COCA Now: People in Four States May Be Drinking Contaminated Raw Milk

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People in Four States May Be Drinking Contaminated Raw Milk


Summary

The Centers for Disease Control and Prevention is warning people in the states of Connecticut, New Jersey, New York and Rhode Island, who might have consumed contaminated raw milk and milk products to visit their doctor. People who drank raw milk from a company called Udder Milk may have been infected with a potentially serious germ called Brucella abortus RB51 and are at high risk for brucellosis infection.

The U.S. Department of Agriculture and the U.S. Food and Drug Administration are working with state health and agriculture officials to trace the source of the contaminated raw milk and raw milk products. Read the FDA alert here.

Health care providers should administer post-exposure prophylaxis (PEP) to patients who drank the contaminated raw milk to avoid infection.

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Symptoms of Brucellosis

Milk

Brucellosis can cause a range of signs and symptoms, some of which may present for prolonged periods of time.

Initial symptoms can include fever, sweats, headaches, anorexia, fatigue, pain in joints and muscles, and malaise.

Some signs and symptoms may persist for longer periods of time. Others may never go away or reoccur. These include recurrent fevers, arthritis, swelling of the testicle and scrotum area, swelling of the heart (endocarditis), neurologic symptoms, chronic fatigue, and depression.

Information for Healthcare Providers

Brucella

The diagnosis of human brucellosis cannot be made solely on clinical symptoms, since there are varying clinical manifestations and initial symptoms are non-specific.

When taking a patient history, inquiring about activities related to risk factors can assist in more precisely assessing the risk of exposure.

PEP for RB51 should include:

  • Doxycycline, in addition to trimethoprim-sulfamethoxazole or another suitable antimicrobial, for 21 days

Prophylaxis for exposure to Brucella species other than RB51 routinely consists of a combination of doxycycline and rifampin. RB51, however, is resistant to rifampin in vitro and to penicillin, so rifampin and penicillin are not recommended.

Symptom Monitoring:

Routine serologic tests for brucellosis are not effective for diagnosing or monitoring RB51 infections. Monitoring should include:

  • For 4 weeks from last exposure, check temperature for fever
  • For 6 months from last exposure, watch for broader symptoms of brucellosis

If brucellosis occurs despite prophylaxis, treatment regimens should be selected based on antimicrobial susceptibility results.

Additional Information


The Emergency Risk Communication Branch in the Division of Emergency Operations, Office of Public Health Preparedness and Response is responsible for the management of all COCA products.

For information about this update or other clinical issues, or to send your feedback, please contact us at coca@cdc.gov

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