بروسلوز (Brucellosis)
اسلاید 1: 1بسم الله الرحمن الرحيم Brucellosis
اسلاید 2: 2 A disease, primarily of animals, that can be transmitted to humans as a result of direct or indirect contact with the infected animal populationZOONOSIS
اسلاید 3: 3Brucella are Ideal Biological Warfare AgentsThey are highly infectiousThey can be easily aerosolizedThey are stable in production, storage, & deliveryThey are sensitive to sunlightThey cause high morbidity, but low mortalityThere are no human vaccines against brucellosisThere is high economic loss to animal agriculture
اسلاید 4: 4Fastidious & aerobicFacultative intracellularGram negative non motile cocobacilli2- عامل يا عوامل اتيولوژيك
اسلاید 5: 5Etiologic agents
اسلاید 6: 6Resistance of brucellaResistance of brucellaHeating at 60ºCFor 10 minutesPhenol 1%For 15 minutesDirect sunlightIn a few hoursMilkFor several daysMilk(till the milk turns sour)Fresh cheeseFor 3 monthsTap-waterFor 57 daysHuman urineFor 1 weekDustFor 6 weeksDamp soilFor 10 weeksAnimal fecesFor 100 days
اسلاید 7: 7SpeciesBiotypesBr. Abortus1,2,3,4,5,6,8,9Br. Melitensis12Br. Suis12Br. CanisNot foundIsolated species in Iran
اسلاید 8: 8Skin abrasion, conjunctivae, inhalation or ingestionEngulfed by neutrophils and monocytes (resistant to killing)Localize regional lymph nodesInfect phagocytic cells in the RE system and form granulomasPathogenesis
اسلاید 9: 91 ـ دوره نهفتگي5-60 days (1-2 month)
اسلاید 10: 10Occurs worldwideEndemic areas - Africa, AsiaTrue incidence not known3 ـ انتشار جغرافيائي
اسلاید 11: 11SeasonRe. 42Ref. 41Ref. 36Ref. 34MinSpring4941285242Summer3322353434Autumn1515251417Winter3121207Seasonal distribution in Iran
اسلاید 12: 12Effect of GenderMen aged 15-45 years are affected twice as often as women of the same ageMale predominance seem to be a factor in some casesThe man is more likely than the woman to be exposed to the heaviest concentration of organisms
اسلاید 13: 13Effect of GenderIn Iran both sexes are nearly always equally contacted with contaminated animals and dairy productsThere is not a significant predominance of male to female brucellosis in Iran
اسلاید 14: 14Sex distribution in IranMale56%Female44%
اسلاید 15: 15Age distribution Children are affected very much less than adultsThe odd low incidence in children is unexplainedIt may be that gastric acidity is less often deficient than in adultOccupational exposure is much more important
اسلاید 16: 160-4 5-9 10-14 20-24 30-34 40-44 50-54 + 60توزيع سني 56000 بيمار ايراني در سال 1370
اسلاید 17: 17Occupational hazardsFarmersShepherds, goatherdsVeterinariansAbattoir workersLaboratory workersButchers
اسلاید 18: 18موقعيت اجتماعي و شغلي 56000 مورد بروسلوز گزارش شده در ايران در سال 1370%
اسلاید 19: 196 ـ تاثير عوامل مساعد كنندهعوامل فرهنگي و عقيدتيزمينه هائي نظير ضعف ايمني ، ابتلاء به بيماريهاي سركوبگر ايمني ، مصرف داروهاي مضعف سيستم ايمنياسترس هاي مختلففقر و بي خانماني
اسلاید 20: 207 ـ حساسيت و مقاومت در مقابل بيماريمقاومت طبيعيمصونيت اكتسابي بعد از ابتلاءمصونيت اكتسابي بعد از واكسيناسيون- در انسان ؟- در حيوانات ؟
اسلاید 21: 21Brucellosis in animalsTransmitted by contact with infected tissue or milk (oral, aerosol or abrasion) Predilection for erythritol rich organs (breast, uterus, epididymis, ect.)Abortions, mastitis and sterility
اسلاید 22: 22Transmission of brucellosisFarmers / RanchersVeterinarians (food animal practice)Brucellosis eradication personnelMeat inspection personnelAbattoir workersLaboratory personnel
اسلاید 23: 23Transmission of brucellosisBrucellosis as a Food Borne DiseaseIs not occupation relatedOften no history of animal contactMay occur outside brucellosis enzootic areasOften occurs in outbreaksMay involve women & childrenMay involve travelers to brucellosis enzootic areas
