对食源性疾病病例定义确定原则的探讨

Study on principles of determining case definition of foodborne illness

为提高食源性疾病的诊断水平,通过对国内外制定食源性疾病病例定义的具体实践的研究,提出了确定食源性疾病病例定义的5项原则1.要全面考虑病例定义的基本要素和基本内容,综合分析流行病学资料、潜伏期和临床表现、现场卫生学调查情况和实验室检验结果;2.要以客观临床体征和实验室检验指标为主,但要考虑实际情况;3.要注意精神诱导因素和伪装“发病者”,不能轻信主观症状,及时予以排除;4.对中毒或感染餐次不明或肇事单位不明的食源性疾病事件,要确定最初病例定义和最终病例定义,一旦通过流行病学调查确定了中毒或感染餐次或肇事单位,则排除确实未在最终确定的中毒或感染餐次或肇事单位进食的发病者;5.要事先考虑、科学解释可能出现的不符合工作假设和最终病例定义的发病者情况。

Five principles of determining the case definition of foodborne illness were put forward as follows by studying the concrete practice at home and abroad. The data of epidemiologic, clinical, environmental and laboratory investigations must be analyzed comprehensively in order to define the key element and content of case definition, giving priority to objective symptoms and laboratory results. The cases whose symptoms were only subjective must be excluded. The initial and final case definitions should be determined especially when the troublemaking location is temporarily obscured. Once the troublemaking location is confirmed, the cases who did not ingest food in this location must also be excluded. A scientific explanation must be given to each of the symptomatic people, including the ones that will be excluded.=