2013年四川省1起霍乱暴发疫情调查

An Outbreak of Cholera Caused by Rural Dinner in Sichuan Province,2013

目的通过调查1起由聚餐引起的霍乱疫情,查找传染源和传播方式,为今后类似疫情提供防控依据。方法制定统一病例定义,开展病例主动搜索,对就餐人员就餐情况开展回顾性队列研究,采集环境及病例标本进行实验室检测。结果 2013-07-02,四川省乐山市犍为县报一起聚餐引起霍乱暴发疫情,经调查92名就餐者中发生15例病例和3例健康带菌者,15例病例中疑似病例9例,实验室诊断病例5例,死亡1例临床诊断病例,罹患率16.0%(15/92)。病例主要表现为无痛性腹泻,均为水样便,呕吐,腓肠肌疼痛及恶心,无发热。采集标本共104份,检出8株O139霍乱弧菌,其中5例病例大便样阳性。8株O139霍乱弧菌,经四川省疾病控制中心鉴定PFGE型别一致。7月2日,对6月27日就餐的92例就餐者开展回顾性队列研究。结果显示6月27日中午的凉拌生姜为危险因素。结论该起疫情可能为宴席中使用的凉拌生姜受霍乱弧菌污染所致,污染来源可能是宴席中的甲鱼,通过盛放工具簸箕交叉污染凉拌生姜所致。

Objective To find the contaminate source and mode of transmission by investigating a cholera outbreak of rural dinner,and thus to provide scientific evidence for developing prevention and control measures. Methods Unified diagnostic criteria was designed. Initiative case searching and retrospective cohort investigation was conducted. The samples were collected from the cases and environment to laboratory tests. Results On July 2nd,2013,Qianwei county reported an outbreak of cholera caused by rural dinner,and 92 people attended the dinner. There were 15 cases and 3 healthy carriers,including 9 suspected cases,5 confirmed cases,and one clinical case. The attack rate was 16. 0%（ 15 /92）. The major clinical symptoms was painless diarrhea,all were watery stools,vomiting,gastrocnemius muscle pain and nausea,no fever. A total of 104 samples were collected,8 strains of Cholera O139 were detected in stool samples or rectal swabs,with the same PFGE. Retrospective cohort investigation was conducted in all diners who attended the banquet at noon on June 27. Cold ginger at noon on June 27 th was a risk factor. Conclusion The outbreaks of cholera may caused by cold ginger,the suspected source of pollution may come from the soft-shelled turtles. The cold ginger may contaminated by the dustpan.