Maurin M
Service de bactériologie-virologie, université Joseph-Fourier, CHU de Grenoble, BP 217, 38043 Grenoble cedex, France.
Med Mal Infect. 2005 Jan;35(1):6-16. doi: 10.1016/j.medmal.2004.08.003.
Human brucellosis is now a rare disease in countries where eradication programs (especially vaccination) against brucellosis in cattle, sheep, and goats have been successfully implemented. In France, fewer than 50 brucellosis cases are annually notified to the National Institute for Infection Surveillance. Human brucellosis, however, remains endemic in the Mediterranean basin, Middle East, Western Asia, Africa, and South America. Shortcomings of standard diagnostic methods for brucellosis (variable sensitivity of culture, frequent serological cross reactions) have been only partially resolved by modern molecular biology techniques. There are now 3 new challenges to be faced by the medical and veterinarian community: the expanding wildlife reservoir of brucellosis, with a possible impact on domestic animals; the emergence of Brucella. melitensis infections in cattle, for which prophylactic efficacy of available vaccines has not been established; and recent recognition of a huge animal reservoir of Brucella species in marine mammals, for which the potential virulence in humans remains unknown.
在已成功实施牛、羊和山羊布鲁氏菌病根除计划(尤其是疫苗接种)的国家,人类布鲁氏菌病如今已属罕见疾病。在法国,每年向国家感染监测研究所通报的布鲁氏菌病病例不足50例。然而,人类布鲁氏菌病在地中海盆地、中东、西亚、非洲和南美洲仍然流行。布鲁氏菌病标准诊断方法的缺点(培养的敏感性不一、频繁的血清学交叉反应)仅通过现代分子生物学技术得到了部分解决。医学和兽医界目前面临3个新挑战:布鲁氏菌病在野生动物中的宿主范围不断扩大,可能对家畜产生影响;牛感染羊种布鲁氏菌的情况出现,现有疫苗的预防效果尚未确定;以及最近认识到海洋哺乳动物中存在大量布鲁氏菌物种宿主,其对人类的潜在毒力尚不清楚。