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首页> 美国卫生研究院文献>Epidemiology and Infection >Bovine tuberculosis in working foxhounds: lessons learned from a complex public health investigation
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Bovine tuberculosis in working foxhounds: lessons learned from a complex public health investigation

机译：猎狐犬的牛结核病：从复杂的公共卫生调查中学到的教训

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In 2017, Public Health England South East Health Protection Team (HPT) were involved in the management of an outbreak of Mycobacterium bovis (the causative agent of bovine tuberculosis) in a pack of working foxhounds. This paper summarises the actions taken by the team in managing the public health aspects of the outbreak, and lessons learned to improve the management of future potential outbreaks. A literature search was conducted to identify relevant publications on M. bovis. Clinical notes from the Public Health England (PHE) health protection database were reviewed and key points extracted. Animal and public health stakeholders involved in the management of the situation provided further evidence through unstructured interviews and personal communications. The PHE South East team initially provided ‘inform and advise’ letters to human contacts whilst awaiting laboratory confirmation to identify the infectious agent. Once M. bovis had been confirmed in the hounds, an in-depth risk assessment was conducted, and contacts were stratified in to risk pools. Eleven out of 20 exposed persons with the greatest risk of exposure were recommended to attend TB screening and one tested positive, but had no evidence of active TB infection. The number of human contacts working with foxhound packs can be large and varied. HPTs should undertake a comprehensive risk assessment of all potential routes of exposure, involve all other relevant stakeholders from an early stage and undertake regular risk assessments. Current guidance should be revised to account for the unique risks to human health posed by exposure to infected working dogs.
机译：2017年，英格兰公共卫生局东南健康保护小组（HPT）参与了一包工作猎狐犬的牛分枝杆菌（牛结核病病原体）暴发的管理工作。本文总结了团队在管理疫情的公共卫生方面采取的行动，并总结了改进未来潜在疫情管理的经验教训。进行了文献检索，以确定有关牛分枝杆菌的相关出版物。审查了来自英国公共卫生（PHE）健康保护数据库的临床笔记，并提取了要点。参与情况管理的动物和公共卫生利益相关者通过非结构化访谈和个人交流提供了进一步的证据。 PHE东南团队最初在与人类接触时提供“通知和建议”信，同时等待实验室确认以确认感染原。一旦确认了牛分枝杆菌，便进行了深入的风险评估，并将接触者分层到风险库中。建议在接触风险最大的20名接触者中，有11名接受结核病筛查，其中1名试验呈阳性，但没有活动性结核感染的证据。使用猎狐犬背包的人接触的数量可能很大且各不相同。 HPT应该对所有潜在的暴露途径进行全面的风险评估，从早期开始就让所有其他相关利益相关者参与进来，并进行定期的风险评估。应修订当前指南，以说明暴露于受感染的工作犬对人体健康造成的独特风险。

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