{"id":10382,"date":"2025-03-01T14:07:50","date_gmt":"2025-03-01T19:07:50","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan407\/"},"modified":"2025-03-02T00:54:34","modified_gmt":"2025-03-02T05:54:34","slug":"dhan407","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan407\/","title":{"rendered":"php\/alerts\/dhan407 ~  Division of Public Health  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n\n\n  <br>\n\n\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n\n    <!-- BEGIN readspeaker div -->\n\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan407.html\" title=\"Listen to this page using ReadSpeaker\">\n\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n\n      <\/a>\n\n\n    <\/div>\n\n\n    <!-- END readspeaker div -->\n\n\n\n\n\n    \n\n\n    <header class=\"pull-left\">\n\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->407 <!--[END]--> <\/h1>\n\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->June 13, 2019 2:13 pm <!--[END]--> <\/h2>\n\n\n    <\/header>\n\n\n  <\/div><br>\n\n\n \n\n\n  <div class=\"container\">\n\n\n    <div class=\"row\">\n\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n\n          <div class=\"panel sectionmenu_panel\">\n\n\n            <div class=\"panel-heading\">\n\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n\n            <\/div>\n\n\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; 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Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; 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Two cases have \n\n\n\n\n\nbeen identified (one confirmed and one suspected) in Delaware from late May to early June 2019.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Summary<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<p>From late May 2019 to early June 2019, two cases of brucellosis (one confirmed and one suspected) have been \n\n\n\n\n\nidentified in Delaware. These cases involve individuals from two separate households (familiar to each other), \n\n\n\n\n\nwho consumed homemade unpasteurized dairy products from Mexico. The products were gifts, not purchased locally.\n\n\n\n\n\nThe first case was identified as <em>B. melitensis<\/em> by the Centers for Disease Control and Prevention (CDC). \n\n\n\n\n\nSpecies identification of the second case is currently pending by the CDC. The principal hosts for <em>B. melitensis<\/em>\n\n\n\n\n\nare goats and sheep. This strain is also most pathogenic in humans and is most commonly related to consumption of \n\n\n\n\n\nunpasteurized dairy products from countries where the disease is present. Brucellosis is not common in the United States. \n\n\n\n\n\nPrior to these cases, in Delaware, DPH confirmed three cases since 2010 \u2013 one each in 2010, 2017, and 2018. \n\n\n\n\n\nThe case in 2010 was associated with consumption of unpasteurized milk while the nature of exposure in the 2017 and \n\n\n\n\n\n2018 cases is unknown.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Background<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<p>Brucellosis is a bacterial infection caused by contact with infected animals or contaminated animal products. \n\n\n\n\n\nInfection is most commonly transmitted by eating or drinking unpasteurized\/raw dairy products. Person-to-person \n\n\n\n\n\nspread of brucellosis is extremely rare. Infected mothers who are breast-feeding may transmit the infection to their \n\n\n\n\n\ninfants. Sexual transmission has been rarely reported. While uncommon, transmission may also occur via tissue \n\n\n\n\n\ntransplantation or blood transfusions.<\/p>\n\n\n\n\n\n<p>Symptoms of brucellosis include fever, sweats, malaise, anorexia, headache, fatigue, and muscle and joint pain. \n\n\n\n\n\nMore serious presentations can include endocarditis, hepatomegaly, splenomegaly, and neurologic symptoms. In \n\n\n\n\n\npregnant women, <em>Brucella<\/em> infections can be associated with miscarriage.<\/p>\n\n\n\n\n\n<p>Symptom onset can occur anywhere from five days to six months following exposure.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Recommendations for Patients with Suspected Infection<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<p>Health care providers caring for febrile patients who live in, or have recently traveled to, a country where \n\n\n\n\n\nbrucellosis is endemic should consider brucellosis among their differential diagnoses. It is also important to \n\n\n\n\n\ninquire about activities related to risk factors to more precisely assess the risk of exposure. Questions about \n\n\n\n\n\nrisk factors may include:<\/p>\n\n\n\n\n\n<ul>\n\n\n\n\n\n\n\n\n\n\n\n<li>\u00a0Travel history \u2013 a list of countries where there is an increased risk of brucellosis can be found \n\n\n\n\n\nhere: <a href=\"https:\/\/www.cdc.gov\/brucellosis\/exposure\/areas.html\">https:\/\/www.cdc.gov\/brucellosis\/exposure\/areas.html<\/a><\/li>\n\n\n\n\n\n<li>\u00a0Consumption of unpasteurized dairy products or undercooked meat<\/li>\n\n\n\n\n\n<li>\u00a0Occupational or recreational exposures such as working in a laboratory, work in a slaughterhouse or \n\n\n\n\n\nmeatpacking industry, hunting and assisting animals with the birthing process.<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Diagnosis<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<p>Isolation and identification of <em>Brucella<\/em> can confirm a diagnosis of brucellosis. <em>Brucella<\/em> is \n\n\n\n\n\nmost commonly isolated from blood cultures.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>When sending specimens to a laboratory for culture and isolation, be sure the laboratory is aware of your suspected \n\n\n\n\n\ndiagnosis. Breathing in the bacteria that causes brucellosis may also lead to infection. This risk is generally greater \n\n\n\n\n\nfor people in laboratories that work with the bacteria.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Treatment<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<p>Generally, doxycycline and rifampin are recommended in combination for a minimum of six to eight weeks for confirmed \n\n\n\n\n\ncases of brucellosis.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Reporting<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<p>Brucellosis is a reportable disease in Delaware. All Delaware health care providers and laboratories are required by \n\n\n\n\n\nregulation to report patients with known or suspected brucellosis.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>How to Report<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<p>Immediately contact the DPH Office of Infectious Disease Epidemiology (888-295-5156, 24\/7) of any known or suspected \n\n\n\n\n\nbrucellosis case.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Additional Information<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<p>CDC: <a href=\"https:\/\/www.cdc.gov\/brucellosis\/index.html\">https:\/\/www.cdc.gov\/brucellosis\/index.html<\/a><\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>************************************<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n\n\n\nIf you are not a member and would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a><\/p><!--[END]-->\n\n\n  \n\n\n        <div class=\"panel panel-danger\">\n\n\n          <div class=\"panel-heading\">    \n\n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n\n       <\/div>\n\n\n       <div class=\"panel-body\">\n\n\n      <ul>\n\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n\n            <\/ul>\n\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n\n          <\/div> \n\n\n        <\/div><br>  \n\n\n\n\n\n      <\/div>\n\n\n    <\/div>\n\n\n  <\/div><!-- \/container -->\n\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #407 June 13, 2019 2:13 pm Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10382","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10382","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10382"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10382\/revisions"}],"predecessor-version":[{"id":11558,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10382\/revisions\/11558"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10382"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}