{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T04:44:50Z","timestamp":1770439490775,"version":"3.49.0"},"reference-count":16,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,9,2]]},"abstract":"<jats:p>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, <jats:italic>Brucella<\/jats:italic> 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.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0246","type":"journal-article","created":{"date-parts":[[2015,6,10]],"date-time":"2015-06-10T13:03:20Z","timestamp":1433941400000},"page":"539-541","source":"Crossref","is-referenced-by-count":21,"title":["Outbreak of Human Brucellosis from Consumption of Raw Goats' Milk in Penang, Malaysia"],"prefix":"10.4269","volume":"93","author":[{"given":"Kar Nim","family":"Leong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting Soo","family":"Chow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng Shyan","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siti Hawa","family":"Hamzah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norazah","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin Chin","family":"Ch'ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Brucellosis. Zoonoses and Communicable Diseases Common to Man and Animals","author":"Acha","year":"2011"},{"key":"ref2","series-title":"Indian J Med Microbiol","first-page":"188","article-title":"Review of clinical and laboratory features of human brucellosis","volume":"25","author":"Mantur","year":"2007"},{"key":"ref3","series-title":"Croat Med J","first-page":"289","article-title":"Brucellosis: regionally emerging zoonotic disease?","volume":"51","author":"Gwida","year":"2010"},{"key":"ref4","series-title":"Lancet Infect Dis","first-page":"775","article-title":"Human brucellosis","volume":"7","author":"Franco","year":"2007"},{"key":"ref5","series-title":"BMJ Case Reports","article-title":"Brucellosis presenting as septic shock","author":"Haran","year":"2011"},{"key":"ref6","series-title":"Lancet Infect Dis","first-page":"520","article-title":"Brucella arteritis: clinical manifestations, treatment, and prognosis","volume":"14","author":"Herrick","year":"2014"},{"key":"ref7","series-title":"PLoS One","first-page":"e32090","article-title":"Systematic review and meta-analysis of randomized clinical trials in the treatment of human brucellosis","volume":"7","author":"Solis Garcia del Pozo","year":"2012"},{"key":"ref8","series-title":"J Chemother","first-page":"466","article-title":"Comparison of five antimicrobial regimens for the treatment of brucellar spondylitis: a prospective, randomized study","volume":"15","author":"Bayindir","year":"2003"},{"key":"ref9","series-title":"Prev Vet Med","first-page":"232","article-title":"The prevalence and distribution of Brucella melitensis in goats in Malaysia from 2000 to 2009","volume":"119","author":"Bamaiyi","year":"2015"},{"key":"ref10","series-title":"Malaysian Veterinary Protocol: Melitensis Disease","author":"Department of Veterinary Services","year":"2010"},{"key":"ref11","series-title":"Malays J Pathol","first-page":"31","article-title":"Seroprevalance of brucellosis among suspected cases in Malaysia","volume":"33","author":"Jama'ayah","year":"2011"},{"key":"ref12","series-title":"Asian Pac J Trop Dis","first-page":"150","article-title":"Clinical human brucellosis in Malaysia: a case report","volume":"4","author":"Hartady","year":"2014"},{"key":"ref13","series-title":"J Hosp Infect","first-page":"321","article-title":"A large exposure to Brucella melitensis in a diagnostic laboratory","volume":"80","author":"Sam","year":"2012"},{"key":"ref14","series-title":"Vet Microbiol","first-page":"392","article-title":"Brucellosis: a re-emerging zoonosis","volume":"140","author":"Seleem","year":"2010"},{"key":"ref15","series-title":"Am J Trop Med Hyg","first-page":"876","article-title":"Brucellosis in northern Australia","volume":"83","author":"Eales","year":"2010"},{"key":"ref16","series-title":"Clin Microbiol Rev","first-page":"389","article-title":"Laboratory-associated infections and biosafety","volume":"8","author":"Sewell","year":"1995"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/93\/3\/article-p539.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/93\/3\/article-p539.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/93\/3\/article-p539.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T19:06:25Z","timestamp":1723057585000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/93\/3\/article-p539.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,2]]},"references-count":16,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.15-0246","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9,2]]}}}