1起由化脓性链球菌引起的性扁桃体炎的暴发

An outbreak of suppurative tonsillitis caused by Streptococcus pyogenes

目的查明本次暴发事件的发生原因及可疑危险因素。方法搜索病例,利用描述流行病学方法对病例进行三间分布分析;开展回顾性队列研究,分析食用不同食物、酒水与事件的关联性,并采集空调系统和病例等样本进行实验室检测。结果 180名聚餐者共发现79例病例,病例症状主要为咽痛（100.00%）、发热（65.82%）、头晕（64.56%）、四肢乏力（60.76%）,感染流行曲线显示为点源暴露模式。病人的咽拭子样本检出化脓性链球菌,空调系统出风口及冷凝水样本未检出致病菌;食用蒜香骨拼脆奶为感染危险因素（RR=3.10,95%CI=1.63~5.87）。结论食用化脓性链球菌污染的蒜香骨拼脆奶是导致本次事件的主要原因。

Objective To investigate the cause of the outbreak and the suspected risk factors. Methods Cases were searched and analyzed by descriptive epidemiological method on the distribution of cases,a retrospective cohort study was conducted to analyze the correlation among different foods,drinks and the event,and samples were collected from the air conditioning system and cases for laboratory testing. Results A total of 79 cases were found from the 180 diners,and the major symptoms were sore throat（100.00%）,fever（65.82%）,dizziness（64.56%）and limb weakness（60.76%）.Epidemic curves were shown as point source exposure mode.Streptococcus pyogenes were detected in the throat swab specimens from patients.Pathogens were not detected from the air conditioning system and the condensed water samples;Eating garlic ribs with crispy milk was the risk factor for infection（RR =3.10,95%CI=1.63-5.87）. Conclusion The outbreak is caused by eating garlic ribs with crispy milk contaminated by Streptococcus pyogenes.