اسلاید 24: 24ReservoirsNatural Human SpeciesHostPathogenBrucella abortusCattle*Brucella suisSwine*Brucella melitensisGoats/Sheep*Brucella ovisSheepBrucella canisDogs*Brucella neotomaeDesert wood rat7
اسلاید 25: 25Occurrence in Wildlife
اسلاید 26: 26ReservoirMammalian parasiteHost specificity is not exclusiveHorse is occasionally infectedSerum from camels have proved positiveHave been isolated from foxes, buffaloes, elk, moose, deer, polecatsRabbits have been infectedInfection of hares have proved
اسلاید 27: 27ReservoirFlies, mosquitoes, ticks and other insects can be infected with all speciesTicks have transmitted to guinea pigs by bitingDogs and cats are fairly resistantHas not been found in monkeys
اسلاید 28: 28In many parts of the world, cattle are heavily infectedBr. Abortus is most commonly involvedThey may readily infect with Br. Melitensis and Br. suisInfection of Cattle
اسلاید 29: 29Br. Melitensis do not cause serious symptoms in cattle Br. Abortus may lead to death of the fetus and abortionThe aborted fetus, the placenta and the discharge from vagina are all heavily contaminatedInfection of Cattle
اسلاید 30: 30Infection of CattleBrucella tend to lodge in mammary gland and supramammary lymph nodesThey may shed in the milk for yearsThe organisms tend to settle in the testicles, epididymis and seminal vesiclesOrganisms may be present in the semen and may transmit sexuallyTransmission by artificial inseminationIn cattle is a serious economic and public health problem
اسلاید 31: 31Infection of GoatsIs always due to Br. MelitensisAbortion is not a prominent symptomsReduced fertility in the herdBr. Melitensis is passed in enormous numbers in the milk for 6-7 month
اسلاید 32: 32Infection of SheepIs always due to Br. MelitensisIs occasionally due to Br. Abortus or Br. SuisAffecting fertility and meat and wool production
اسلاید 33: 33Infection of SwineBr. Suis is the most common brucella in swine Swine may infect with brucella abortus and melitensisThe semen may be teeming with brucella and the boar may disseminate infection throughout the herd
اسلاید 34: 34Transmission between animalsMilkMeatTrans placentallySexually (& artificial insemination)RespiratoryUrine
اسلاید 35: 35Mode of transmissionIngestionInhalationAbrasion skinMucous membranesConjunctiveSexual Blood transfusionOrgan transplant
اسلاید 36: 36
اسلاید 37: 37Mode of transmission1 ) تغذيه با شير خام در دوران شيرخوارگي و بعد از آن.2 ) مصرف لبنيات خام، نظير پنير و خامه روستايي.3 ) خوردن دنبلان آلوده اي كه خوب پخته نشده باشد.4 ) تماس مستقيم با نوزادان تازه متولد شده حيوانات (گوساله، بزغاله، بره) 0 5 ) تماس مستقيم با نسوج حيواني آلوده، نظير مثانه حيوانات ذبح شده.6 ) از طريق افشانه‌هاي (آئروسل) موجود در هواي آغل و اصطبل .7 ) به هنگام بازي با وسايل كشاورزي، از طريق پوست آسيب ديده.8 ) از طريق پاها و دست‌هاي ترك خورده كودكان روستايي.9 ) تغذيه با شير آلوده مادر و انتقال داخل رحمي را نيز در بروسلوز مادرزادي (Congenital)، دخيل دانسته اند.در شيرخواران و كودكان روستائي
اسلاید 38: 38ج ـ پيشگيري و كنترل بروسلوزPrimordial Prevention: “…minimize hazards to health”Primary Prevention:Prevention of disease in “well” individualsSecondary Prevention:Identification and intervention in early stages of diseaseTertiary Prevention:Prevention of further deterioration, reduction in complications
اسلاید 39: 39كنترل بروسلوز1 ـ مبارزه با منابع و مخازن2 ـ قطع زنجيره انتقال3 ـ حفظ افراد سالم
اسلاید 40: 40كنترل بروسلوز1 ـ مبارزه با مخازنشناسائي حيوانات بيمارايزوله كردن بيماران ؟؟منابع محيطي ؟؟
اسلاید 41: 41كنترل بروسلوز2 ـ قطع زنجيره انتقالتماس‌هاي مستقيم و غيرمستقيمآب، غذا و . . . پوست، مخاط، هوا، جفت . . .
اسلاید 42: 42كنترل بروسلوز3 ـ حفظ افراد سالممصونسازي اكتيو ؟مصونسازي پاسيو ؟كموپروفيلاكسي ؟
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