Castell Monsalve J, Rullán J V, Peiró Callizo E F, Nieto-Sandoval Alcolea A
Centro Nacional de Epidemiología, Programa de Epidemiología Aplicada de Campo.
Rev Esp Salud Publica. 1996 May-Jun;70(3):303-11.
In spite of the great effort that has been made in recent years in Castilla-La Mancha to control brucelosis, a lack of awareness on the part of producers and consumers leads to major epidemic outbreak, such as the one described below.
A description of the outbreak is described and a study is conducted of cases and controls to determine the factors which are responsible for the epidemic. Unadjusted and adjusted Odds Ratios (O.R.) are obtained together with their confidence intervals, for the main epidemiological factors studied.
A total of 81 cases of brucelosis were recorded in a period of 25 weeks. All the cases occurred in the same borough or were in some way linked to it. In the case and controls study no differences were found with regard to age, sex, contact with livestock or the consumption of pasteurised milk or cheese. A strong link was established between the illness and the consumption of home-made cottage cheese prepared by a small-scale producer in the borough, (O.R. = 311.9; C.I. = 95% = 41.48-12735)., whose livestock turned out to be infected with Brucella Mellitensis.
This outbreak showed that in Spain, there is a risk of contracting brucelosis by consuming non-pasteurised dairy products, particularly cheese, when these are not subjected to the normal sanitary and health controls. The benefits of epidemiological research in the search for cases and determining the factors responsible for the outbreak are also demonstrated. An intensification of controls, the cleansing of the herds and flocks and health education in general, are suitable instruments for controlling this zoonosis in Spain.
尽管近年来卡斯蒂利亚-拉曼恰在控制布鲁氏菌病方面付出了巨大努力，但生产者和消费者缺乏认识导致了重大疫情爆发，如下所述。
描述了此次疫情爆发情况，并对病例和对照进行了研究，以确定导致疫情的因素。获得了主要研究的流行病学因素的未调整和调整后的优势比（O.R.）及其置信区间。
在25周内共记录了81例布鲁氏菌病病例。所有病例都发生在同一个市镇或以某种方式与之相关。在病例对照研究中，未发现年龄、性别、与牲畜接触或食用巴氏杀菌牛奶或奶酪方面存在差异。疾病与该市镇一名小规模生产者制作的自制农家奶酪的消费之间建立了紧密联系（O.R. = 311.9；C.I. = 95% = 41.48 - 12735），其牲畜被证明感染了羊种布鲁氏菌。
此次疫情表明，在西班牙，食用未经巴氏杀菌的乳制品，特别是奶酪，若未经过正常的卫生和健康控制，就有感染布鲁氏菌病的风险。还证明了流行病学研究在寻找病例和确定疫情爆发原因方面的益处。加强控制、对畜群进行清洁以及开展一般健康教育，是在西班牙控制这种人畜共患病的合适手段。
