| Yellowstone Bison Slaughter
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Article 3/13/05 |
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| On
the job (Undulant fever)
By Nadia White, Casper Star-Tribune
3/13/05 |
SYBILLE
CANYON -- For Walt Cook and Terry Kreeger, the
undulant fever experience started one day in May 1997,
as they helped a cow elk infected with brucellosis deliver
a stillborn calf at a research facility.
Come November, both men had inexplicable chills and fever.
Cook was stoved up with severe lower back pain. Kreeger
was so depressed he thought of cashing it in.
"I was almost suicidal," Kreeger recalled nearly
six years later from his home and work at Wyoming's wildlife
research center in Sybille Canyon. "I just wanted
to go away, give it all up, live in a yurt. I had no idea
it was the disease doing that."
Depression, along with rolling fevers, and various combinations
of headache, severe joint and muscle pain and swollen
internal and sexual organs are symptoms associated with
undulant fever, the human form of brucellosis.
Kreeger is the supervisor of veterinary research services
for the Wyoming Game and Fish Department. Cook is the
assistant state veterinarian. As practicing animal health
experts, Cook and Kreeger were in a group of people who
for many years were more likely to contract undulant fever
than other Americans.
Once brucellosis was a fairly common disease spread in
raw milk, but the uniform use of pasteurization in the
1950s made it less likely that the general public would
be exposed to the bacteria. As the number of new cases
of undulant fever dropped dramatically, what new infections
did occur were most likely to happen on the job. Meatpackers,
butchers and veterinarians were among those at risk.
In 1938, nine percent of more than 7,000 school children
in Kansas City had positive skin reaction tests to the
disease. In 1948, 18.5 percent of blood donors at the
University of Minnesota Hospitals showed signs of exposure
to the disease, according to a review of the literature
by Robert Wise, published by the Journal of the American
Medical Association.
Then came pasteurization.
A 1965 study found 846 rural people in Illinois tested
negative for exposure to the disease. But 17 percent of
1,315 veterinarians and 13 percent of 783 meatpackers
tested positive, according to Wise.
That trend of on-the-job exposure also shifted as intensive
efforts to test cattle and slaughter infected herds weeded
the bacteria out of America's cattle herds.
By the time Kreeger and Cook became infected, many fewer
workers were encountering the brucella bacteria on the
job. Kreeger and Cook's unusual work with infected wild
animals essentially stepped the men back in time.
"We got it the way people used to get it 50 years
ago," Cook said.
Knowing they were putting themselves at risk in helping
the cow elk calve, the men had worn the latest in protective
gear: face masks, Tyvek suits, gloves. That gear proved
no match for the billions of brucella bacteria that can
be released during a delivery.
"That stuff aerosolizes so well that it's really
easy to just inhale it," Cook said. "Without
knowing it, you've been exposed."
Despite their knowledge of the disease, it took the usually
hardy veterinarians a while to realize what was bringing
them down.
"It had been so long since I'd been exposed to it,
it just didn't click in my mind that I'd had undulating
fevers," Cook said.
Diagnosis is one of the challenges of brucellosis. Some
estimate as few as one in 10 cases is actually diagnosed.
In part, that is because its symptoms resemble other ailments
such as flu or chronic fatigue syndrome.
Recent journal articles have urged physicians to refamiliarize
themselves with the symptoms if they are treating recent
immigrants from areas where the disease is endemic: the
Middle East, Mediterranean countries, South America.
"There is a concern that this disease is largely
underdiagnosed and under reported (in the United States),"
wrote doctors John Sauret and Natalia Vilissova in 2002
in The Journal of the American Board of Family Practice.
"Human brucellosis affects all age-groups, and family
physicians are not well versed in recognizing and treating
this potentially life-threatening condition."
Once diagnosed, Kreeger and Cook were given a specific
course of antibiotic treatment. Both said they felt better
almost right away. Cook suffered a relapse as soon as
he finished that first course of antibiotics. A second
round, taken intravenously, seems to have kept the bacteria
at bay, he said.
On the run
Wildlife researchers such as Kreeger and Cook, along with
scientists who risk being exposed to the bacteria in the
lab, are a small group who remain at risk of catching
undulant fever on the job.
But for the U.S. population at large, pasteurization,
test-and-slaughter programs and new vaccines have essentially
eliminated the brucella bacteria from daily life. While
it may still appear in people or products coming from
affected parts of the world, brucellosis in the United
States is on the run.
Wyoming and the greater Yellowstone area is one of the
last places in the country where there is a ready reservoir
of brucella bacteria. The disease is found among elk,
especially those that use the feedgrounds in western Wyoming,
and among the bison of Yellowstone National Park.
While Wyoming officials have yet to come up with a practical
plan to eliminate brucellosis from its wildlife, the strategies
used to prevent commonplace exposure of people to the
disease nationwide have worked. The risk of exposure to
brucellosis today is a tiny fraction of what it once was.
"Brucellosis is going away," Kreeger said. "It's
disappearing in the United States. And it's going to go
away, except in our elk."
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