World Health Organization TB Consultants Group, Buenos Aires, Argentina.
Int J Tuberc Lung Dis. 2010 Nov;14(11):1369-73.
Human tuberculosis (TB) caused by Mycobacterium bovis appears to be rare in most of the region of the Americas, although some localities have reported an unusually high prevalence of M. bovis among human TB cases (e.g., San Diego, CA, USA; parts of Mexico). As surveillance data are lacking in many countries, there is substantial uncertainty regarding actual incidence. M. bovis is most often not identified, as the diagnosis of TB is made by smear microscopy alone or using egg-containing culture media lacking pyruvate. Where human M. bovis cases have been studied in the region, they appear to be associated with ingestion of unpasteurized dairy products, or with airborne acquired infection in animal keepers and meat industry workers from countries where bovine TB remains a problem. Human-to-human transmission of M. bovis does occur, but appears to account for a very small proportion of cases. Efforts to eradicate M. bovis in humans in the Americas should therefore be directed at eradicating the disease in cattle, increasing pasteurization of dairy products and providing education about the dangers of consuming unpasteurized dairy products.
人感染牛分枝杆菌引起的结核病（TB）在美洲大部分地区似乎很少见，尽管有些地方报告了人类结核病病例中牛分枝杆菌异常高发（例如，美国加利福尼亚州圣地亚哥；墨西哥的一些地区）。由于许多国家缺乏监测数据，实际发病率存在很大的不确定性。由于分枝杆菌的诊断仅通过涂片显微镜检查或使用缺乏丙酮酸盐的含卵培养基进行，因此通常无法识别牛分枝杆菌。在该地区对人类牛分枝杆菌病例进行的研究表明，这些病例与摄入未经巴氏消毒的乳制品或与动物饲养员和肉类行业工人从牛结核病仍然是一个问题的国家空气中获得的感染有关。人传人牛分枝杆菌确实会发生，但似乎只占病例的很小一部分。因此，在美洲消除人类牛分枝杆菌的努力应针对消除牛的疾病，增加乳制品的巴氏消毒，并教育人们食用未经巴氏消毒的乳制品的危险。
