Question - SAQ/OSPE

A 45 years-old Italian farmer visiting the UK has presented to the A&E with severe and persistent headaches, insomnia, neck stiffness, and confusion. His wife mentioned noticing some personality changes and odd behaviour recently. He had a fever for the last few days but refused to visit the hospital.
He does not have any rash. He drinks alcohol occasionally and is not on any regular medication. He is usually fit and well and has no other background diseases.
On questioning, you have found that the farmer and his wife regularly drink unpasteurised milk.

Lumbar puncture was done:

CSF showed -lymphocytosis, increased protein, and decreased glucose levels.

Both Blood culture and CSF culture have grown gram-negative coccobacilli.

• What other test(s) would you request?
• What advice would you give to the lab?
• What advice would you give to the clinicians?
• What public health/infection control measures would you take?

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