title: A Case-Study of Implementation of Improved Strategies for Prevention of Laboratory-acquired Brucellosis.
abstract: BACKGROUND
  In 2012, the Alaska Section of Epidemiology investigated personnel potentially exposed to a Brucella suis isolate as it transited through three laboratories.
  
  
  METHODS
  We summarize the first implementation of the United States Centers for Disease Control and Prevention 2013 revised recommendations for monitoring such exposures: (1) risk classification; (2) antimicrobial postexposure prophylaxis; (3) serologic monitoring; and (4) symptom surveillance.
  
  
  RESULTS
  Over 30 people were assessed for exposure and subsequently monitored for development of illness. No cases of laboratory-associated brucellosis occurred. Changes were made to gaps in laboratory biosafety practices that had been identified in the investigation.
  
  
  CONCLUSIONS
  Achieving full compliance for the precise schedule of serologic monitoring was challenging and resource intensive for the laboratory performing testing. More refined exposure assessments could inform decision making for follow-up to maximize likelihood of detecting persons at risk while not overtaxing resources.
authors.affiliation: Alaska Department of Health and Social Services, Division of Public Health, Anchorage, AK, USA.
authors.forename: Louisa J
authors.initials: LJ
authors.lastname: Castrodale
authors.affiliation: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Zoonotic and Emerging Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Anchorage, AK, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Raczniak
authors.affiliation: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Zoonotic and Emerging Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Anchorage, AK, USA.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Rudolph
authors.affiliation: Yukon-Kuskokwim Delta Regional Hospital, Bethel, AK, USA.
authors.forename: Lori
authors.initials: L
authors.lastname: Chikoyak
authors.affiliation: Yukon-Kuskokwim Delta Regional Hospital, Bethel, AK, USA.
authors.forename: Russell S
authors.initials: RS
authors.lastname: Cox
authors.affiliation: Alaska Department of Health and Social Services, Division of Public Health, Anchorage, AK, USA.
authors.forename: Tricia L
authors.initials: TL
authors.lastname: Franklin
authors.affiliation: Division of High-consequence Pathogens and Pathology, NCEZID, CDC, Atlanta, GA, USA.
authors.forename: Rita M
authors.initials: RM
authors.lastname: Traxler
authors.affiliation: Division of High-consequence Pathogens and Pathology, NCEZID, CDC, Atlanta, GA, USA.
authors.forename: Marta
authors.initials: M
authors.lastname: Guerra
keywords: Alaska; brucellosis; laboratory biosafety; laboratory-acquired infections; laboratory-associated brucellosis