食源性布鲁氏菌病

布氏菌病（简称布病）是布氏菌病属侵入机体引起人、畜共患的传染病。人患布病主要来自染疫的家畜，患者多为与牲畜密切接触者。近年来，在城市无疫源接触史的病例屡见增多，经消化道感染布病患者时有发生，故食源性布病应引起关注。     

浙江省首例布氏菌病调查

目的为了解全省与布氏菌病阳性牲畜接触人群布氏菌病感染情况，防止疫情蔓延。方法采用皮试、血清学及流行病学调查等方法，对重点人群进行布氏菌病检测。结果近20年来发现首例布氏菌病病人。结论应做好牲畜检疫，建立牲畜健康证制度，及时捕杀疫畜，作无害化处理。加强对牲畜养殖、生皮毛加32、屠宰等重点人群的布氏菌病监测。     

保定市1994～2004年人间布氏菌病流行特点及分析

目的 分析保定市1994～2004年人间布氏菌病流行特点，为布氏菌病防治提供科学依据。方法 收集1994～2004年本市布氏菌病患者个案资料进行分析。结果 发病人数显著增加；发病以从事羊只饲养、屠宰、皮毛加工人员为主；4～8月份为发病高峰；发病至确诊间隔时间长，及时诊断率低。结论 保定市人间布氏菌病疫情有上升趋势，局部地区存在布氏菌病暴发流行的可能性。     

一例疑似急性布氏菌病的鉴别诊断

目的 检查1名持续发热病人是否患布氏菌病。方法 采用布氏菌病血清学和细菌学检查方法，使用了微生物自动分析仪，以及沙门氏菌的鉴定方法。结果 布氏菌病血清学检查阳性，布氏菌病细菌学检查阴性，微生物自动分析仪检测为沙门氏菌，最后进一步鉴定为甲型副伤寒沙门氏菌。结论 该患者感染了甲型副伤寒沙门氏菌，甲型副伤寒沙门氏菌与布氏菌存在严重血清学交叉反应。     

布氏菌保护性抗原及人对布氏菌感染的免疫反应

世界各国对动物布氏菌病的研究主要集中于诊断方法和菌苗免疫,对人布氏菌病的研究涉及到应用链霉素、四环素等抗生素治疗。尽管如此,至今动物和人布氏菌病仍在世界许多地区流行。只有少数发达国家通过严密的监视系统根除牛布氏菌病。     

安阳市1997～2001年人间布氏菌病流行特点及分析

目的分析安阳市1997～2001年人间布氏菌病流行特点,为布氏菌病防治提供科学依据。方法收集1997～2001年本市布氏菌病患者个案资料进行分析。结果发病人数显著增加;发病以从事羊、牛饲养的人员为主;4、5月份为发病高峰;发病至确诊间隔时间长,及时诊断率低,误诊率高。结论安阳市人间布氏菌病疫情有上升趋势,局部地区存在布氏菌病暴发流行的可能性。     

全国布氏菌病干预试点县布氏菌病经济损失调查

目的 通过调查布氏菌病给人、畜间造成的损失,给有关部门制定布氏菌病防治措施提供科学依据.方法 在全国布氏菌病干预试点(吉林省洮南市、黑龙江省龙江县)进行布氏菌病直接经济损失费用调查.结果 2个干预试点每年由布病造成的经济损失约为1 638.65万元.结论 布氏菌病不仅给人带来精神、肉体上的痛苦,同时也带来了巨大的经济损失.     

锦州市一起人间布氏菌病暴发调查

布氏菌病（简称布病）是由布氏菌引起的人畜共患传染-变态反应性疾病，在我国流行已久，危害严重。2004年5月11～17日，锦州市疾病预防控制中心免疫与地方病门诊先后接诊了11例持续发热患者，这些患者均来自于北镇市间阳镇间一村，经中心化验室血清学检验11例患者，RBPT和SAT均阳性，结合临床表现，流行病学接触史确诊为急性期布病。将疫情迅速上报市卫生局和省疾控中心相关部门，确定为人间布病暴发。组织专业人员会同北镇市卫生防疫站分别于5月18日、20日到间一村进行了流行病学调查。     

公主岭市2002～2004年人间布氏菌病血清学监测结果

对公主岭市 2 0 0 2～ 2 0 0 4年布氏菌病暴发点的病人、周围人群及暴发点发生一年后回顾性调查人群和全市 32个乡镇部分牛、羊养殖户养殖人员进行血清学检测 ,共收集血清 837份 ,阳性 6 2份 ,阳性率 7.4 %。在 6 2例阳性患者中 ,布氏菌病平板试验均阳性 ,布氏菌病试管试验有 2例出现前滞现象 ,即滴度为 1∶2 5～ 1∶5 0时抗原抗体不发生凝集反映 ,当滴度 >1∶10 0时出现凝集反应 ,提示在布氏菌病试管试验时应适当提高稀释倍数 ,增高阳性检出率。 1例患者的流行病学、临床表现均符合布氏菌病 ,试管试验阴性 ,但布氏菌病平板试验凝集时间大约…     

吉林市饮食肉类加工人员布氏菌病流行病学调查

吉林市饮食肉类加工人员布氏菌病流行病学调查曲彬宁存宇舒恩仁于清洁代春福为了解人间布氏菌病的流行情况，我市于１９９６年６～９月份对市内从事饮食肉类加工人员进行流行病学调查及血清学检验，现将结果报告如下：１调查对象与方法１．１调查对象：市区所辖从事饮食肉...     

