[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-detail-458900-en":59,"doc-seo-458900-105":80},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":5,"data":60},{"doc_id":61,"user_id":62,"nickname":63,"user_avatar":64,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":66,"doc_content":67,"file_id":68,"file_url":69,"file_type":70,"file_size":71,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":72,"language_code":73,"site_id":74,"html_lang":73,"table_of_contents":75,"faqs":76,"seo_title":77,"seo_description":66,"update_tm":78,"read_time":79,"preview_page_count":4},458900,962090760608,"Indoniesian Boy","https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Intraoperative Transmission of Brucellae - Comment Letter","Letter addressing intraoperative transmission of Brucella melitensis, responding to a recent report of infection acquired by an orthopedic surgeon during spinal irrigation. The author summarizes rarity yet describes relevant exposure conditions, noting low inhaled infectious doses and entry via respiratory tract and conjunctiva. Emphasizes that low organism counts in specimens limit hazard, while risk rises sharply after bacteriologic media incubation. Highlights aerosol generation, high-risk procedures, and inconsistent mask or goggles use, and discusses missing reports in developing regions due to surveillance gaps.","COMMENT LETTER  \nIntraoperative Transmission of Brucellae  \nPablo Yagupsky  \nAuthor affiliation: Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel  \nDOI: [https://doi.org/10.3201/eid3112.251518](https://doi.org/10.3201/eid3112.251518)  \nTo the Editor: In a recent article, I. Potparić et al. described transmission of Brucella melitensis to an orthopedic surgeon during the irrigation of a spinal infection (1) . Although rare, transmission of B. melitensis from patients to the surgical staff has been reported (1–5) .  \nA low inhaled infective dose (102 bacteria) characterizes brucellae, and the organism may enter the human body through the respiratory tract and conjunctivae, representing the most common agents of laboratory-acquired infections (2) . Because the concentration of brucellae in body fluids and tissues is low, unseeded biologic specimens are not considered to pose a substantial transmission hazard. However, the risk of contagion increases exponentially after incubation of bacteriologic media. Thus, cultures of presumptive Brucella species bacteria should be processed in biologic safety cabinets (2) . Physicians who care for patients with brucellosis, however, are not deemed to be at an increased risk because person-toperson transmission of the disease is extremely uncommon (3,4) .  \nThe reported events of intraoperative acquisition of the disease show common factors. The possibility of brucellosis in the patient was not suspected or contemplated, even when the patient was from an endemic region (1–4); the cases involved high-risk procedures, such as unprotected bone drilling and  \nirrigation, or aspiration of respiratory secretions (1,3,4); the surgical procedure created aerosol clouds, or massive spillage of blood, amniotic fluid, or both (3,4); or the medical staff did not consistently wear face masks or goggles (2) .  \nOf note, the 5 published events occurred in nonendemic countries that have advanced medical and laboratory diagnostic capabilities. In contrast, accounts from developing countries, where the zoonosis is rampant, are absent. We presume that lack of adequate epidemiologic surveillance and reporting, and the assumption that the disease was acquired outside the hospital, could be responsible for the missing reports.  \nReferences  \n1. Potparić I, Bošnjak K, Avberšek J, Papić B, Bogovič P, Vodičar PM, et al. Investigation of possible intraoperative transmission of Brucella melitensis, Slovenia. Emerg Infect Dis. 2025;31:2034–7. [https://doi.org/10.3201/](https://doi.org/10.3201/)[ ](https://doi.org/10.3201/)[eid3110.250587](eid3110.250587)  \n2. Lowe CF, Showler AJ, Perera S, McIntyre S, Qureshi R, Patel SN, et al. Hospital-associated transmission of Brucella melitensis outside the laboratory. Emerg Infect Dis. 2015;21:150–2. [https://doi.org/10.3201/eid2101.141247](https://doi.org/10.3201/eid2101.141247)  \n3. Mesner O, Riesenberg K, Biliar N, Borstein E, Bouhnik L, Peled N, et al. The many faces of human-to-human transmission of brucellosis: congenital infection and outbreak of nosocomial disease related to an unrecognized clinical case. Clin Infect Dis. 2007;45:e135–40 . [https://doi.org/10.1086/523726](https://doi.org/10.1086/523726)  \n4. Poulou A, Markou F, Xipolitos I, Skandalakis PN. A rare case of Brucella melitensis infection in an obstetrician during the delivery of a transplacentally infected infant. J Infect. 