Kapoor Sunandini, Goel Akhil Dhanesh, Jain Vidhi
Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India.
Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India.
Front Microbiol. 2023 Apr 6;14:1041051. doi: 10.3389/fmicb.2023.1041051. eCollection 2023.
Reviewing "zoonotic diseases" classically brings to mind human infections contracted in close association with animals, where outdoor occupations and afforested lands usually play a key role in the epidemiological triad. However, there is a very common, yet overlooked route of infection where humans may not come in direct contact with animals or implicated environments. Milk-borne diseases are a unique set of infections affecting all age groups and occupational categories of humans, causing 4% of all the foodborne diseases in the world. The infection reservoir may lie with milch animals and associated enzootic cycles, and the infectious agent is freely secreted into the animal's milk. Commercial pooling and processing of milk create unique environmental challenges, where lapses in quality control could introduce infective agents during downstream processing and distribution. The infectious agent is finally brought to the doorstep of both rural and urban households through such animal products. The domestic hygiene of the household finally determines human infections. One health approach can target preventive measures like immunization in animals, pasteurization and stringent quality control during the commercial processing of milk, and finally, hygienic practices at the level of the consumer, to reduce the burden of milk-borne diseases. This review hopes to draw the attention of policymakers to this unique route of infection, because it can be easily regulated with cost-effective interventions, to ensure the safety of this precious food product, permeating the life and livelihood of humans from all walks of life.
回顾“人畜共患病”，人们通常会想到与动物密切接触而感染的人类疾病，在这种情况下，户外工作和林地通常在疾病传播的流行病学三角关系中起着关键作用。然而，存在一种非常常见却被忽视的感染途径，即人类可能并未直接接触动物或相关环境。通过牛奶传播的疾病是一类独特的感染性疾病，影响着所有年龄组和职业类别的人群，占全球所有食源性疾病的4%。感染源可能存在于产奶动物及其相关的动物疫病流行周期中，感染因子会自由分泌到动物的乳汁中。牛奶的商业集中收集和加工带来了独特的环境挑战，质量控制环节的失误可能会在下游加工和分销过程中引入感染源。最终，这些传染源通过此类动物产品进入农村和城市家庭。家庭的日常卫生状况最终决定了人类是否会被感染。“同一健康”方法可以针对一些预防措施，比如给动物进行免疫接种、在牛奶商业加工过程中进行巴氏杀菌和严格的质量控制，以及最后在消费者层面采取卫生措施，以减轻牛奶传播疾病的负担。本综述希望引起政策制定者对这一独特感染途径的关注，因为通过具有成本效益的干预措施可以很容易地对其进行管控，以确保这种珍贵食品的安全，这种食品渗透到了各行各业人们的生活和生计之中。