Human to human transmission of Brucella melitensis

Human brucellosis is acquired mainly through contact with infected animal tissues, ingestion of unpasteurized dairy products or infected aerosols. Person to person transmission is still considered uncertain. The case of a woman diagnosed with proven brucellosis after her husband suffered a relapse of bacteremia with Brucella melitensis biotype 3, which was originally acquired abroad by eating goat cheese, is described. It was postulated that person to person spread of brucellosis is a likely mode of transmission in this case.     

A Case of HIV Infection with Thrombocytopenia: Assosiation of HIV,Thrombotic Thrombocytopenic Purpura and Brucellosis

To report a case of HIV infection presenting with thrombotic thrombocytopenic purpura (TTP) and brucellosis that responded well to plasmapheresis and anti-infective therapy. A 64-year-old woman with moderate confusion, fever and pancytopenia was admitted. HIV infection history was taken from her family and she was not receiving antiretroviral therapy last one year. She had generalized purpuric skin lesions. Wright tube agglutination test was found positive with a 1:160 dilution and the patient was diagnosed as brucellosis. Detailed literature search showed brucellosis as a possible cause of TTP. Patient was treated by plasma exchange/fresh frozen plasma and antimicrobials and the response was excellent. Although brucellosis seems to explain the clinical picture of this patient, it is revealed that broad differential diagnosis is needed to reach uncommon diagnosis like TTP particularly in HIV infected patients.     

An unusual case of ruptured distal anterior cerebral artery aneurysm associated with brucellosis

Reports have noted aneurysmal dilatation of arteries in association with brucellosis, but involvement of intracranial vessels has not been documented to date. Sixty-one year old female patient who had been diagnosed with brucellosis 14 months earlier presented with symptoms of subarachnoid hemorrhage (SAH). Due to deterioration of the patient's clinical condition in spite of a two-drug antibiotic regimen, she was treated surgically and made a full recovery. It is important to identify this association promptly, as there are clinical implications for optimal management. The article also discusses the timing and duration of antibiotic therapy, indications for and considerations regarding surgery, and the use of other treatment modalities.     

布鲁氏菌病与人类白细胞抗原相关关系的初步探讨

本文报道对51名在工作中因接触带菌羊毛而感染发病的布鲁氏菌病患者,15名同厂健康职工及60名厂外健康者进行了人类白细胞抗原(HLA)分布频率的比较研究。结果表明:病例组与同厂对照组间差异无显著性;病例组与厂外组对照比较可见 A9、A30抗原频率增高。经分析,本文认为遗传性因素对布鲁氏菌病易感性的影响较弱。     

Fieber, Unterschenkelschwellung, Husten und linksseitige Oberbauchschmerzen bei einer 19-jährigen Patientin

Persistent fever and unspecific general symptoms need a complete and thorough medical history and search for infection. We report on a case of brucellosis (Malta fever) with involvement of organs in a 19-year-old woman. She had previously lived on a farm in Portugal for several weeks, where she had consumed self-produced goat cheese. After a latency period of several months, unspecific general symptoms, fever, monarthritis, an increase of transaminases, and a newly diagnosed cardiac murmur became apparent. After the serologic and cultural proof of brucellosis, the patient underwent an antibiotic combination therapy. Within 20 days she was free of symptoms and could be released.     

2020年陕西省一起布鲁氏菌病暴发疫情的调查分析

目的 调查2020年陕西省泾阳县一起家庭布鲁氏菌病(布病)暴发疫情的原因,明确传染源和传播途径,为阻断疫情传播提供科学依据。方法 对报告病例开展布病流行病学调查,并对病例和牲畜进行布病检测和布鲁氏菌分离培养鉴定种型,对结果进行描述和分析。结果 共发现7例确诊病例和6例隐性感染者;确诊病例发病时间为3月18日至5月7日,临床表现以发热为主;经分析,病例发病与食用牛肉无关联(OR=0.48,95%CI:0.08~2.85),与去过首发病例家有关(OR=141.00, 95%CI:17.15~1 159.28);13例病例、2只羊和2只公犬布鲁氏菌抗体检测阳性,血清抗体滴度从1∶100(++)到1∶800(++++)以上;从2例病例、2只羊和1只公犬血液中共分离到5株布鲁氏菌,均为羊种3型,MLVA-16基因型均为(1-5-3-13-2-2-3-2-4-41-8-6-4-3-4-5)。结论 该起布病家庭暴发疫情的原因为公犬叼食了布病阳性羊只的流产物而感染布病,继而人通过与病犬直接接触以及接触被病犬污染的水等生活物质而发病。     

