Hepatitis E Virus Genotype 1, Cuba

never carried to the sites where they were housed or taken out for grazing. Thus, the only way for the infant patient to be infected would be environmental exposure. Since the infant had not been carried to the animal sites, the pathogen must have been transmitted to the household by the clothes or skin of the father or grandfather, who had been shepherding the infected animals. Subsequently, the baby became infected either by inhaling infected aerosolized particles or by direct transmission of the pathogen through minor skin abrasions (which were specifi cally looked for on admission but were not seen) or mucosal surfaces. This case suggests that B. melitensis may even affect persons who are not directly exposed to infected animals, through direct contact with contaminated persons or the environment. In this context, brucellosis can be considered as not simply a household disease but as a disease of the house.