Bulletin No. 17
August 21, 1981
An astute Fairbanks physician recently established the diagnosis of Brucellosis in a man from California who works from time to time in Alaska. The patient had a history of persistent intermittent fever for an indefinite period prior to his arrival in Alaska over a year ago. He had often obtained temporary relief from courses of antibiotics, but no one had been able to diagnose his fever until his physician considered this uncommon illness and ordered the appropriate serology. The resultant 1:320 Brucella titer was diagnostic.
Brucellosis, or Undulent Fever, is a bacterial infection caused by one of three species of Brucella, a small gram negative rod. Direct contact with infected reindeer or caribou is the usual source of infection in Alaska, but drinking the milk of an infected animal can also lead to illness. Cows, pigs, sheep and goats are the usual sources elsewhere. Person to person transmission is rare. Fever and any of a large number of constitutional symptoms persist for months and sometimes years without treatment. Swollen lymph nodes and an enlarged spleen may be noted, but half of the patients exhibit no such findings. Blood cultures may be negative. Tetracycline, 250 mg P.O. QID for three weeks is usually curative.
Since 1958, Brucellosis cases diagnosed in Alaska have averaged one a year (range 0-5), for 24 cases in all. The present case is the first reported since 1979. It is unusual in that most cases here have been diagnosed in Alaskans who work with reindeer or caribou. In contrast, this man had symptoms when he came to Alaska; he did not work with domestic animals here. He had divided his time previously between Mexico and California. Efforts to locate him in California are underway so that health officials there may conduct further epidemiologic investigation.
Brucellosis is reportable to the Section of Communicable Disease Control at Zenith 1700. Epidemiologic investigation may then lead to a previously unsuspected active source of infection or to other cases requiring treatment. Charles Ryan, M.D. or John Middaugh, M.D. are available to discuss suspected cases at 272-7534.
(Reported by Joseph Ribar, M.D.)State of Alaska Brucellosis