Intravenous gamma globulin is effective as an urgent treatment in Brucella-induced severe thrombocytopenic purpura

Severe thrombocytopenia is a rare hematologic manifestation of brucellosis, which can occasionally be associated with bleeding into the skin and from mucosal sites. Prompt recognition of this brucellosis complication and aggressive therapy is vital because the mortality rate associated with bleeding into the central nervous system is high. We report a case of a patient infected with Brucella melitensis who was admitted with a severe case of thrombocytopenic purpura. The patient responded well to intravenous gamma globulin (IVIg) treatment with platelet recovery within 2-3 days. For cases of Brucella-induced thrombocytopenic purpura, IVIg may be administered as an urgent therapy until the microbial therapy takes effect.     

自贡市2016-2021年布鲁氏菌病暴发疫情特征分析

目的 分析自贡市2016-2021年布鲁氏菌病暴发疫情特点,为非牧区布病聚集性疫情控制提供依据。方法 对2016-2021年自贡市布鲁氏菌病暴发进行现场调查,筛查重点及高危人群和涉及牲畜,分析疫情发生原因及特点,采取相应控制措施。结果 2016-2021年共报告4起布鲁氏菌病本地暴发疫情,涉及20例患者。病例共同暴露者筛查阳性率14.67%(11/76),畜间血清学筛查阳性率16.67%(19/114);MLVA分析显示分离到菌株与北京、宁夏分离菌株同源性为90.6%。结论 2016-2021年自贡布病疫情传染源均为病羊,食用未煮熟羊肉、私下引种(交易)山羊及无防护屠宰加工是引起布鲁氏菌病暴发的主要原因,应强化国内重点地区牲畜引种、畜产品交易的检疫力度,加强对职业人群的监测工作,开展重点人群的知识宣传。     

DRESS syndrome with fatal results induced by sodium valproate in a patient with brucellosis and a positive cytoplasmic antineutrophilic cytoplasmic antibody test result

DRESS syndrome is a life-threatening adverse reaction characterized by skin rashes, fever, leukocytosis with eosinophilia or atypical lymphocytosis, lymph node enlargement, and liver or renal dysfunctions. DRESS syndrome related to valproic acid use is very rarely observed. We present a case of DRESS syndrome induced by sodium valproate, which developed and progressed fatally in a brucellosis patient with a positive c-ANCA test. A 19-year-old female patient presented with fever, cough, jaundice, and rash all over her body. Brucella Coombs test was positive at 1:1280 titers, and the Rose Bengal test was also positive. The involuntary movements were thought to be due to chorea, and the patient was started on sodium valproate 500 mg 2*1, as well as streptomycin 1?g flk 1*1 and tetradox capsules 2*1 for the brucellosis and was discharged. DRESS syndrome was suspected in the patient, and she was taken off sodium valproate and tetradox; N-acetylcysteine, ceftriaxon, prednizolone, and support treatment were started. When sodium valproate is used on its own, it carries no risk of inducing DRESS syndrome. However, in the case presented, another co-morbidity such as brucellosis and c-ANCA positivity was present. We believe that the presence of further co morbidity not yet reported in literature is important from the perspective of the risk of valproate-induced DRESS syndrome. Therefore, if sodium valproate treatment is to be started in patients, especially those with co morbidity, they must be closely monitored with clinical and laboratory observations. At the slightest suspicion of DRESS syndrome, all medication should be ceased immediately and the patient should be placed under continuous observation.     

The Antibody Response to Brucella: Immunoglobulin Response Measured by Enzyme-linked lmmunosorbent Assay and Conventional Tests

Abstract: The antibody response to Brucella: immunoglobulin response measured by enzymelinked immunosorbent assay and conventional tests. G. L. Gilbert and L. A. Hawes, Aust. N.Z. J. Med ., 1981, 11, pp 40–45.
An enzyme-linked immunosorbent assay was adapted to measure total and individual classes of brucella antibody. The results were compared with those of conventional tests for brucella antibody on the sera of a number of healthy seropositive abattoir workers and several patients with either acute or suspected chronic brucellosis. IgG was the class of brucella specific immunoglobulin most commonly detected in all groups. IgM was present in the sera of 40% of seropositive abattoir workers, all but one of the patients with recent acute brucellosis or seroconversion and none of those with suspected chronic brucellosis. Many of the abattoir workers' sera which contained brucella specific IgM gave negative results in the direct agglutination test. The presence of brucella specific lgM in the sera of these men was, in most cases, associated with no past history of acute brucellosis and a relatively short period of employment in the abattoir. It is suggested that the presence of brucella specific IgM in the serum of a person occupationally exposed to 6. abortus, probably indicates a relatively recent primary infection, either symptomatic or sub clinical and has no prognostic significance. Repeated or prolonged exposure is associated with IgG brucella antibodies, often in high titre, irrespective of symptoms. It was not possible, on the basis of any serological tests performed in this study to distinguish healthy people exposed to brucella from those with symptoms consistent with chronic brucellosis