbreak at a Peruvian police officer cafeteria was discovered, which led to active surveillance (serology, blood culture) for additional cases among 49 police officers who had also eaten there. The cohort was followed up to 18 months regardless of treatment or symptoms. Active surveillance estimated the attack rate at 26.5% (13 of 49). Blood cultures from four cases were positive; these isolates were indistinguishable using multiple locus variable number tandem repeat analysis. This investigation indicates the importance of case tracking and active surveillance for brucellosis in the context of potential common source exposure. These results provide rationale for public health investigations of brucellosis index cases including the bioterrorism-related dissemination of Brucella.
Author Notes
Financial support: This study was funded by a Cooperative Agreement from the United States Public Health Service, National Institutes of Health, National Institute of Allergy and Infectious Diseases (U01AI075420).
Disclosure: R. Castillo is an employee of the U.S. Government and R. Maves is a military service member. This work was prepared as part of their official duties. Title 17 U.S.C. §105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person's official duties.
Authors' addresses: Karina Román and Maritza Calderón, Universidad Peruana Cayetano Heredia, Department of Microbiology, Faculty of Sciences and Philosophy, Lima, Perú, E-mails: karitaroman@gmail.com and mmcalderons@yahoo.es. Paolo Meléndez, A.B. PRISMA - Biomedical research unit, Lima, Peru, E-mail: dantepao@hotmail.com. Rosa Castillo, NAMRU-6, Microbiology, Lima, Perú, E-mail: Rosa.Castillo@med.navy.mil. Robert H. Gilman, Johns Hopkins University, International Health, Baltimore, MD, E-mail: rgilman@jhsph.edu. Aldo Vivar, Hospital Macional Arzobispo Loayza — Medicine, Lima, Perú, E-mail: avivar@prisma.org.pe. Manuel Céspedes, Instituto Nacional de Salud, Diagnostic Laboratories, Lima, Perú, E-mail: manuel.cespedesz@gmail.com. Henk L. Smits, Royal Tropical Institute, Kit Biomedical Research, Amsterdam, The Netherlands, E-mail: h.smits@kit.nl. Eduardo Gotuzzo and Humberto Guerra, Universidad Peruana Cayetano Heredia, Instituto de Medicine Tropical Alexander von Humboldt, Lima, Perú, E-mails: eduardo.gotuzzo@upch.pe and humberto.guerra@upch.pe. Ryan C. Maves, United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú, current affiliation: Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, CA, E-mail: Ryan.Maves@med.navy.mil. Michael A. Matthias, UC San Diego — Medicine, La Jolla, CA, E-mail: mmatthias@ucsd.edu. Joseph M. Vinetz, Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, CA, E-mail: jvinetz@ucsd.edu. Mayuko Saito, A.B. PRISMA — Biomedical Research Unit, Lima, Perú, and Universidad Peruana Cayetano Heredia — Department of Microbiology, Faculty of Sciences and Philosophy, Lima, Perú, and, Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, CA, E-mail: msaitop@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Pappas G, Akritidis N, Bosilkovski M, Tsianos E, 2005. Brucellosis. N Engl J Med 352: 2325–2336.
-
2.
Franco MP, Mulder M, Gilman RH, Smits HL, 2007. Human brucellosis. Lancet Infect Dis 7: 775–786.
-
3.
Singh K, 2009. Laboratory-acquired infections. Clin Infect Dis 49: 142–147.
-
4.
Yagupsky P, Baron EJ, 2005. Laboratory exposures to brucellae and implications for bioterrorism. Emerg Infect Dis 11: 1180–1185.
-
5.
Castell Monsalve J, Gutierrez Avila G, Ruiz Valdepenas MA, 2009. Three outbreaks of brucellosis in a one-year period investigated by the occupational health service in Ciudad Real (Spain). Gac Sanit 23: 562–563.
-
6.
Castell Monsalve J, Rullan JV, Peiro Callizo EF, Nieto-Sandoval Alcolea A, 1996. Epidemic outbreak of 81 cases of brucellosis following the consumption of fresh cheese without pasteurization. Rev Esp Salud Publica 70: 303–311.
-
7.
Luna Sanchez A, Rodriguez de Cepeda A, Suarez Morano T, 1998. Analysis of a disease outbreak of brucellosis in slaughterhouse workers. Rev Esp Salud Publica 72: 137–146.
-
8.
Fiori PL, Mastrandrea S, Rappelli P, Cappuccinelli P, 2000. Brucella abortus infection acquired in microbiology laboratories. J Clin Microbiol 38: 2005–2006.
-
9.
Staszkiewicz J, Lewis CM, Colville J, Zervos M, Band J, 1991. Outbreak of Brucella melitensis among microbiology laboratory workers in a community hospital. J Clin Microbiol 29: 287–290.
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