摘要
目的查明引起某学校食源性疾病暴发的可疑食品、致病因子和危险因素,为今后类似事件的防控和调查提供参考依据。方法通过描述性流行病学方法分析病例的临床特征、流行病学特征及相关危险因素,开展病例对照研究,确定可疑餐次及食物,采集病例和厨工肛拭子、留样食物及环境样本进行病原学检测,采用脉冲场凝胶电泳(PFGE)对沙门菌分离株进行分型分析。结果共搜索到病例74例,患病率为1.9%,临床症状主要为腹泻(83.8%)、腹痛(78.4%)、发热(63.5%)等。流行曲线为间歇性同源暴露,病例班级和宿舍分布无明显聚集性。病例对照研究结果显示在第二饭堂滑蛋饭窗口打餐是危险因素(10月8日OR=7.00,95%CI:1.51~32.48;10月9日OR=262.50,95%CI:22.21~3102.06)。共采集76份样本,其中12份样本分离培养出肠炎沙门菌,经PFGE图谱分析为2种带型,相似度95.7%。结论本次事件为一起由肠炎沙门菌引起的食源性疾病暴发,可疑食品为滑蛋饭,应加强学校等集体单位食品卫生监管工作,蛋类食物应彻底煮熟煮透。
Objective To identify the suspected food,pathogenic factors and risk factors of the foodborne disease outbreak in a school,and to provide reference for the prevention,control and investigation of similar events in the future.Methods Descriptive epidemiological method were used to analyze the clinical characteristics,epidemiological characteristics and related risk factors of the cases.Suspicious meals and food were identified by case-control study.Samples such as anal swabs of cases and kitchen workers,reserved food and environment were collected for etiological detection.Salmonella isolates were classified by pulsed field gel electrophoresis.Results A total of 74 cases were found,with an incidence rate of 1.9%.The main clinical symptoms were diarrhea(83.8%),abdominal pain(78.4%)and fever(63.5%).The prevalence curve showed intermittent homologous exposure,and the distribution of cases in classes and dormitories showed no obvious aggregation.Results of a case-control study showed the risk factor was the rice with scrambled egg from the second dining hall(October 8 OR=7.00,95%CI:1.51~32.48;October 9 OR=262.50,95%CI:22.21~3102.06).A total of 76 samples were collected,12 of which were isolated and cultured for Salmonella enteritidis.There are two zonal types with similarity of 95.7%by PFGE analysis.Conclusion This incident was a foodborne disease outbreak caused by Salmonella enteritidis,and suspected food was the rice with scrambled egg.Food hygiene supervision should be strengthen in schools and other collective units,and food with eggs should be thoroughly cooked.
作者
萧松建
吴燕飞
刘东妹
方艳梅
阮峰
XIAO Songjian;WU Yanfei;LIU Dongmei;FANG Yanmei;RUAN Feng(Zhuhai Center for Disease Control and Prevention,Guangdong Zhuhai 519000,China;Guangming District Center for Disease Control and Prevention,Guangdong Shenzhen 518107,China;Fogang County Center for Disease Control and Prevention,Guangdong Qingyuan 511600,China)
出处
《中国食品卫生杂志》
CSCD
北大核心
2021年第5期595-599,共5页
Chinese Journal of Food Hygiene
基金
珠海市医学科研基金项目(20171009A010009)。
关键词
沙门菌
食源性疾病暴发
调查
学校
脉冲场凝胶电泳
Salmonella
foodborne disease outbreak
survey
school
pulsed field gel electrophoresis
