Belmaker Ilana, Alkan Michael, Barnea Ada, Dukhan Larissa, Yitzhaki Shmuel, Gross Ellis
Ministry of Health, Southern Regional Health Office, Beer Sheva, Israel.
Isr Med Assoc J. 2004 Jan;6(1):24-7.
Leptospirosis is a zoonotic disease that occurs worldwide, found predominantly in agricultural workers, port workers and dairy workers.
To investigate the risk of disease transmission to dairy workers following an outbreak in 1999 of Leptospirosis hardjo in the dairy herds of two kibbutzim in southern Israel.
A seroepidemiologic survey of all the dairy workers from these two kibbutzim was conducted, including individual interview and examination. Data were collected on the presence of clinical symptoms of leptospirosis during the previous month. One month later the medical personnel on the two kibbutzim were contacted in order to determine if any worker had subsequently developed clinical signs or symptoms of leptospirosis. All dairy workers had blood drawn for serology. Those workers whose initial serology had been borderline for leptospirosis had a repeated serology test between 2 and 4 weeks later. Doxycycline was given prophylactically to all dairy workers on one kibbutz only.
Either with or without chemoprophylaxis, no dairy workers exposed to herds infected with Leptospira hardjo showed evidence of seroconversion or disease. This indicated a low risk of transmission of this serovar from cows to dairy workers.
Since human illness with leptospirae can cause illness associated with significant morbidity, we recommend that physicians make an informed decision regarding doxycycline prophylaxsis for dairy workers exposed to cattle herds infected with Leptospira hardjo.
钩端螺旋体病是一种全球性的人畜共患病，主要发生在农业工人、港口工人和乳品工人中。
调查1999年以色列南部两个基布兹奶牛群爆发哈焦型钩端螺旋体病后疾病传播给乳品工人的风险。
对这两个基布兹的所有乳品工人进行了血清流行病学调查，包括个人访谈和检查。收集了前一个月钩端螺旋体病临床症状出现情况的数据。一个月后联系了这两个基布兹的医务人员，以确定是否有工人随后出现钩端螺旋体病的临床体征或症状。所有乳品工人均采血进行血清学检测。那些初始血清学检测结果处于钩端螺旋体病临界值的工人在2至4周后进行了重复血清学检测。仅对一个基布兹的所有乳品工人给予多西环素进行预防性治疗。
无论是否进行化学预防，接触感染哈焦型钩端螺旋体牛群的乳品工人均未出现血清转化或患病迹象。这表明该血清型从奶牛传播给乳品工人的风险较低。
由于感染钩端螺旋体可导致人类患病并伴有明显的发病率，我们建议医生就是否对接触感染哈焦型钩端螺旋体牛群的乳品工人进行多西环素预防性治疗做出明智的决定。
