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目的查明该起食源性疾病暴发的病因和来源。方法在学校、医疗机构进行病例主动搜索,开展病例个案、病例对照专题调查和现场勘察,及采集标本进行实验室相关检测。结果该起事件涉及学校3个年级的45个班,暴发始于3月17日,持续11d,发病高峰在3月19-23日间;共报告91名病例,罹患率为2.5%(91/3721);症状以恶心、呕吐、腹胀、腹痛和水样腹泻为主;病例暴露于学校食堂,可疑食物不确定;实验室检测结果,2份病例和3份厨工的肛拭子检出致泻性大肠埃希菌,其中2份病例和1份厨工肛拭子检出的肠侵袭性大肠埃希菌菌株间高度同源。结论这是一起食源性疾病局部暴发,由致泻性大肠埃希菌感染为主,暴露来源与途径不单一。建议规范和落实学校饭堂餐饮卫生监管,开展学校突发卫生事件症状监测,及时发现和报告学生健康异常状况对学校预防和控制食源性疾病暴发是非常重要的。
Objective To identify the etiology and source of the outbreak of foodborne illness. Methods Active searches of cases in schools and medical institutions were carried out to conduct case studies, case-control special investigations and site surveys, and to collect specimens for laboratory-related testing. Results The incident involved 45 classes in three grades of school. The outbreak started on March 17 for 11 days and peaked from March 19 to March 23. A total of 91 cases were reported with an attack rate of 2.5% (91 / 3721). The symptoms were mainly nausea, vomiting, bloating, abdominal pain and watery diarrhea. The cases were exposed to school canteens and the suspicious food was uncertain. The results of laboratory tests, two cases and three cooks’ anal swabs were detected Escherichia coli diarrhea, two of which were highly homologous to enterohepacial Escherichia coli strains detected by a kitchen auger. Conclusion This is a local outbreak of foodborne diseases, mainly caused by diarrheal Escherichia coli, exposure sources and ways are not uniform. It is very important for schools to prevent and control food-borne outbreaks by proposing to standardize and implement food hygiene supervision in school canteens, to carry out the monitoring of school-based emergencies, to detect and report on student health anomalies in a timely manner.