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人兽界面牛分枝杆菌职业暴露及应对挑战:叙事性综述。

Occupational exposure and challenges in tackling M. bovis at human-animal interface: a narrative review.

机构信息

Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia.

Prima Nexus Sdn. Bhd, Menara CIMB, Jalan Stesen Sentral 2, Kuala Lumpur, Malaysia.

出版信息

Int Arch Occup Environ Health. 2021 Aug;94(6):1147-1171. doi: 10.1007/s00420-021-01677-z. Epub 2021 Mar 16.

Abstract

Zoonotic tuberculosis caused by Mycobacterium bovis (M. bovis), a member of Mycobacterium tuberculosis complex (MTBC) has increasingly gathered attention as a public health risk, particularly in developing countries with higher disease prevalence. M. bovis is capable of infecting multiple hosts encompassing a number of domestic animals, in particular cattle as well as a broad range of wildlife reservoirs. Humans are the incidental hosts of M. bovis whereby its transmission to humans is primarily through the consumption of cattle products such as unpasteurized milk or raw meat products that have been contaminated with M. bovis or the transmission could be due to close contact with infected cattle. Also, the transmission could occur through aerosol inhalation of infective droplets or infected body fluids or tissues in the presence of wound from infected animals. The zoonotic risk of M. bovis in humans exemplified by miscellaneous studies across different countries suggested the risk of occupational exposure towards M. bovis infection, especially those animal handlers that have close and unreserved contact with cattle and wildlife populations These animal handlers comprising of livestock farmers, abattoir workers, veterinarians and their assistants, hunters, wildlife workers as well as other animal handlers are at different risk of contracting M. bovis infection, depending on the nature of their jobs and how close is their interaction with infected animals. It is crucial to identify the underlying transmission risk factors and probable transmission pathways involved in the zoonotic transmission of M. bovis from animals to humans for better designation and development of specific preventive measures and guidelines that could reduce the risk of transmission and to protect these different occupational-related/populations at risk. Effective control and disease management of zoonotic tuberculosis caused by M. bovis in humans are also hindered by various challenges and factors involved at animal-human interface. A closer look into factors affecting proper disease control and management of M. bovis are therefore warranted. Hence, in this narrative review, we have gathered a number of different studies to highlight the risk of occupational exposure to M. bovis infection and addressed the limitations and challenges underlying this context. This review also shed lights on various components and approaches in tackling M. bovis infection at animal-human interface.

摘要

由牛分枝杆菌(M. bovis)引起的人畜共患结核病越来越受到关注,成为一个公共卫生风险,特别是在疾病流行率较高的发展中国家。M. bovis 能够感染多种宿主,包括许多家畜,特别是牛,以及广泛的野生动物宿主。人类是 M. bovis 的偶然宿主,其向人类的传播主要是通过食用受 M. bovis 污染的未经巴氏消毒的牛奶或生肉产品,或者是由于与受感染的牛密切接触而传播。此外,在受感染动物的伤口存在的情况下,也可能通过吸入感染性飞沫或受感染的体液或组织的气溶胶,或者通过气溶胶吸入感染性飞沫或受感染的体液或组织而发生传播。来自不同国家的各种研究表明,M. bovis 在人类中的人畜共患病风险,表明了职业接触 M. bovis 感染的风险,特别是那些与牛和野生动物种群密切且无保留接触的动物处理人员。这些动物处理人员包括牲畜农民、屠宰场工人、兽医及其助手、猎人、野生动物工作者以及其他动物处理人员,根据其工作性质以及与受感染动物的接触程度,感染 M. bovis 的风险各不相同。确定动物向人类传播 M. bovis 的潜在传播风险因素和可能的传播途径对于更好地指定和制定特定的预防措施和准则至关重要,这些措施和准则可以降低传播风险,并保护这些不同的职业相关/高危人群。M. bovis 引起的人畜共患结核病在人类中的有效控制和疾病管理也受到动物-人界面涉及的各种挑战和因素的阻碍。因此,有必要更深入地研究影响 M. bovis 疾病控制和管理的因素。因此,在本叙述性综述中,我们收集了许多不同的研究,以强调职业接触 M. bovis 感染的风险,并解决了这方面的局限性和挑战。本综述还阐明了在动物-人界面处理 M. bovis 感染的各种组成部分和方法。

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