Tuberculosis and cattle breeding : the case of an Egyptian milker

Occupational health in breeding activities is strongly embedded with animal health. Tuberculosis (TB) – known for its critical progress and for the long duration of the drug treatment – has the specificity of a bi-directional infectious potential. Tuberculosis is still endemic in Africa, Asia and Balkan Area. Among these, the most risky regions for the disease are North Africa and India. In the Italian agricultural system, about 37000 migrants are legally employed, most of them in seasonal activities (e.g.: harvesting) but if we consider Northern Italy, we can easily find a significant presence of foreign workers also in animal breeding. In our experience, we have observed that people from India and North Africa are often involved in cattle breeding. Case-report This case report deals with a worker from Aegypt, employed as milker in an Italian enterprise since 1990. The worker, a 51 years old man, affected by chronic HCV, showed suddenly symptoms and signs suggesting lung TB (cough, haemoptysis, weight loss and thoracic pain). A diagnosis of lung TB was made in the past and the worker underwent a multidrug therapy. A re-activation of a silent lung TB due to the immunodepression linked to the chronic liver disease or to a new infection have been inquired with questionnaire. The diagnostic approach performed included BK search in the sputum, lung X-ray, Mantoux test, pulmonary evaluation. The worker was held temporarily not suitable for work. Consequences Preventive measures provide to perform Mantoux test to all milker’s colleagues and to perform tuberculin test to all animals reared. The occupational risk of TB to cattle breeders is discussed in light of bovine TB cases in Lombardy Region.