| Titre : | Epidemic nephritis in Nova Serrana, Brazil. (2000) |
| Auteurs : | S. BALTER ; G.G. ALVIM ; A. BENIN ; J. ELLIOTT ; R. FACKLAM ; D. JACKSON ; L. LACLAIRE ; S.W. LIMA PINTO ; E. LUNA ; A. SCHUCHAT ; L.M. TEIXEIRA ; Respiratory Diseases Branch. Centers for Disease Control and Prevention. Atlanta. GA. USA |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 355, n° 9217, 2000) |
| Pagination : | 1776-1780 |
| Langues: | Anglais |
| Mots-clés : | Epidémiologie ; Bactérie ; Brésil ; Amérique ; Homme ; Infection urinaire ; Appareil urinaire [pathologie] ; Rein [pathologie] ; Bactériose ; Infection ; Amérique du Sud |
| Résumé : | [BDSP. Notice produite par INIST oR0xRowP. Diffusion soumise à autorisation]. Background Outbreaks of nephritis have been rare since the 1970s. From December, 1997, to July, 1998,253 cases of acute nephritis were identified in Nova Serrana, Brazil. Seven patients required dialysis, and three patients died. We did a case-control study to investigate the cause of the outbreak. Methods Using a matched cluster design, we examined seven recent patients, their family members (n=23), and members of neighbourhood-matched control households (n=22). We subsequently interviewed 50 patients and 50 matched controls about exposure to various dairy products. We also cultured dairy foods and took udder-swab and milk samples from cows. Findings Throat cultures indicated that nephritis was associated with group C Streptococcus equi subspecies zooepidemicus, a cause of bovine mastitis. S zooepidemicus was detected in four of seven case households (six of 30 people) and no control households (p=0.09). Patients were more likely than matched controls to have consumed a locally produced cheese called queijo fresco (matched odds ratio 2.1, p=0.05). The nephritis attack rate was 4.5 per 1000 in Nova Serrana but 18 per 1000 in the village Quilombo do Gaia (p=0.003). The largest supplier of unpasteurised queijo fresco was a farm in Quilombo do Gaia. S zooepidemicus was not detected in food samples or in swabs collected from cows in August, 1998, although mastitis was evident among cows on the suspected farm. (...) |
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