Bovine tuberculosis in working foxhounds: lessons learned from a complex public health investigation.
Bovine tuberculosis in working foxhounds: lessons learned from a complex public health investigation.
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DOI：
10.1017/s0950268818002753
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发表时间：
2018-10-09
影响因子：
4.2
通讯作者：
Morris J
中科院分区：
文献类型：
--
作者：
Phipps E;McPhedran K;Edwards D;Russell K;O'Connor CM;Gunn-Moore DA;O'Halloran C;Roberts T;Morris J
2017年，英国公共卫生东南健康保护小组(HPT)参与了对一群工作猎犬爆发的牛分枝杆菌(牛结核病的病原体)的管理。本文件总结了该小组在管理疫情的公共卫生方面采取的行动，以及为改进对未来潜在疫情的管理而吸取的经验教训。进行了文献检索，以确定有关牛分枝杆菌的相关出版物。回顾了来自英国公共卫生(PHE)健康保护数据库的临床记录，并提取了关键点。参与情况管理的动物和公共卫生利益攸关方通过非结构化面谈和个人沟通提供了进一步的证据。PHE东南小组最初向人类接触者提供“通知和建议”信函，同时等待实验室确认以确定感染源。一旦牛分枝杆菌在猎犬中被确认，就进行了深入的风险评估，并将接触者分层到风险池中。在20名接触风险最高的接触者中，有11人被建议参加结核病筛查，其中一人检测呈阳性，但没有活动性结核病感染的证据。与猎狐猎犬打交道的人类接触人数可能很多，而且多种多样。HPTS应对所有可能的暴露途径进行全面的风险评估，从早期阶段就让所有其他相关利益攸关方参与，并进行定期风险评估。应修订现行指南，以考虑到接触受感染的工作犬对人类健康构成的独特风险。
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.