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Tuberculosis, an unusual source - a case report
Alexandra Lima Roque1, Silvia Maria Pimenta1, Rita Assis Ribeiro1
1Serviço de Saúde Ocupacional, Centro Hospitalar Lisboa Ocidental, Lisboa, Lisboa, Portugal.
Abstract:
Tuberculosis is an infectious disease caused by bacteria in the Mycobacterium tuberculosis complex. It can affect any organ, but the pulmonary form is the most common manifestation. Not only humans can be affected by tuberculosis, and animals are also commonly infected. This disease can be transmitted to humans usually by inhalation of aerosols or by ingestion of unpasteurized milk or dairy products. We report the case of a zoo worker. He reported an epidemiological context of contact with sea lions and dolphins, of which he takes care, with tuberculosis in the last 4 months. He sought permanent medical care for a 3-week history of cough, fever, sweating, and weight loss. Bronchial lavage was positive for acid-alcohol resistant bacilli. Lavage cultures were positive for the M. tuberculosis complex. The patient was referred for treatment with antituberculosis drugs. Tuberculosis is a major public health problem worldwide. In the occupational setting, tuberculosis remains a matter of great concern and attention, most often in the hospital environment or among health care professionals. However, the case reported here shows another, less usual occupational setting in which this type of contact can also occur. It is expected that the warning of this case can be used by occupational health teams, namely those who are responsible for periodic surveillance of workers' health in the animal sector.
Insights
Tuberculosis (TB) can spread from animals to humans. A zoo worker caring for sea lions and dolphins contracted TB, highlighting a less common occupational risk.
Area of Science:
- Zoonotic Diseases
- Infectious Disease Epidemiology
- Occupational Health
Background:
- Tuberculosis (TB) is a significant global public health issue caused by Mycobacterium tuberculosis.
- While commonly associated with human-to-human transmission, TB can also affect animals and be transmitted to humans.
Observation:
- A zoo worker with extensive contact with sea lions and dolphins presented with classic TB symptoms including cough, fever, and weight loss.
- Diagnostic tests confirmed the presence of Mycobacterium tuberculosis complex in the worker's bronchial lavage.
Findings:
- The case demonstrates a potential occupational transmission of tuberculosis from marine mammals to a zoo worker.
- This highlights an unusual zoonotic transmission route distinct from typical hospital or farm settings.
Implications:
- This case underscores the importance of considering zoonotic TB in occupational health surveillance for animal handlers.
- Awareness of this risk can inform preventative measures and health monitoring protocols for workers in zoological environments.
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