전북 정읍지역 젖소농장 결핵병 집단 발생에 대한 역학조사

The present study describes an investigation on an epidemic of Tuberculosis (TB) which has been occurred among dairy cattle farms in Jeongeup, Jeollabuk-do since 2007. The investigation was performed in three ways as follows: 1. Collecting information about bovine TB outbreaks using investigation reports, an on-the-spot and tracing-back investigations; 2. Analyzing the outbreak pattern; 3. Establishing hypothesis and performing statistical analysis on potential risk factors. In the early 2000s, TB outbreaks were sporadically reported in beef cattle, and only a small number ($1{\sim}2$) of reactors was confirmed in each of outbreak farms. The number of TB outbreaks has been suddenly increased from 2007, mainly in dairy cattle farms. And these outbreaks were temporarily clustered during the period, from March 2007 to April 2009 (relative risk, RR = 13.7, p < 0.001). And two spatial clusters of which radiuses were 0.3 km (RR = 6.9, p < 0.001) and 0.9 km (RR = 3.6, p < 0.01). The analysis to find risk factors was performed on 99 dairy farms (21 outbreaks), which are located in the most seriously affected village during 2007-2009. Middleman (odds ratio, OR = 47.4, p < 0.05) and raw milk collecting system (OR = 6.9, p < 0.05) were recognized as with the highest association. Considering the fact that all the outbreak farms except one had their own manure composting tank, it might be that the manure containing pathogen was leaked from tank and transmitted to other farms by fomites such as middleman or raw milk collecting system.