2006;53:e39–41. [https://doi.org/10.1016/j.jinf.2005.09.004](https://doi.org/10.1016/j.jinf.2005.09.004)  \n[5](5). Kiel FW, Khan MY. Brucellosis among hospital employees in Saudi Arabia. Infect Control Hosp Epidemiol. 1993;14:268–  \n72. [https://doi.org/10.1086/646733](https://doi.org/10.1086/646733)  \nAddress for correspondence: Pablo Yagupsky, Clinical Microbiology Laboratory, Soroka University Medical Center, Shderot Reger, Beer  \nSheva 84101, Israel; [email: pyagupsky@gmail.com](email: pyagupsky@gmail.com)  \n2346 Emerging Infectious Diseases • [www.","cbCaihefttbscm7k","https://ap.wps.com/l/cbCaihefttbscm7k","pdf",203390,"English","en",105,"# Letter Content\n## Transmission context and exposure routes\n## Risk factors during surgery and laboratory processing\n## Epidemiologic reporting gaps and conclusions","[{\"question\":\"Why is intraoperative transmission of brucellae considered rare?\",\"answer\":\"The letter notes that person-to-person transmission is extremely uncommon and that unseeded biologic specimens generally do not pose a substantial transmission hazard due to low concentrations.\"},{\"question\":\"What factors increased the risk of transmission during surgery?\",\"answer\":\"Reported cases involved high-risk procedures such as unprotected bone drilling and irrigation or aspiration of respiratory secretions, with aerosol clouds or massive blood/amniotic fluid spillage, and inconsistent use of face masks or goggles.\"},{\"question\":\"How do laboratory handling and incubation affect transmission risk?\",\"answer\":\"Risk increases exponentially after incubation of bacteriologic media; therefore, cultures of presumptive Brucella species should be processed in biologic safety cabinets.\"}]","Intraoperative Transmission of Brucellae - Comment Letter | PDF",1790754716,3,{"code":4,"msg":81,"data":82},"ok",{"site_id":74,"language":73,"slug":83,"title":65,"keywords":84,"description":66,"schema_data":85,"social_meta":138,"head_meta":140,"extra_data":142,"updated_unix":78},"intraoperative-transmission-of-brucellae-comment-letter","",{"@graph":86,"@context":137},[87,100,120],{"@type":88,"itemListElement":89},"BreadcrumbList",[90,94,96,98],{"item":91,"name":92,"@type":93,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":95,"name":9,"@type":93,"position":14},"https://docshare.wps.com/document/",{"item":97,"name":35,"@type":93,"position":79},"https://docshare.wps.com/document/healthcare/",{"item":99,"name":65,"@type":93,"position":19},"https://docshare.wps.com/document/intraoperative-transmission-of-brucellae-comment-letter/458900/",{"url":99,"name":65,"@type":101,"image":102,"author":107,"headline":65,"publisher":109,"fileFormat":112,"inLanguage":73,"description":66,"dateModified":113,"datePublished":114,"encodingFormat":112,"isAccessibleForFree":115,"interactionStatistic":116},"DigitalDocument",{"url":103,"@type":104,"width":105,"height":106},"https://docshare.wps.com/thumbnails/intraoperative-transmission-of-brucellae-comment-letter/458900.png","ImageObject",300,407,{"name":63,"@type":108},"Person",{"url":91,"name":110,"@type":111},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":117,"interactionType":118,"userInteractionCount":14},"InteractionCounter",{"@type":119},"ViewAction",{"@type":121,"mainEntity":122},"FAQPage",[123,129,133],{"name":124,"@type":125,"acceptedAnswer":126},"Why is intraoperative transmission of brucellae considered rare?","Question",{"text":127,"@type":128},"The letter notes that person-to-person transmission is extremely uncommon and that unseeded biologic specimens generally do not pose a substantial transmission hazard due to low concentrations.","Answer",{"name":130,"@type":125,"acceptedAnswer":131},"What factors increased the risk of transmission during surgery?",{"text":132,"@type":128},"Reported cases involved high-risk procedures such as unprotected bone drilling and irrigation or aspiration of respiratory secretions, with aerosol clouds or massive blood/amniotic fluid spillage, and inconsistent use of face masks or goggles.",{"name":134,"@type":125,"acceptedAnswer":135},"How do laboratory handling and incubation affect transmission risk?",{"text":136,"@type":128},"Risk increases exponentially after incubation of bacteriologic media; therefore, cultures of presumptive Brucella species should be processed in biologic safety cabinets.","https://schema.org",{"og:url":99,"og:type":139,"og:title":65,"og:site_name":110,"og:description":66},"article",{"robots":141,"canonical":99},"index,follow",{"doc_id":61,"site_id":74}]