人感染猪链球菌病屠宰过程危险因素病例对照调查

Case Control Study of Streptococcus suis Disease in Humans on Butcher

目的探讨屠宰过程中感染人感染猪链球菌病的危险环节。方法采用成组病例对照调查方法,病例为发病前有屠宰病死猪史的患者(病原学诊断或临床诊断),对照为与患者共同屠宰过病死猪的健康人,调查两者在屠宰中的不同环节和接触方式的差异。结果病例66例,对照74例,各因素及其OR的95%可行限分别为屠宰过程中的开膛(OR2.2～9.4)、掏内脏(OR2.2～9.2)、清洗内脏(OR1.01～4.5)、开边分块(OR1.6～6.6),以及接触内脏(OR1.7～8.1)、血液(OR1.6～8.0)、猪肉(OR1.4～5.9)、皮肤(OR1.2～6.1),身上有伤口(OR4.1～24)、屠宰时受伤(OR1.5～16)。结论屠宰过程中的开膛、掏内脏、清洗内脏和开边分块,以及接触内脏、血液、猪肉和皮肤,身上有伤口、屠宰时受伤为危险因素。禁止屠宰病死猪,在屠宰过程中注意个人防护可以有效地避免感染人感染猪链球菌病。

Objective To detect and analysis the risk factors of Streptococcus suis disease （SSD） in humans in Sichuan Province during slaughter sick pigs. Method SSD cases in 2005 were those who slaughtered the sick or dead pig 10 days before being sick, and controls were healthy ones who slaughtered the same sick or dead pig as SSD cases. The exposures, contract activities and others at the duration of slaughter of both cases and controls were compared. Results We obtained exposure information for 66 cases and 74 controls. On the pro- gram of butcher, cases were more likely than controls to do cutting open（ OR 2.2 -9. 4） , eviscerate（ OR 2.2 -9.2）, cleaning gut（OR 1.01 -4.5）, dividing（OR 1.6 -6.6）, and contact gut（OR 1.7 -8.1）, blood （0R1.6-8.0）, meat（ OR 1.4-5.9）, and skin（OR 1.2-6.1）.Wound（OR4.1-24） and hurt in hu- man body（ OR 1.5 - 16） also associated with the disease. Conclusion On the program of butcher, contact with gut, blood or fresh meat was the risk factors and working with open wounds increased SSD risk. Slaughter workers and villagers need guidance to use protective gloves, clean new wounds, and limit contact with fresh blood and tissue while slaughtering pigs.