摘要
目的 查明2019年11月广西钦州4所学校食源性疾病暴发事件的原因和危险因素,采取有效的预防控制措施,控制暴发的扩散和蔓延,为今后调查处置类似事件的发生提供依据。方法 采用描述性流行病学方法分析病例的临床特征、三间分布及相关危险因素,运用分析性流行病学方法确定病因食品,通过食品卫生学调查追溯食品污染的过程,采集患者和食品从业人员的生物标本、可疑食物、外环境标本进行实验室检测,并对检出的沙门菌进行脉冲场凝胶电泳(pulsed field gel electrophoresis, PFGE)的同源性分析。结果 事件共涉及4所学校,搜索到69名疑似患者,罹患率0.52%(69/13 307),临床症状主要为腹痛、腹泻、发热,平均潜伏期20 h,流行曲线提示为点源暴发。描述性流行病学方法提示可疑食物为F公司配送的烘焙类食品,病例对照研究发现购买进食F公司配送的食品是发病的危险因素(OR=34.14,95%CI:12.67~91.94),其中购买进食美味汉堡是发病的危险因素(OR=31.08,95%CI:13.16~73.35)。在12份患者肛拭子、1份患者呕吐物、1份面包用小麦粉、1份鸡蛋中检出肠炎沙门菌(Salmonella enteritidis),对以上15份沙门菌阳性菌株进行PFGE分子分型,显示同源性达到100%。结论 本次事件是由沙门菌污染引起的食源性疾病暴发事件。建议监管部门加强对生产加工企业的监督管理,规范食品加工流程,学校建立健全食品安全管理制度和食品安全知识宣传教育的长效机制,提高学生的卫生意识,预防同类事件发生。
Objective To find out the causes and risk factors of this food-borne disease outbreak that occurred in November 2019 at four schools in Qinzhou,Guangxi,implement effective preventive and control measures to curb the spread and escalation of the outbreak,and provide a basis for the investigation and management of similar incidents in the future.Methods Descriptive epidemiological methods were used to analyze the cases'clinical characteristics,three-dimensional distribution,and related risk factors.The etiological food was determined by the method of analytical epidemiology.A food hygiene investigation was conducted to trace the process of food contamination,and biological samples from cases and workers,suspicious food,and environmental samples were collected for laboratory testing.The detected Salmonella strains were analyzed for homogeneity using pulsed-field gel electrophoresis(PFGE).Results The event involved four schools,with 69 suspected cases identified,resulting inan attack rate of 0.52%(69/13307).The main clinical symptoms were abdominal pain,diarrhea,and fever,with an average incubation period of 20 hours.The epidemic curve indicated a point-source outbreak.Descriptive epidemiological methods inferred that bakery products distributed by Company F were the suspect foods.The case-control study indicated the risk of illness was increased among those who purchased and consumed food supplied by Company F(OR=37.67,95%CI:14.03-101.13),particularly those who consumed the delicious hamburger(OR=30.13,95%CI:13.22-68.67).Salmonella Enteritidis(SE)was detected in 12 anal swabsfrom patients,one patient's vomit,one flour sample used for bread-making,and one egg,with homogeneity of 100%achieved in PFGE molecular typing of the 15 positive Salmonella strains.Conclusions The outbreak is a food-borne disease outbreak caused by Salmonella contamination.It is recommended that regulatory authorities strengthen supervision and management of production and processing enterprises,standardize food processing processes,and establis
作者
香燕丽
陈永正
何年芳
黄晓霞
姜艳
廖瑜
XIANG Yanli;CHEN Yongzheng;HE Nianfang;HUANG Xiaoxia;JIANG Yan;LIAO Yu(Qinzhou Center for Disease Control and Prevention,Qinzhou,Guangxi 535099,China)
出处
《中国热带医学》
CAS
北大核心
2024年第6期734-739,共6页
China Tropical Medicine
关键词
食源性疾病
暴发
沙门菌
脉冲场凝胶电泳
Foodborne illness
outbreak
Salmonella
pulsed field gel electrophoresis
