In a follow-up to a Brucella case reported in Texas last month, the Centers for Disease Control and Prevention (CDC) issued a Health Advisory concerning the investigation.
The strain has been identified as Brucella RB51, a rifampin and penicillin resistant strain.
Federal health officials write:
A person who drank raw milk from K-Bar Dairy in Paradise, Texas, has been hospitalized with brucellosis. Milk samples from the dairy have tested positive for a Brucella strain called RB51. People who consumed milk or milk products from this dairy from June 1, 2017, to August 7, 2017 are at an increased risk for brucellosis and should receive appropriate post-exposure prophylaxis (PEP). They are advised to consult with their health care providers regarding PEP care and possible diagnostic testing.
Concerning culture and treatment, the CDC says:
A combination of doxycycline and trimethoprim/sulfamethoxazole for 21 days is the recommended first-line PEP regimen for RB51 exposure. There is no serological test available to detect RB51 infection. Blood culture is the recommended diagnostic test for exposed symptomatic individuals. When ordering blood cultures to diagnose brucellosis, please advise the laboratory that blood culture may grow Brucella and that appropriate laboratory precautions should be observed. If brucellosis occurs despite prophylaxis, treatment regimens should be selected based on antimicrobial susceptibility results.
Brucella can cause a range of symptoms including fever, sweats, headache, muscle and joint pain, loss of appetite and fatigue. Symptoms can persist for a long time or may come and go repeatedly. Less common symptoms include inflammation of the heart, swelling of the liver and spleen, neurologic symptoms, and in pregnant women, miscarriage. Pregnant women, very young children, older adults and people with suppressed immune systems are at an increased risk of serious illness due to Brucella.
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