title: Human brucellosis outbreak acquired through camel milk ingestion in southern Israel.
abstract: BACKGROUND
  Human brucellosis is common in southern Israel among the semi-nomadic Bedouin, a population that consumes unpasteurized dairy products. Though camel milk ingestion is a known mechanism for brucellosis acquisition, only a few reports of sporadic cases have been published in the medical literature.
  
  
  OBJECTIVE
  To describe a local brucellosis outbreak in 15 extended Bedouin family members, following ingestion of infected camel milk.
  
  
  METHODS
  Data regarding patient's clinical manifestations, laboratory findings, treatment and outcome were collected from the hospital and the health fund clinics' computerized database. Camel's blood and milk were tested for Brucella serology and culture. Cases were defined by positive Rose Bengal test, symptoms correlating with brucellosis, and consumption of infected camel milk.
  
  
  RESULTS
  Fifteen patients were diagnosed with acute brucellosis from March to June 2011. Sixty percent of cases had serum agglutination test titers of 1:160 or higher and 4/8 (50%) had positive blood culture for Brucella melitensis. Arthralgia and fever were the most consistent clinical manifestations. Blood and milk serology and milk culture taken from the female camel were positive for Brucella melitensis.
  
  
  CONCLUSIONS
  The treating physicians must consider the possibility of infected camel milk ingestion as the mode of infection, both in sporadic cases and in outbreaks of brucellosis.
authors.affiliation: Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel shalomb2@clalit.org.il
authors.forename: Shalom Ben
authors.initials: SB
authors.lastname: Shimol
authors.forename: Larissa
authors.initials: L
authors.lastname: Dukhan
authors.forename: Ilana
authors.initials: I
authors.lastname: Belmaker
authors.forename: Svetlana
authors.initials: S
authors.lastname: Bardenstein
authors.forename: David
authors.initials: D
authors.lastname: Sibirsky
authors.forename: Chiya
authors.initials: C
authors.lastname: Barrett
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000818:Animals; D018912:Arabs; D002006:Brucellosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission*; D002162:Camelus / Q000382:microbiology*; D002648:Child; D004196:Disease Outbreaks; D005260:Female; D005516:Food Microbiology; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000382:microbiology