A Case of Human Brucellosis Who had No Contact with Infected Animal: Sero-epidemiology Study on Market, by-product, Stock-raising

감염된 가축과의 직접 접촉 없이 발생한 브루셀라증 환자1례와 축산 부산물 시장에서의 역학조사

Jung, Sung-Joo;Kim, Sung-Bum;Park, Bae-Won;Jeong, Hye-Won;Kee, Sae-Yoon;Kwon, Jung-Ah;Park, Man-Suck;Park, Mi-Yeoun;Cheong, Hee-Jin;Kim, Woo-Joo
정성주;김성범;박대원;정혜원;기세윤;권정아;박만석;박미연;정희진;김우주

  • Published : 20040600

Abstract

Brucellosis is a world-wide zoonotic disease. We report the first case of brucellosis in South Korea that is not related to direct contract with intected cattles. The patient had been working in the market of by-product, stock raising for twenty years and complained of 1-month history of fever, chill, and intermittent epistaxis. We confirmed brucellosis by anti-brucella antibody test and PCR. After 6 weeks' treatment with rifampicin and doxycycline, fever and chilling subsided, and, generalized weakness and oral intake improved. We performed seroepidemiology study against workers who were working in the same market as the patient. However, we couldn't find out other cases with seropositivity. We concluded that although the workers of by-product market have a risk of getting brucellosis, the risk is low.

브루셀라증은 전 세계적으로 발생하는 인수공통 전염병중에 하나로서, 본 증례는 국내에서 감염된 가축에 대한 노출력이 없는 집단에서 현증 브루셀라증이 발생한 첫 증례이기에 문헌 고찰과 함께 보고한다. 또한 환자가 근무하였던 축산물 부산물 시장에서 역학 조사를 실시하여, 현증환자 및 기감염자를 발견하여 축산물 부산물 시장 근무자에서 현증 브루셀라증이 발생할 위험성을 평가하였다. 역학 조사 결과 축산물 부산물을 다루는 일을 하는 사람들에서 감염된 가축과의 직접 접촉이 없이도 브루셀라증이 발생할 수 있음을 알 수 있었다.

Keywords

References

  1. Elzer PH Update:Knowledge on bovine brucellosis. Korean Journal of Buiatrics 3:101-108., 1998
  2. 김종만, 김옥경:최근 문제시되는 인수공통전염병의 발생현황 및 근절대책. 2000년도 한국수의공중보건학회 추계학술대회:34-46, 2000
  3. 박만석, 우영석, 이민정, 심수경, 이혜경, 최영실, 이우홍, 김기현, 박미연:국내 브루셀라균에 감염된 환자 1예. 감염과 화학요법 35:461-466, 2003
  4. 질병관리본부:브루셀라증 예방.관리. 1-37 , 2002
  5. Taleski V, Zerva L, Kantardjiev T, Cvetnic Z, Erski-Biljic M, Nikolovski B, Bosnjakovski J, Katalinic-Jankovic V, Panteliadou A, Stojkoski S, Kirandziski T:An overview of the epidemiology and epizootology of brucellosis in selected countries of Central and Southeast Europe. Vet Microbiol 90:147-155, 2002
  6. Buchanan TM, Hendricks SL, Patton CM, Feldman RA:Brucellosis in the United States, 1960-1972; An abattoir-associated disease. Part III. Epidemiology and evidence for acquired immunity. Medicine 53:427-439, 1974
  7. Rumley RL, Chapman SW:Brucella canis:an infectious cause of prolonged fever of undetermined origin. South Med J 79:626-628, 1986
  8. Stantic-Pavlinic M. Cec V. Mehle J:Brucellosis in spouses and the possibility of interhuman infection. Infection 11:313-314, 1983
  9. Gotuzzo E, Carillo C, Guerra J, Llowa L:An evaluation of diagnostic methods of brucellosis-the value of bone marrow culture. J Infect Dis 153: 122-125, 1986
  10. Araj GF, Lulu AR, Mustafa MY, Khateeb ML: Evaluation of ELISA in the diagnosis of acute and chronic brucellosis in human beings. J Hyg 97: 457-469, 1986
  11. Lee G, Dennis A:Cecil textbook of medicine 22nd ed. p 1889, Philadelphia, WB Saunders Co., 2004
  12. Crosby E, Llosa L, Miro Quesada M, Carrillo C, Gotuzzo E:Hematologic changes in brucellosis. J Infect Dis 150:419-424, 1984
  13. Figueroa Damian R, Rojas Rodriguez L, Marcano Tochon ES:Brucellosis in pregnancy:course and perinatal results. Ginecol Obstet Mex 63:190-195, 1995
  14. WHO Publications Center USA:Joint FAO/WHO Expert Committee on Brucellosis:sixth report. World Health Organ Tech Rep Se 740:1-132, 1986
  15. Sauret JM, Vilissova N:Human Brucellosis. J Am Board Fam Pract 15:401-406, 2002