Researchers have provided details on a Brucellosis outbreak in Israel linked to commercially sold, unregulated camel milk.

Brucella infection traced to a single brand of unpasteurized, raw camel milk was diagnosed in 19 patients during a four-month period.

From July to November 2016, the Israeli Ministry of Health noted an increase in brucellosis cases in non-Arab patients in central and northern parts of the country, according to the study published in Emerging Infectious Diseases.

The suspected vendor got milk from a Bedouin camel farm in southern Israel. A total of four female camels had positive serologic test results for Brucella. Scientists sampled six bottles of camel milk from a natural food store carrying the suspected brand and recovered a few colonies of Brucella melitensis from three bottles. They were bought on a single day and represented just one batch.

The outbreak resulted from online commercial sales of an unregulated food product, enabling the spread of Brucella melitensis throughout Israel, according to officials.

Whole genome sequencing showed a link between bottled camel milk and eight isolates from seven patients, providing evidence of a common source.

An additional four unrelated isolates were sequenced and used as outliers, including one from camel milk and two from patients with Brucella melitensis with no camel milk exposure.

Two of these isolates clustered with the outbreak strains, suggesting an unrecognized epidemiologic chain of transmission. This finding could reflect the unregulated animal trade in which domesticated animals, including camels, are trafficked from Hebron throughout the Negev region to Bedouin communities, according to the study. It also suggests the outbreak might have been more widespread.

Raw goat milk outbreak in China
Meanwhile, researchers in China have described the first outbreak of brucellosis in Zhangping City, Fujian Province.

Six confirmed cases were found. One patient experienced onset of symptoms in April while the others fell sick from late May to mid-June 2019, according to a study published in China CDC weekly.

The investigation suggested the transmission chain included a private butcher, an infected goat, a dairy farmer, close contact spread, unsterilized goat milk, and consumers drinking raw goat milk.

In July, Zhangping City officials reported an outbreak of brucellosis in a family. A mother and daughter had drunk goat milk produced and bottled from a local farmer. The city only reported one case of human brucellosis in both 2011 and 2017.

From the six confirmed cases, one of the blood specimens was cultured as Brucella ovis. All patients had symptoms of fatigue, five also had fever, two had abnormally excessive sweating and muscle aches, and one had vomiting, chills and headache.

Five women and one man were affected including three workers, two unemployed house workers, and a student. Cases were from four households, all within the delivery scope of goat milk of the suspected dairy farmer.

Two private dairy farms in Zhangping City supplied fresh goat milk. One of them was a family workshop that did not follow adequate sanitation measures, and three samples of dairy goats were positive by the rose Bengal test while samples from the other farm tested negative, confirming the source of infection was dairy goats from the former’s farm. The likely infected dairy goat was thought to have been purchased in 2017 in Zhangping City.

An interviewer found that residents in Zhangping City generally believed that raw milk products were more nutritious and were not aware of the possible health risks.

Crypto linked to milk from farm
Finally, earlier this year the Animal and Plant Health Agency (APHA) investigated the source of three Cryptosporidium parvum infections in the West of England linked to consumption of home pasteurized milk from an on-farm vending machine.

In 2015, the farm invested in an on-farm pasteurizer and vending machine to sell milk direct to the consumer. In the past year, about 100 liters have been sold on a daily basis.

From the 28 samples collected, one Cryptosporidium parvum positive was detected. Further subtyping identified the same unusual subtype as those in human cases, providing microbiological evidence of a link to the farm as a source of infection.

To ensure the farm can continue to safely sell their milk, environmental health officers are involved, with sampling of the pasteurizer, equipment and product being carried out, and advice given to the operator.