José Pereira, Ana Vieira, Pedro Pinto, A. Pereira
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引用次数: 0

摘要

鹦鹉热是由鹦鹉衣原菌引起的一种罕见的疾病。这种细菌通过接触受污染的鸟类传播,即鹦鹉形目动物,包括鹦鹉、金刚鹦鹉和长尾小鹦鹉,如鸽子和鸡。这项工作的目的是突出病理和职业健康在其中的作用。方法采用关键词“鹦鹉热”、“职业暴露”和“职业健康”,对PubMed和Cochrane图书馆数据库中于2022年6月以葡萄牙语和英语发表的原创文章进行书目检索。此外,报告葡萄牙现实情况的三篇文章也被纳入研究范围之外,但与工作相关。疫情可能发生在与活禽或死禽有接触的工作人员中,如兽医、饲养员或宠物店工作人员。然而,可能由于缺乏常规筛查,很难确定鹦鹉热的确切发病率和患病率。传播主要通过气溶胶、吸入尿液、粪便或其他污染颗粒发生;人与人之间的传播虽然可能,但很罕见。潜伏期为5至14天,但在亚急性或潜伏感染的情况下可延长至数周。它的临床表现类似于流感样综合征,可引起播散性甚至可能致命的疾病。胸片上最常见的表现是节段性或大叶实变,尤其是在下肺叶。偶尔可引起明显的白细胞增多,c反应蛋白(CRP)常升高,约半数住院患者肝酶改变,伴有天冬氨酸转氨酶(AST)升高和血清白蛋白水平降低。四环素是治疗的首选药物。虽然病例数量显然很少,但这种疾病的影响很可能被低估了。因此,有必要提高职业卫生专业人员以及雇主和工人自己对这种病理的认识。另一方面,需要一种方法,包括人类和动物卫生机构、实验室以及医疗和兽医专业人员之间的合作,以便及时监测、报告和治疗。因此,为了诊断和制定适当的治疗,对流行病学背景的回顾和早期识别是极其重要的。此外,应考虑职业风险因素和工人之间的接触控制,以防止在工作场所传播。关键词:鹦鹉热,职业暴露,职业健康。
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Psitacose e Saúde Ocupacional
Introduction/framework/objectives Psittacosis is a rare entity caused by Chlamydophila psittaci. This bacterium is transmitted through contact with contaminated birds, namely psittaciformes, which include parrots, macaws and parakeets, as pigeons and chickens. The objective of this work is to highlight the pathology and the role of Occupational Health in it. Methodology A bibliographic search was carried out on original articles published in Portuguese and English, in June 2022, in the PubMed and Cochrane Library databases, using the keywords “Psittacosis”, “Occupational exposure” and “Occupational health”. Three articles were also included, not covered by the research, relevant to the work, for reporting the Portuguese reality. Contents Outbreaks can occur in workers with occupations that involve contact with live birds or carcasses, such as veterinarians, breeders, or pet store workers. However, it is difficult to establish the precise incidence and prevalence of psittacosis, probably due to the lack of routine screening. Transmission occurs mainly by aerosols, inhalation of urine, feces or other contaminated particles; transmission between humans, although possible, is rare. The incubation period ranges from five to 14 days, but may extend to weeks in cases of subacute or latent infection. It has a clinical presentation like a flu-like syndrome and can cause disseminated and even potentially fatal disease. The most frequent findings on chest radiography are segmental or lobar consolidation, especially in the lower lobes. It can occasionally cause marked leukocytosis, c-reactive protein (CRP) is often elevated, and liver enzymes change in approximately half of hospitalized patients, with elevation of aspartate aminotransferase (AST) and low serum albumin levels. Tetracyclines are the drug of choice for treatment. Discussion and Conclusions Although the number of cases is apparently small, the impact of the disease is most likely underestimated. Thus, it is necessary to increase the awareness of this pathology both for Occupational Health professionals and for employers and workers themselves. On the other hand, an approach is needed that encompasses collaboration between human and animal health agencies, laboratories and medical and veterinary professionals, for timely surveillance, reporting and treatment. Thus, anamnesis and early recognition of the epidemiological context are extremely important, with a view to diagnosing and instituting appropriate therapy. In addition, occupational risk factors and exposure control among workers should be considered to prevent transmission in the workplace. KEYWORDS: psittacosis, occupational exposure, occupational health.
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