Journal Club

1
Journal Club

• Dr. Jaruwan Kampa
• Dr. Piyawat Saipan
• Ass.Prof.Dr.Komkrit Pimpukdee

2
Investigation of the spread of brucellosis among
human and animal populations in southeastern
Bulgaria, 2007
3
Structure

• Abstract
• Introduction
• (Material ) Methods
• Results
• Discussion and Conclusion

4
Structure

• Abstract
• Introduction
• (Material ) Methods
• Results
• Discussion and Conclusion

5
Structure

• Abstract
• Introduction
• (Material ) Methods
• Results
• Discussion and Conclusion

6
Structure

• Abstract
• Introduction
• (Material ) Methods
• Results
• Discussion and Conclusion

7
Abstract

• ??????????? ?? 2007 ???????????? brucellosis 3 ??
  ????? Haskovo ???????????????????????????????
• ?????????????????????????????????????????
  ??????????????????????????????
• ??????????? 410/ 90,000 ???
• ?? 47/561
• ?????????
• ?????????
• ?????????????????????????????

8
Introduction
9
???????????

• Brucella spp.
• Brucella melitensis ??? ???
• Brucella abortus ?? ??????
• Brucella suis ????
• Brucella canis ????? ???

10
General characteristic

• Coccobacilli
• Gram negative, non-spore forming
• Obligate parasite
• Reticuloendothelial system genital tract

11
Transmission

• Shedding
• Milk, urine, vaginal discharge, semen, lochia,
  fetus

• Direct contact
• insemination, respiration, transplacenta
• Indirect contact
• ingestion of contaminated food/water/milk
• Semen
• Vaccine
• Air????

12
?????????????

• ?????????? 2-10 ??????? ? 6 ?????
• ??? ???? ??????? ??? ??????????
• ???????????????, ?????????????, ???

13
??????????

• ???????
• ??????????? 500,000 ???/??
• ???????????????????????????????
• ?????????
• ?????
• ????????
• ??????????????????????

• ????????? 100,000 ??
• ????(1.1), ??????(0.78), ?????????(0.72),
  ????(0.3)

14
?????? ????????? (Bulgaria)

• ?? 2005 37 cases
• ?? 2006 11 cases
• ?? 2007 50 cases

15
(No Transcript)
16
Objective

• ????????????????????????
• ?????????????????????????????
• ???????????????????????????
• ????????????????????????????????????

17
Methods

• Case investigation
• Epizootiological study
• Study in human poppulation

18
Case investigation ???????????????
19
Case investigation (cont.)

• ?????????
• ????????????
• ???????????????????????? Brucellosis
• ??????????????????????????????
• ?????????? ???????????? ?????????? pasturization
• ?????????

20
Epizootiological study

• ??????????????????????????
• Serological screening
• ?????????????????? ??? ??? ?? ??? ??
• 90,345
• Rose bengal test
• Complement fixation test
• Confirmation
• Rose Bengal, Complement fixation
• ELISA

21
Study in human population

• ??????? 22,335 ??
• ??????????????????
• ????????????? ????????????????
• ??????? ??? ??/??? ??????????????????????
• ?????? ???????? ????????????????????????????????
  ??????????????????

22
Study in human population

• ?????????
• ???? 561 ?? ??????????? 581 ????????
• ???????????
• Rose Bengal, Wright test (agglutination)
• Brucellacapt (ELISA) , Rose Bengal, Wright test
• Questionnaire 561 ??

23
Results

• Case investigation
• Epizootiological investigation
• Study in human population

24
Case investigation

• 3 cases
• 1 ???????? Valche pole
• 2 ????? Harmanli

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- case 1

• ???? ???? 62 ??
• ???????????
• ????? ??? ??????? ??????????? ??????????
  ?????????????????????
• ELISA positive brucellosis

• ???????????????
• ???????????????-???? ??????????????????????????
  ???????? Valche pole
• ??????????????????????????
• ????????????????
• ????????????????????? (??? ???)
• 4 ??????? brucellosis

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-case 2

• ??? ???? 62 ??
• ???????????????? (May)
• ????????????
• ??????? (July)
• ?????
• ??? ???? ??????
• ???????????????? ? boutonneous fever?
• ???????????

• ????????????
• ???????????
• ?????????
• ??????? (September)
• Positive brucellosis
• ????????????????
• Positive brucellosis

27
-case 3

• ???? 74 ??
• ??????? (September)
• ??? ??????????????? ?????????

• ?????????
• ????????????? 2006 ?????? 2007
• ?????????

28
Epizootiological investigation

• ????? 90,345 ???
• ??? ??? ?? ??? ?? ??10 ???????
• ??????????????
• ???????? ????????????? ?????????? 2007

• ?? positive brucellosis
• ?????????????
• 403 ??? ???
• 7 ??
• ??????????
• 83 ?????

29
Study in human population
Interview ??????????????????????????????????????
???? ???????? /????????????????????????????????
30
- Study in human population (cont)

• 1. ??? ???????? ---? ??
• 2. ???????????????????? 3 ?? ????????????????? 47
  ??
• 3. ??????????? ?????? ???? ????????????
• 4. ???????????
• ?????? ??????????? 45 ?? (84)
• ???????????????????? 64 ??
• ?????????? ??????????????????????????????
• ?????? 52

31
(No Transcript)
32
??? 26 (52)
???? 24 (48)
33
???????????????????
34
Discussion Conclusion
35
Discussion Conclusion

• 1. ?????????? brucellosis ???? ???????????????????
  ??????????
• 2. ???????? ??? ???????????
• 3. ???????????? ???
• ??????????????????????
• ????/??? ?????
• 4. Brucellosis ?????????????????????????????????
• 5. ??????????? ???????????????

36
Discussion Conclusion (cont.)

• ??????????????? ????????????????????
• ?????????????????????
• ????????????????????????????????????????? ??

• ????????
• ????????????? brucellosis ????????????????????????
  ??????????? (case 2)
• ??????????????
• ?????????????

37
Discussion Conclusion (cont.)

• ????????????????????????????????
• ??????????????
• ?????????????????????
• ?????????????????????????????????
• ???????????????
• ???????????????????

38
Discussion Conclusion (cont.)

• ??????????????????
• ??????????????????? 3 ?????
• ????????? ????????????????????????????????????????
  ?????????
• 2008
• 1 ?????????????????
• 10 ?????????????????????????