摘要
目的通过一起O139霍乱疫情调查,分析发病原因,为霍乱防控提供科学依据。方法建立病例定义,开展病例搜索、卫生学调查和实验室检测。提出假设,开展回顾性队列研究,确定危险因素。结果 2名霍乱病例全部为午餐就餐者,罹患率3.4%。流行病学调查支持点源暴露的流行模式,食用哈密瓜是危险因素(RR=+∞,P<0.05)。该餐同批次"温水甲鱼"中检测出与病人同源O139霍乱弧菌。聚餐饭店食品加工器具生熟不分,存在交叉污染。碱性且不消毒的自备井水、湿热的环境和富含营养的食品为霍乱弧菌增殖适宜的条件。结论本次霍乱疫情是聚餐所致,带菌甲鱼通过食品加工器具污染了生食的水果是导致疾病的原因,提示需要认真做好农村聚餐及餐饮从业人员的监督管理,加强甲鱼等水产品市场管理和监测;不同品种的甲鱼带菌情况可能不同,采样检测时应注意区分品种;当地乡镇、农村自备井水在夏秋肠道病多发季节应开展消毒处理,减少疫情发生。
Objective To investigate the cause of a food - borne cholera outbreak so as to provide a scientific basis for the effective prevention and control of cholera. Methods Case definition was established. Case search, hygienic investigation and laboratory testing were carried out. A hypothesis was developed and a retrospective cohort study was conducted to determine the risk factors. Results Two cases of cholera were searched out and both of them were the lunch diners of a rural banquet. The attack rate was 3.4 %. Epidemiological survey supported point source exposed pattern, and eating Hanai melon was the risk factor （RR = ＋ ∞, P〈0.05）. The homologous O139 Vibrio cholerae was detected in the same batch of turtles. Cross contamination through using the same equipments to process raw and cooked foods in the restaurant by the kitcheners was the main cause of the outbreak. The alkaline and unsterilized well water, hot and humid environment and nutritious food provided conditions for the proliferation of Vibrio cholerae. Conclusions A food- borne cholera outbreak occurs in the rural banquet. Fruit contamina- tion by processing equipments of turtles carrying Vibrio cholerae is the leading cause of the outbreak. Supervision of rural ban- quets and kitcheners, management and monitoring of aquatic product markets, especially the turtle market, need to be further strengthened. Vibrio cholerae infection differs in various kinds of turtles. Turtle species should be concerned when the samples are collected. The rural household well water should be disinfected in summer and autumn so as to prevent the outbreak of intesti- nal infectious diseases.
出处
《实用预防医学》
CAS
2013年第2期171-174,共4页
Practical Preventive Medicine
