Laboratory-acquired Infections
A total of nine laboratory-acquired infection events were reported during the 2006–2016 period in China (Table. 1). Two events were observed in northern China (Beijing and Ningxia province), and the remaining seven events were found in southern China (Zhejiang, Jiangsu, Jiangxi, and Anhui provinces). Seven of them were microbiological technicians, and the other two were cleaners of a microbiology laboratory. The age range of the nine cases was 28–65, and the mean age of 45. Two were males, and seven were females. Five patients were infected by identifying or handling suspect Brucella strains, two by handling blood culture samples from patients with brucellosis, and the remaining individuals were infected while cleaning up the microbiology laboratory waste. All accidental infections occurred due to substandard laboratory safety conditions, manipulations outside biological safety cabinets, or inadequate personal protective equipment. Fever was the most common clinical manifestation among patients, who also suffered from fatigue, sweating, joint pain, and headache. Only one patient was suspected of brucellosis; seven cases were diagnosed with a fever of unknown origin, and one patient was diagnosed with inflammation of the psoas major muscle. Eight patients were first diagnosed with brucellosis by bacteriology test, and a serology test (SAT titer≥1:100) was used only in one case.
From March to May 2011, a total of 28 individuals (including 27 students and one teacher) were diagnosed with Brucella infections in the college of animal medicine of Northeast Agricultural University. The field epidemiology survey showed that the source of infection were four goats without the quarantine inspection that experimental animals require. In December 2010, teachers of the College of Animal Medicine of Northeast Agricultural University purchased four goats from a Qingxi farm, Jijia village, Xingfu Town, Xiangfang District, Harbin city. However, they did not follow the quarantine and inspection regulations on the management of experimental animals of the national and Heilongjiang Province. Subsequently, the four goats infected withBrucella were used for teaching experiments (obstetric experiment and animal anatomy experiment) five times, involving four teachers, two experimenters, and 110 students, resulting in the brucellosis infections in 27 students and one teacher in this college from March to May 2011. Based on a comprehensive survey and the analysis of the four goats, these animals (infected with brucellosis) were found to be the source of infection for these cases. Aerosols and contact with infected goats were the main route of transmission, and the failure to comply with the standard experimental norms and ensure that the students would follow the biosafety protection-operating procedures were the main reason for this cluster infection events. According to the unified prescription by the expert Committee on accident handling, the treatment consisted of intravenous doses of combined doxycycline, rifampin, and levofloxacin (or etoperidone sulbactam) for six weeks, followed by oral rifapentine and tetracycline for 40 days. Twenty-five patients were cured, one patient improved, and two patients still showed a small amount of effusion in the joint cavity by MRI.