Texas health officials agreed yesterday to allow a raw milk dairy to resume sales, but warned that the threat of antibiotic-resistant brucellosis infection remains for anyone who drank the dairy’s unpasteurized milk this summer.
The strain of antibiotic-resistant Brucella (RB51) bacteria, isolated from a woman in a Texas hospital, is a genetic match for Brucella found in the dairy’s milk. She reported drinking raw milk from K-Bar Dairy before becoming ill.
“Since raw milk is not pasteurized to kill bacteria, people who consumed milk or milk products purchased from K-Bar between June 1 and Aug. 14 are considered to be at high risk of Brucella infection and should contact their health care providers about whether they should get antibiotics to treat or prevent illness,” according to the Texas Department of State Health Services (DSHS).
“Because Brucella can cause pregnancy complications, including miscarriage, it’s particularly important for affected pregnant women to seek medical attention.”
Even people who have not developed symptoms should ask their doctors about taking a 21-day course of two specific antibiotics as a post-exposure precaution. The RB51 strain is resistant to two front-line antibiotics, rifampin and penicillin, according to the Centers for Disease Control and Prevention.
“A combination of doxycycline and trimethoprim/sulfamethoxazole for 21 days is the recommended first-line PEP regimen for RB51 exposure,” according to the CDC, which reports that brucellosis symptoms can develop as quickly as five days after exposure, but can also take up to six months to develop in some people.
“Initially, people with brucellosis experience fever, sweats, aches and fatigue,” according to the CDC’s most recent update on the situation.
“If not treated, Brucella RB51 infection can result in long-term complications, like arthritis, heart problems, enlargement of the spleen or liver, and, in rare cases, nervous system problems. Like meningitis RB51 can cause severe illness in people with weakened immune systems and miscarriages in pregnant women.”
Corrective action at dairy
As part of the brucellosis investigation, the U.S. Department of Agriculture tested milk from all of the cows at the K-Bar Dairy, which is near Paradise, TX. Two of the cows’ milk showed the animals were shedding Brucella bacteria.
“Those two cows were separated from the herd, and subsequent testing of milk from the remaining cows has shown no evidence of Brucella bacteria in the milk or equipment, clearing the way for the resumption of sales,” the Texas health department reported yesterday.
“As part of an agreement with the dairy, DSHS will test its milk for Brucella periodically for up to one year.”
Although the Texas health department has a standing warning against drinking raw milk, state law allows on-farm sales of unpasteurized milk. It is illegal in Texas and the vast majority of other states to sell raw milk at retail. Federal law prohibits the sale of raw milk across state lines.
To protect against illness, DSHS recommends drinking only milk that has been pasteurized to kill parasites and bacteria, including Brucella, E. coli, Salmonella and Campylobacter. The risk of getting sick from drinking raw milk is greater for young children, the elderly, pregnant women and others who have a weakened immune system, according to public health officials.
Disease investigators with DSHS and the CDC have been attempting to contact people who purchased raw milk and milk products from K-Bar Dairy to warn them of the situation. The CDC reported in mid-September that illnesses associated with K-Bar Dairy raw milk had been reported in seven states.
“However, because not all customers left contact information, health officials believe there are still people unaware they were likely exposed to harmful bacteria,” the Texas health department reported yesterday.
More than 800 households are known to have purchased K-Bar raw milk during the exposure period, according to the CDC. The dairy’s incomplete records have complicated the job of public health officers.
“Of the 485 households with contact information, CDC successfully reached 236 households. Among the 236 households, 83 percent of people were exposed to RB51 by drinking the milk,” the federal agency reported.
Texas officials have reported the owners of K-Bar Dairy have been “cooperating fully with the investigation” and that they have been operating in compliance with state dairy laws and rules.
However, the dairy does not have the required sales records. The records that the dairy owners do have show that their milk has been purchased by people outside the Lone Star State.
“Purchase records and illness reports indicate additional people in Texas and some as far away as California and North Dakota may need antibiotics to prevent or treat infection,” according to the CDC.
“Due to incomplete contact information, CDC staff have been unable to reach about 200 households in which someone bought K-Bar milk. People who sampled the milk at the dairy or got the milk from friends or family also may not be aware of their risk.”
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