Mishal J, Ben-Israel N, Levin Y, Sherf S, Jafari J, Embon E, Sherer Y
Department of Medicine B, Barzilai Medical Center, Ashkelon 78306, Israel.
Int J Mol Med. 1999 Dec;4(6):655-8. doi: 10.3892/ijmm.4.6.655.
Israel is one of the Mediterranean countries in which Brucellosis is endemic. As recently there has been a Brucellosis outbreak in a kibbutz, the aim of this study is to identify asymptomatic infected Kibbutz members, and to delineate the manner of infection in this setting. Therefore, all the asymptomatic Kibbutz members were screened by the Rose Bengal test for Brucellosis, while both patients and healthy members were asked to fill in a questionnaire in order to pinpoint the manner of infection, and signs and symptoms of the disease. In addition to the 14 patients with Brucellosis, 2 other Kibbutz members were also found to be infected by the screening tests. Analysis of the data of the questionnaires from 142 healthy and 16 patients disclosed that almost all of the infected patients (15/16) worked in the cowshed, as opposed to only 24 out of 142 (16.9%) of the healthy members. The infected tended to participate more in calf deliveries, and had contact with cow's blood and placenta, compared with the healthy subjects (P<0.001), while there were no significant differences with respect to having cuts on hands, or working in the cowshed without gloves. In addition, 15 out of 16 (93.8%) infected persons also drank unpasteurized milk, as compared with only 17 of the 142 (12%) healthy members (P<0.001), and thus were exposed to 2 major risk factors (working in the cowshed and consumption of unpasteurized milk). As the cows of the Kibbutz's cowshed were affected by Brucella melitensis (which usually affects flocks of goats and sheep rather than cows), the microbe was probably transmitted to the cowshed from neighboring flocks by wandering dogs, and then to the infected humans.
以色列是布鲁氏菌病流行的地中海国家之一。由于最近一个基布兹发生了布鲁氏菌病疫情，本研究的目的是识别无症状感染的基布兹成员，并确定在这种情况下的感染方式。因此，所有无症状的基布兹成员都通过布鲁氏菌病的玫瑰红试验进行筛查，同时要求患者和健康成员填写问卷，以确定感染方式以及该疾病的体征和症状。除了14名布鲁氏菌病患者外，通过筛查还发现另外2名基布兹成员也受到感染。对142名健康成员和16名患者的问卷数据进行分析后发现，几乎所有受感染患者（15/16）都在牛棚工作，而健康成员中只有24人（16.9%）在牛棚工作。与健康受试者相比，受感染者更倾向于参与小牛接生，并接触牛血和胎盘（P<0.001），而在手部有伤口或不戴手套在牛棚工作方面没有显著差异。此外，16名受感染者中有15人（93.8%）饮用了未经巴氏消毒的牛奶，而健康成员中只有142人中的17人（12%）饮用（P<0.001），因此他们面临两个主要风险因素（在牛棚工作和饮用未经巴氏消毒的牛奶）。由于基布兹牛棚的奶牛感染了羊种布鲁氏菌（这种菌通常感染山羊和绵羊群而非奶牛），这种微生物可能是通过流浪狗从邻近的羊群传播到牛棚，然后再传播给受感染的人类。
