NCJ Number
190508
Journal
MMWR Weekly Volume: 49 Issue: 23 Dated: June 16, 2000 Pages: 509-513
Date Published
June 2000
Length
4 pages
Annotation
This article describes the public health and law enforcement assessment of a suspected case of Brucellosis in New Hampshire in 1999.
Abstract
Brucella species, particularly B. melitensis and B. suis, are potential agents of biological terrorism. A woman was admitted to a hospital with fever, myalgia, and weakness, which progressed over 3 days to respiratory failure requiring mechanical ventilation. After 3 weeks of intensive care, the patient was transferred to a Boston (Massachusetts) hospital. Paired serum specimens obtained on day 4 and day 22 of the illness showed Brucella antibodies by slide agglutination testing. Cultures of blood were negative for Brucella species. The hospital made a routine case report of brucellosis to the public health commission on day 23. The patient’s family reported to hospital personnel that the patient’s illness might have been caused by exposure to “laboratory flasks” and “cultures” kept in her apartment by her boyfriend, who was a foreign national studying marine biology who had recently returned to his country of citizenship. The positive Brucella antibody serology in association with the unusual laboratory-like equipment in the patient’s residence and the acknowledged potential for Brucella species to be used as a bioterrorist agent raised concerns among the infection-control staff that this might be associated with a bioterrorist event. Local law enforcement in New Hampshire was contacted, along with the Massachusetts Department of Public Health and the Federal Bureau of Investigation. The Centers for Disease Control (CDC) and the New Hampshire Department of Health and Human Services (NHDHHS) were notified as well. Personnel from NHDHHS entered the patient’s apartment to assess any possibility of an ongoing public health hazard. Further epidemiologic investigation by Federal and State public health authorities identified no common exposures among this case and two others previously reported in Massachusetts. The laboratory materials tested negative for Brucella species and several other potential bioterrorism agents. On day 33, testing on the patient’s paired serum specimens was negative and the patient died from adult respiratory distress syndrome. Further testing of the patient’s tissue samples, CDC testing, and the patient’s prolonged antecedent medical history of multiple febrile illnesses over the past decade suggest an unspecified autoimmune process. 8 references