一起食源性急性砷中毒事件的调查

Investigation of An Incidence of Foodborne Acute Arsenic Poisoning

目的了解急性砷中毒事件的流行病学特征,查明致病原、中毒餐次、中毒食物和中毒环节。方法应用《广州市食物中毒个案调查表》进行病例面对面调查,确定病例定义;采集病人生物、留样食品及环境样品进行实验室检测。结果共有86名员工进食晚餐,48名饮用紫菜蛋花汤者罹患率高达100%。潜伏期1～240min,中位数35min;病例工种和宿舍分布相对分散,男20人,女28人;年龄18～45岁,中位数28岁;临床表现主要以恶心(100%)、呕吐(100%)为主,伴有头痛(41.67%)、头晕(47.92%)、寒战(18.75%)、腹泻(12.50%)等症状;19病例呕吐物砷含量检出值介于0.45～134mg/L,平均值24.50mg/L;1例剩余的紫菜蛋花汤砷含量高达783mg/L;人均摄入总砷量达196mg。结论判定为一起宾馆员工食源性急性砷中毒事件,中毒48人,中毒食物为紫菜蛋花汤,中毒餐次为12月8日晚餐,中毒环节为厨房一工作人员在晚餐时投毒所致。

Objective To study the epidemiological characteristics of a case of the poisoning. Methods Descriptive epidemiologieal study was performed. Questionnaire type survey using the ＂food poisoning questionnaire of guangzhou＂ was conducted during the face-to-face interview. Specimens from the patients, residual foods, and environmental samples were collected for the laboratory testing. Results Among the 86 employees having the same supper, 48 employees （20 males and 28 females, median age was 28, ranged from 18-45） eonsumpting Zicaidanhua soup had the symptoms of food poisoning and the attack rate was 100%. The average incubation period was 35 minutes （ranged from 1 to 240 minutes）. The was no correlation between the disease development and the types of work in these patients. The major clinical symptoms were nausea （48 [ 100% ]）, vomiting （48 [ 100% ]）, headache （20 [41.67%]）, swirling （23 [47.92%]）, chilling （9 [ 18.75%] ） and diarrhea （6 [ 12.50%]）. Arsenic compound was found in 19 samples of the vomits （median concentration was 24.50 ml/L, ranged from 0.45-134 mg/L） 1 sample of Zicaidanhua soup had a high concentration of arsenic （783 mg/L）. The average intake of arsenic was 196 rag. Conclusion The cause of an incidence of foodborne acute arsenic poisoning related to the consumption of Zicaidanhua soup was analyzed.