RESUMO
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.
A tuberculose é uma doença infecciosa causada por bactérias do Mycobacterium tuberculosis complex. Pode atingir qualquer órgão, sendo a forma pulmonar a mais frequente. Não só os humanos podem ser atingidos pela tuberculose, sendo também muito comum a existência de infecção de animais. Essa patologia pode espalhar-se para os humanos, normalmente pela inalação de aerossóis ou pela ingestão de leite ou derivados não pasteurizados. Trata-se do caso de um trabalhador de zoológico, com contexto epidemiológico de contato com leões-marinhos com tuberculose nos últimos 4 meses. Recorreu a atendimento permanente por história de 3 semanas de tosse, febre, sudorese e perda ponderal. A pesquisa de bacilos resistentes a álcool-ácido no lavado brônquico revelou-se positiva. Quanto ao exame cultural do lavado, concluiu-se positivo para M. tuberculosis complex. Foi, então, realizado o devido encaminhamento, e o paciente iniciou tratamento com antibacilares. A tuberculose constitui um importante problema de saúde pública em nível global. No contexto ocupacional, mantém-se como um motivo de grande preocupação e atenção, mais frequentemente em meio hospitalar ou entre os profissionais de saúde. No entanto, este caso mostra outro contexto ocupacional, menos óbvio, em que este tipo de contato também pode acontecer. Espera-se que o alerta do presente caso possa ser utilizado pelas equipas de saúde ocupacional, nomeadamente as que realizam vigilância periódica a trabalhadores do setor animal.
RESUMO
Introduction: Healthcare professionals are among the main risk groups for novel coronavirus disease (COVID 19). The identification of respiratory symptoms is important in the clinical assumption of infection, but it may be asymptomatic or paucisymptomatic. Objectives: To compare the proportion of professionals with symptoms suggestive of COVID-19 who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with the proportion of positive asymptomatic professionals with high-risk contact; and to identify respiratory and non-respiratory symptoms of professionals with suspected COVID-19 and the proportion of those who tested positive for SARS CoV-2. Methods: This is a cross-sectional study that retrospectively analyzed clinical records of health professionals who spontaneously sought the occupational health service of a university hospital center from March to August 2020 for presenting with symptoms and/or for having had high risk contact with a confirmed case of COVID-19 and who, in this context, underwent the reverse transcription polymerase chain reaction test for SARS-CoV-2. Results: COVID-19 was confirmed in 27 of the 420 symptomatic professionals vs. three of the 193 asymptomatic professionals (p = 0.009). Of the 371 professionals with respiratory symptoms, 19 were positive for COVID-19 vs. 11 among the 242 with no respiratory symptoms (p = 0.750). Nasal congestion and rhinorrhea were the respiratory symptoms with the highest proportion of positive cases (11.43 and 8.97%, respectively). Conclusions: Although COVID-19 is typically associated with respiratory symptoms, not all these symptoms were predictive of disease. It becomes crucial to value mild symptoms among healthcare professionals.
RESUMO
La epidemiología espacial se utiliza para describir, cuantificar y explicar las variaciones geográficas de las enfermedades; para evaluar la relación entre la incidencia de enfermedades y posibles factores de riesgo, y para identificar los conglomerados geográficos de las enfermedades. Este artículo revisa los principales aspectos de la epidemiología espacial, empezando con una explicación de la importancia de trazar mapas de los datos de salud, una perspectiva histórica del desarrollo de la disciplina, una descripción de los tipos de datos espaciales, algunos métodos de estadística espacial y la importancia de los Sistemas de Información Geográfica (SIG) en el análisis de datos referenciados espacialmente.Algunas aplicaciones de los SIG en salud bucal se presentan también.
Spatial Epidemiology is used to describe, quantify and explain the geographical variations of diseases, to evaluate the association between the incidence of diseases and potential risk factors and to identify spatial clusters of diseases. This article goes through the main aspects of spatial epidemiology, starting with an explanation of the importance of mapping health data, an historical perspective of the development of the discipline, a description of spatial data types, some methods of spatial statistics, and the importance of Geographical Information Systems (GIS) in the analysis of spatially-referenced data. Some applications ofGIS regarding oral health are presented.