title: [Epidemic outbreak of 81 cases of brucellosis following the consumption of fresh cheese without pasteurization].
abstract: BACKGROUND
  In spite of the great effort that has been made in recent years in Castilla-La Mancha to control brucelosis, a lack of awareness on the part of producers and consumers leads to major epidemic outbreak, such as the one described below.
  
  
  METHODS
  A description of the outbreak is described and a study is conducted of cases and controls to determine the factors which are responsible for the epidemic. Unadjusted and adjusted Odds Ratios (O.R.) are obtained together with their confidence intervals, for the main epidemiological factors studied.
  
  
  RESULTS
  A total of 81 cases of brucelosis were recorded in a period of 25 weeks. All the cases occurred in the same borough or were in some way linked to it. In the case and controls study no differences were found with regard to age, sex, contact with livestock or the consumption of pasteurised milk or cheese. A strong link was established between the illness and the consumption of home-made cottage cheese prepared by a small-scale producer in the borough, (O.R. = 311.9; C.I. = 95% = 41.48-12735)., whose livestock turned out to be infected with Brucella Mellitensis.
  
  
  CONCLUSIONS
  This outbreak showed that in Spain, there is a risk of contracting brucelosis by consuming non-pasteurised dairy products, particularly cheese, when these are not subjected to the normal sanitary and health controls. The benefits of epidemiological research in the search for cases and determining the factors responsible for the outbreak are also demonstrated. An intensification of controls, the cleansing of the herds and flocks and health education in general, are suitable instruments for controlling this zoonosis in Spain.
authors.affiliation: Centro Nacional de Epidemiología, Programa de Epidemiología Aplicada de Campo.
authors.forename: J
authors.initials: J
authors.lastname: Castell Monsalve
authors.forename: J V
authors.initials: JV
authors.lastname: Rullán
authors.forename: E F
authors.initials: EF
authors.lastname: Peiró Callizo
authors.forename: A
authors.initials: A
authors.lastname: Nieto-Sandoval Alcolea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017347:Brucella melitensis / Q000302:isolation & purification*; D002006:Brucellosis / Q000453:epidemiology* / Q000382:microbiology; D002611:Cheese / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005260:Female; D005511:Food Handling; D006801:Humans; D008297:Male; D008875:Middle Aged; D013029:Space-Time Clustering; D013030:Spain / Q000453:epidemiology