Winthrop K L, Scott J, Brown D, Jay M T, Rios R, Mase S, Richardson D, Edmonson A, MacLean M, Flood J
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Int J Tuberc Lung Dis. 2005 Jul;9(7):809-13.
In May 2002, a Mycobacterium bovis outbreak occurred among cattle at a California dairy. We investigated to determine whether persons were infected after working with the cattle or drinking their raw milk.
We identified persons with potential contact with infected cattle, including dairy workers, their family members, and slaughterhouse workers. Persons were given a tuberculin skin test (TST), and their occupational and milk-drinking habits were recorded.
Of 88 potential contacts, 78 (90%) were given a TST; 33 (43%) had positive TST results, of whom 32 were Mexican-born (RR 15.8, 95%CI 2.3-108.8). No persons had active tuberculosis. Eighteen (72%) dairy workers, 11 (27%) family members, and four (33%) slaughterhouse workers had positive TST results. After adjusting for Mexican-birth and age, dairy workers were no more likely to have positive TST results than others (adjusted RR 1.2, 95%CI 0.6-2.1). Forty-one (62%) dairy staff and their family members drank raw milk from the dairy; 21 (51%) had positive TST results and were Mexican-born. All 13 US-born raw milk drinkers had negative TST results.
A high prevalence of positive TST results was documented among workers at the affected dairy, although results were not independently associated with contact with infected cattle or milk products. Further assessment of California dairy workers should be considered.
2002年5月,加利福尼亚州一家奶牛场的牛群中爆发了牛分枝杆菌疫情。我们进行调查以确定人员在与牛接触或饮用其生奶后是否受到感染。
我们确定了与受感染牛有潜在接触的人员,包括奶牛场工人、他们的家庭成员以及屠宰场工人。对这些人员进行结核菌素皮肤试验(TST),并记录他们的职业和饮用牛奶的习惯。
在88名潜在接触者中,78人(90%)接受了TST;33人(43%)TST结果呈阳性,其中32人出生于墨西哥(相对风险15.8,95%可信区间2.3 - 108.8)。没有人患有活动性结核病。18名(72%)奶牛场工人、11名(27%)家庭成员和4名(33%)屠宰场工人TST结果呈阳性。在对出生于墨西哥和年龄进行调整后,奶牛场工人TST结果呈阳性的可能性并不比其他人更高(调整后相对风险1.2,95%可信区间0.6 - 2.1)。41名(62%)奶牛场工作人员及其家庭成员饮用了该奶牛场的生奶;21人(51%)TST结果呈阳性且出生于墨西哥。所有13名在美国出生的生奶饮用者TST结果均为阴性。
在受影响奶牛场的工人中,TST结果呈阳性的患病率较高,尽管结果与接触受感染的牛或奶制品并无独立关联。应考虑对加利福尼亚州的奶牛场工人进行进一步评估。