A large exposure to Brucella melitensis in a diagnostic laboratory

Sam, I‐Ching; Karunakaran, Rina; A, Kamarulzaman; Ponnampalavanar, Sasheela; Omar, S.F. Syed; Ng, Kok Peng; Yusof, Mohd Yasim Mohd; Hooi, Poh Sim; Jafar, Faizatul Lela; AbuBakar, Sazaly

doi:10.1016/j.jhin.2011.12.004

Cited by 40 publications

(33 citation statements)

References 17 publications

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“…10 Despite efforts by DVS, several isolated cases of human brucellosis have been reported in the literature involving farmers, veterinarians, 11 and laboratory staff. 12,13 The occurrence of the disease is still low, however, as a study from 2004 to 2009 only found 10 (5.4%) of 184 suspected brucellosis cases to be seropositive. 11 Still, the true incidence of the disease could be higher as its nonspecific symptoms usually causes it to be underreported.…”

Section: Discussionmentioning

confidence: 99%

Outbreak of Human Brucellosis from Consumption of Raw Goats' Milk in Penang, Malaysia

Leong¹,

Chow²,

Wong³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. We report the largest outbreak of brucellosis in Penang, Malaysia. Brucellosis is not endemic in this region. The index case was a 45-year-old goat farm owner presented with 3 weeks of fever, headache, severe lethargy, poor appetite, and excessive sweating. He claimed to have consumed unpasteurized goat's milk that he had also sold to the public. Tests were negative for tropical diseases (i.e., dengue fever, malaria, leptospirosis and scrub typhus) and blood culture showed no growth. Based on epidemiological clues, Brucella serology was ordered and returned positive. Over a period of 1 year, 79 patients who had consumed milk bought from the same farm were diagnosed with brucellosis. Two of these patients were workers on the farm. Four laboratory staff had also contracted the disease presumably through handling of the blood samples. The mean duration from onset of symptoms to diagnosis was 53 days with a maximum duration of 210 days. A combination treatment of rifampin and doxycycline for 6 weeks was the first line of treatment in 90.5% of patients. One-third of the patients had sequelae after recovering and 21% had a relapse. We highlight the importance of Brucellosis as a differential diagnosis when a patient has unexplained chronic fever.

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Section: Discussionmentioning

confidence: 99%

Outbreak of Human Brucellosis from Consumption of Raw Goats' Milk in Penang, Malaysia

Leong¹,

Chow²,

Wong³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…Complete rpoB gene sequences from 56 globally distributed B. melitensis strains, including two human B. melitensis MY1483/09 (accession number: PRJEB7499) [14] and Phil1136/12 (accession number: PRJEB7504), were aligned. SNPs from the sequence alignment were identified and compared.…”

Section: Methodsmentioning

confidence: 99%

Geographical distribution of Brucella melitensis inferred from rpoB gene variation

Tan

Tan²,

Chang

et al. 2017

J Infect Dev Ctries

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Introduction: Currently available tests have limitations for the identification of Brucella species and strains, and their genetic lineage. The genome sequence of the rpoB gene encoding the β-subunit of DNA-dependent RNA polymerase was investigated for its use in genotyping Brucella melitensis. Methodology: Complete rpoB gene sequences of globally distributed Brucella melitensis strains were analyzed. Single nucleotides polymorphisms (SNPs) of the rpoB gene sequences were identified and used to type Brucella melitensis strains. Results: Six DNA polymorphisms were identified, of which two (nucleotides 3201 and 558) were novel. Analysis of the geographical distribution of the strains revealed a spatial clustering pattern with rpoB type 1 representing European and American strains, rpoB type 2 representing European, African, and Asian strains, rpoB type 3 representing Mediterranean strains, and rpoB type 4 representing African (C3201T) and European (C3201T/T558A) strains. Conclusions: We report the discovery of two novel SNPs of rpoB gene that can serve as useful markers for epidemiology and geographical tracking of B. melitensis.

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“…1 The incident was managed according to the US Centres for Disease Control and Prevention (CDC) guidelines, which are based on expert opinion as the evidence base is weak. 2 Like the UK, Malaysia is a non-endemic country for brucellosis.…”

Section: Madammentioning

confidence: 99%