Fanning A, Edwards S, Hauer G
Tuberculosis Services, Alberta Health, Edmonton.
Can Dis Wkly Rep. 1991 Nov 2;17(44):239-40, 243.
The evidence of zoonotic transmission of M. bovis infection in the 1 veterinarian is confirmed by growth of the organism from his sputum 6 months after animal contact. The high rate of initial tuberculin reactivity and the skin test conversions of 6 persons in contact with culture-positive animals strongly suggest that further human infection has taken place. However, the lack of baseline testing on 48/81 test-positive individuals and the relatively high proportion of immigrants in some occupational groups makes it impossible to determine the extent of reactivity and infection that can be attributed to handling diseased elk. The method of spread is likely by aerosolization of infected particles produced from the cough of live animals, or by the housing of infected material in the rendering plant or postmortem laboratory. Although isoniazid prophylaxis has not been demonstrated to be protective against M. bovis reactivation disease, it seems reasonable to offer the drug to those contacts who are newly infected. Follow-up of human contacts of animal tuberculosis must be carried out.
该名兽医在接触动物6个月后，痰液中培养出牛分枝杆菌，证实了牛分枝杆菌感染的人畜共患病传播证据。6名接触培养阳性动物的人员初始结核菌素反应率高且结核菌素皮肤试验发生血清转化，强烈提示已发生进一步的人感染。然而，81名检测呈阳性的个体中有48名缺乏基线检测，且某些职业群体中移民比例相对较高，因此无法确定因接触患病麋鹿而导致的反应性和感染程度。传播途径可能是活畜咳嗽产生的感染性颗粒气溶胶化，或者是在提炼厂或尸体剖检实验室中存放感染性物质。虽然尚未证明异烟肼预防对牛分枝杆菌再激活疾病有保护作用，但向新感染的接触者提供该药似乎是合理的。必须对动物结核病的人类接触者进行随访。
