Maximum incubation period: 6 months (24 weeks)
Tasks:
(1) Determine the person's risk of exposure (high, low or none, as listed in Chapter 26).
(2) Offer appropriate antibiotic prophylaxis at any time during the incubation period (the sooner the better). It is strongly recommended for those with a high risk exposure.
(3) Perform active surveillance to detect any febrile illness.
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Antibiotic Selection
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species other than B. abortus RB51
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B. abortus RB51
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first choice
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doxycycline and rifampin
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doxycycline
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second choice
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trimethoprim (TMP)- sulfamethoxazole (SMX)
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trimethoprim- sulfamethoxazole
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where:
• Brucella abortus strain RB51 (animal vaccine strain) is resistant to rifampin.
• Dose of doxycycline is 100 mg po bid for 3 weeks.
• Dose of rifampin is 600 mg qd po for 3 weeks.
• Dose of TMP.SMX (Bactrim) is 160 mg TMP with 800 mg SMX (presumably po qid for 3 weeks). The interval of 3 weeks is half of the 6 weeks used for active infection.
• A pregnant woman should consult with her obstetrician to decide what therapy to use since doxycycline and TMP-SMX are not recommended during pregnancy.
• Prior exposure to brucellosis or other source of immunity to a new infection was not considered.
Surveillance:
(1) Determine baseline serologic titer to Brucella species involved (an exception is B. abortus strain RB51 which is not detected by available assays)
(2) Test all exposed workers for serologic response at 2, 4, 6 and 24 weeks after the exposure (exception B. abortus strain RB51).
(3) Monitor all patients for febrile illness for 6 months (24 weeks) after the exposure.
