Presentation Shanyars Lecture Explorer布氏杆菌病的演讲shanyar演讲的探险家课件.pptVIP

Center for Food Security and Public Health Iowa State University - 2004 Brucellosis A zoonosis Brucella spp. Gram negative, coccobacilli bacteria Facultative, intracellular organism Multiple species Species Brucella melitensis: most common B. abortus B. suis B. canis Transmission to Humans 1) Conjunctiva or broken skin contacting infected tissues: Blood, urine, vaginal discharges, aborted fetuses, placentas 2) Ingestion: Raw milk unpasteurized dairy products Rarely through undercooked meat Transmission to Humans 3) Inhalation of infectious aerosols: Pens, stables, slaughter houses 4) Inoculation with vaccines 5) Person-to-person (sexual, congenital, breast-feeding) is rare Incubation varies 7-21 days to several months Who is at Risk? 1) Occupational Disease Cattle ranchers/ dairy farmers Veterinarians Abattoir workers Meat inspectors Lab workers 2) Hunters 3) Travelers 4) Consumers of unpasteurized dairy products B. melitensis B melitensis is thought to be the most virulent and causes the most severe and acute cases of brucellosis; it is also the most prevalent worldwide. Human Disease Flu-like illness is the most common presentation ( 80-100%). Fever is intermittent in 60% of patients with acute and chronic disease. Fever can be associated with a relative bradycardia. Constitutional symptoms include anorexia, asthenia, fatigue, malaise, and wt loss. Hepatosplenomegaly and lymphadenopathy (30%) Human Disease Localized infection may be the presenting feature: Osteoarticular complications Arthritis, spondylitis, osteomyelitis Genitourinary involvement: Orchitis and epididymitis most common Human Disease Neurological: Depression, meningitis Cardiovascular: Endocarditis resulting in death Chronic brucellosis The diagnosis of chronic brucellosis is typically made after symptoms have persisted for 1 year or more. Low-grade fevers and neuropsychiatric symptoms predominate. Results of serologic studies and cultures are often negative Diagnosis in H