摘要
目的调查一起胃肠炎暴发疫情病原和传播危险因素,为有效控制疫情提供依据,同时为减少该类事件的发生提供经验。方法制定统一病例定义,开展主动病例搜索,利用病例对照研究寻找可疑餐次和可疑食品。采集病例粪便、肛拭子、呕吐物、环境样本等进行荧光定量PCR核酸检测和细菌分离培养。结果该公司共发现病例18例,流行曲线提示为点源暴露。病例对照研究结果显示3月30日午餐是危险餐次（OR=6.13,OR 95%CI=1.248～30.44）,其中香辣花蛤是危险食物（OR=30,OR 95%CI=5.67～158.80）。采样的16名病例中10人样品诺如病毒核酸阳性,阳性病例的4人为肛拭子、4人为粪便、2人为呕吐物。现场卫生学调查发现,在食品加工过程中,存在生熟食物交叉污染或花蛤未煮熟煮透引起可能。结论该起疫情为诺如病毒感染引起的胃肠炎聚集性病例疫情,可能的感染来源是食用了受诺如病毒污染的花蛤,制作过程中生熟食物交叉污染或未煮熟煮透是可能的危险因素。
Objective To investigate the pathogens and transmission risk factors of an outbreak of gastroenteritis, and to pro- vide evidence and experience for controlling the epidemic effectively and decreasing the occurrence of the similar events. Meth- ods The uniform case- definition was formulated and the cases were actively searched. Case - control study method was used to search the suspicious meals and food. Stool, anal swabs, vomit and other environmental samples were collected, and then ana- lyzed using fluorescent quantitative PCR nucleic acid detection. The pathogens were isolated and cultured. Results Eighteen cases were found in the company surveyed, and the epidemic curve suggested a point source of exposure. The result of case - con- trol study demonstrated that the lunch of March 30 was the dangerous meal time （ OR = 6.13, OR 95 % CI = 1. 248 - 30.44） and the spicy clams were the dangerous food （ OR = 30, OR 95 % CI = 5.67 - 158.80）. 10 specimens of 16 cases were detected to be nomvims nucleic acid positive, which consisted of 4 anal swabs, 4 stool samples and 2 vomit specimens. Field hygienic in- vestigation showed that cross - contamination might occur in the process of preparing raw food and cooked food and the spicy clams might be half - cooked or not be thoroughly cooked. Conclusions The epidemic is a cluster of gastroenteritis cases caused by norovirus infection. Eating spicy clams contaminated by norovirus may be the source of the norovirus outbreak, and the risk factors may be cross- contamination during raw food and cooked fc~ preparation or half- cooked spicy clams.
出处
《实用预防医学》
CAS
2014年第6期683-685,共3页
Practical Preventive Medicine
