Mor Z, Nuss N, Savion M, Nissan I, Lidji M, Maneshcu S, Kaidar-Shwartz H, Amitai Z, Rorman E, Sheffer R
Tel Aviv Department of Health, Ministry of health, 12 Ha'arba'a Street, 6473912, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr J Health Policy Res. 2018 Jul 15;7(1):36. doi: 10.1186/s13584-018-0219-y.
OBJECTIVES: Israel has absorbed > 60,000 migrant from the horn of Africa (MHOA) since 2006. No cross-transmission of Mycobacterium tuberculosis from MOHA to Israeli citizens has yet been reported. This study describes the results of contact investigation and laboratory work-out of a unique mixed cluster which included both MOHA and Israeli citizens.
Description of the results of epidemiological investigation including laboratory confirmation.
This unique Mycobacterium tuberculosis strain included 29 patients: 26 were MOHA and three citizens who immigrated to Israel from the former Soviet Union. This is the first mixed cluster described in Israel, which has not been represented in the SITVIT international database of genotyping markers. The transmission from non-citizens to citizens occurred in a nursing institution, when MOHA infected three other contacts- two of whom were retarded residents, one of them died. The index case was screened before employment, and was permitted to return to wok although his chest X-ray demonstrated radiological findings compatible with tuberculosis. Epidemiological links were found in other 12 MOHA members of the cluster.
This report describes cross-transmission of Mycobacterium tuberculosis from non-citizens MOHA to Israeli citizens who were residents of a nursing home, which may be the first sign for an epidemiological shift. Although cross-ethnical transmission is still rare in Israel, medical settings should employ efficient infection control measures to protect both patients and staff from Mycobacterium tuberculosis.
目的：自2006年以来，以色列已接纳了6万多名来自非洲之角的移民（MHOA）。尚未有MHOA将结核分枝杆菌传播给以色列公民的报告。本研究描述了对一个独特的混合群体进行接触者调查和实验室检测的结果，该群体包括MHOA和以色列公民。
描述流行病学调查结果，包括实验室确诊情况。
这个独特的结核分枝杆菌菌株涉及29名患者：26名是MHOA，3名是从前苏联移民到以色列的公民。这是以色列描述的首个混合群体，在SITVIT国际基因分型标记数据库中没有相关记录。非公民向公民的传播发生在一家护理机构，一名MHOA感染者传染了另外3名接触者，其中两名是智障居民，一人死亡。首例病例在就业前接受了筛查，尽管其胸部X光显示有与结核病相符的影像学表现，但仍被允许回去工作。在该群体的其他12名MHOA成员中发现了流行病学关联。
本报告描述了结核分枝杆菌从非公民MHOA传播给一家疗养院的以色列公民居民的情况，这可能是流行病学转变的首个迹象。尽管跨种族传播在以色列仍然很少见，但医疗机构应采取有效的感染控制措施，保护患者和工作人员免受结核分枝杆菌感染。
