Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Brucellosis is an infectious disease caused by bacteria termed Brucella; the disease is found mainly in animals (zoonotic infection), but humans can be infected with these bacteria.
Brucellosis has been described as long as 2,000 years ago, and the organisms finally were identified in 1887; the disease is worldwide and usually confined to animals. Because the bacteria can be aerosolized, it has been designated as a potential biologic weapon.
Brucellosis is caused by Brucella strains that can infect humans through cuts in the skin, through mucous membranes, by inhalation and by eating contaminated meat or other animal-derived foods; the bacteria can survive inside human cells and spread to many different organs.
Risk factors include drinking unpasteurized milk, eating unpasteurized cheese, and close association with animals (farmers, veterinarians) and with hunters and meat processors.
Brucellosis is spread to humans by milk, meat, or cheese that is obtained from infected animals; human person-to-person spread is very rare.
Early symptoms of brucellosis include fever, fatigue, sweating, pain in the muscles and joints, pain in the back, and/or loss of appetite; over time, fevers may become recurrent, organ damage may occur (organ swelling), and skin changes such as rashes and/or micro-abscesses may form.
Brucellosis is preliminarily diagnosed by the patient's history and physical exam and definitively diagnosed by culturing bacteria from the patient. Blood tests are also available to show antibodies to the infection.
Treatment is usually done with a combination of doxycycline (Vibramycin, Oracea, Adoxa, Atridox) and rifampin (Rifadin) for an extended period (about six to eight weeks).
The prognosis of brucellosis that is treated early and effectively is very good; however, if the disease progresses to cause organ damage, the prognosis worsens.
Prevention of brucellosis is possible by avoiding contact with infected animals and utilizing pasteurized milk and cheese products; if contact is necessary, wearing gloves and a facemask may reduce the chance of getting brucellosis.
A vaccine is available for animals to protect them from brucellosis; there is no vaccine available for humans.
What are the biological agents that can be utilized for bioterrorism?
While any germ, bacteria, or virus could potentially be utilized by terrorist, there are a number of biological agents that have been recognized as being more likely to be utilized. The reason for these agents being of concern is based on their availability to terrorists and the ease by which these agents can be disseminated.
There are many causes of chest pain, and while many are not serious, it may be difficult to distinguish among heart attack, pulmonary embolus or aortic dissection, and another diagnosis that is not life-threateni"...