Fanning A, Edwards S
Department of Medicine, Walter MacKenzie Health Sciences Centre, University of Alberta, Edmonton, Canada.
Lancet. 1991 Nov 16;338(8777):1253-5. doi: 10.1016/0140-6736(91)92113-g.
Human infection with Mycobacterium bovis is rare in developed countries because of milk pasteurisation and the slaughter of infected cattle. An epizootic of M bovis infection in domesticated elk (Cervus elaphus) in Alberta, Canada, which started in April, 1990, prompted us to seek human contacts of elk herds. There were 446 identified contacts, in 394 of whom tuberculin skin tests were done. Of 81 contacts who were skin-test positive, 50 had been in contact with culture-positive animals. 6 of 106 subjects tested a second time became tuberculin positive. 1 case of active M bovis infection was diagnosed by sputum culture. The mode of transmission of M bovis from these farm animals to man is likely to be aerosolisation of infected particles. Because of the apparent susceptibility of farmed Cervidae (deer) to M bovis infection, and the evidence of spread to man, control measures to prevent human infection should be developed.
在发达国家,由于牛奶经过巴氏杀菌处理以及对感染牛进行屠宰,人类感染牛分枝杆菌的情况较为罕见。1990年4月在加拿大艾伯塔省,圈养的驼鹿(马鹿)暴发了牛分枝杆菌感染的 epizootic,这促使我们寻找驼鹿群的人类接触者。共确定了446名接触者,其中394人进行了结核菌素皮肤试验。在81名皮肤试验呈阳性的接触者中,50人曾接触过培养阳性的动物。106名再次接受检测的受试者中有6人结核菌素呈阳性。通过痰培养诊断出1例活动性牛分枝杆菌感染病例。牛分枝杆菌从这些农场动物传播给人类的方式可能是感染颗粒的气溶胶化。鉴于养殖的鹿科动物(鹿)对牛分枝杆菌感染明显易感,且有传播给人类的证据,应制定预防人类感染的控制措施。