Shimol Shalom Ben, Dukhan Larissa, Belmaker Ilana, Bardenstein Svetlana, Sibirsky David, Barrett Chiya, Greenberg David
Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel
Isr Med Assoc J. 2012 Aug;14(8):475-8.
Human brucellosis is common in southern Israel among the semi-nomadic Bedouin, a population that consumes unpasteurized dairy products. Though camel milk ingestion is a known mechanism for brucellosis acquisition, only a few reports of sporadic cases have been published in the medical literature.
To describe a local brucellosis outbreak in 15 extended Bedouin family members, following ingestion of infected camel milk.
Data regarding patient's clinical manifestations, laboratory findings, treatment and outcome were collected from the hospital and the health fund clinics' computerized database. Camel's blood and milk were tested for Brucella serology and culture. Cases were defined by positive Rose Bengal test, symptoms correlating with brucellosis, and consumption of infected camel milk.
Fifteen patients were diagnosed with acute brucellosis from March to June 2011. Sixty percent of cases had serum agglutination test titers of 1:160 or higher and 4/8 (50%) had positive blood culture for Brucella melitensis. Arthralgia and fever were the most consistent clinical manifestations. Blood and milk serology and milk culture taken from the female camel were positive for Brucella melitensis.
The treating physicians must consider the possibility of infected camel milk ingestion as the mode of infection, both in sporadic cases and in outbreaks of brucellosis.
在以色列南部，布鲁氏菌病在半游牧的贝都因人中很常见，这一人群食用未经巴氏消毒的乳制品。虽然摄入骆驼奶是感染布鲁氏菌病的一种已知途径，但医学文献中仅发表了少数散发病例的报告。
描述15名贝都因大家庭成员在摄入受感染骆驼奶后发生的局部布鲁氏菌病疫情。
从医院和健康基金诊所的计算机数据库中收集有关患者临床表现、实验室检查结果、治疗及转归的数据。对骆驼的血液和乳汁进行布鲁氏菌血清学检测和培养。病例定义为玫瑰红试验阳性、有与布鲁氏菌病相关的症状且摄入了受感染的骆驼奶。
2011年3月至6月，15例患者被诊断为急性布鲁氏菌病。60%的病例血清凝集试验滴度为1:160或更高，4/8（50%）的患者血培养布鲁氏菌羊种呈阳性。关节痛和发热是最常见的临床表现。从雌性骆驼采集的血液和乳汁血清学检测以及乳汁培养布鲁氏菌羊种呈阳性。
无论是散发病例还是布鲁氏菌病疫情，治疗医生都必须考虑摄入受感染骆驼奶作为感染途径的可能性。
