2013—2015年吉林省食源性疾病流行病学特征分析

Epidemiological analysis on the surveillance results of foodborne diseases in Jilin Provincein,2013-2015

目的分析2013—2015年吉林省食源性疾病的流行病学特征和规律,为防控食源性疾病暴发事件提出有针对性的措施和建议。方法对2013—2015年"食源性疾病监测报告系统"中吉林省的病例进行描述性分析和统计学检验。结果 2013—2015年吉林省哨点医院共报告食源性疾病病例12 049例,其中11 497例患者的标本做病原学检测,807例患者检出致病微生物,总检出率为7.02%;诺如病毒、沙门菌、致泻性大肠埃希菌属、志贺菌、副溶血性弧菌检出率分别为15.63%(389/2 489)、2.54%(283/11 141)、1.32%(147/11 167)、0.08%(9/11 153)、0.06%(6/9 410),未检出小肠耶尔森菌(0/201)。诺如病毒、沙门菌和致泻性大肠埃希菌属与志贺菌、副溶血性弧菌和小肠耶尔森菌相比是吉林省主要流行的食源性致病微生物(P<0.05)。诺如病毒在第一季度检出率(31.00%)高于其他三个季度;沙门菌、致泻性大肠埃希菌属在第二、三季度检出率(3.78%、3.12%;1.32%、1.69%)高于第一、四季度;志贺菌和副溶血性弧菌均在第三季度检出率最高(0.14%、0.15%)。诺如病毒在80岁以上和5岁以下年龄组检出率较高(20.00%、18.90%),沙门菌和致泻性大肠埃希菌属在5岁以下年龄组检出率最高(3.38%、1.75%)。2015年的食源性致病菌检出率高于2013年和2014年,差异有统计学意义(P<0.05),第四季度的检出率低于前三季度差异有统计学意义(P<0.05),不同性别的食源性致病菌检出率差异无统计学意义(P>0.05),5岁以下年龄组儿童、商业服务人员、城市居民食源性致病微生物检出率最高,差异有统计学意义(P<0.05)。结论 2013—2015年吉林省食源性疾病检出率逐年升高,第一、二、三季度检出率高于第四季度,诺如病毒、沙门菌和致泻性大肠埃希菌属是主要流行的病原体,5岁以下年龄组儿童和商业服务人员易受食源性致病微生物感染。

Objective To analyze the epidemiological characteristics of foodborne disease in Jilin Province in 2013-2015,and to propose targeted measures and recommendations for the prevention and control of foodborne disease outbreaks.Methods Descriptive analysis and statistical tests were used to analyze data from foodborne disease surveillance and report system in Jilin Province in 2013-2015. Results There were 12 049 cases of foodborne diseases in Jilin Province in 2013-2015. Among all specimens for pathogen detection collected from 11 497 cases,807 patients were detected positive for pathogenic microorganisms. The overall foodborne pathogen detection rate was 7. 02%; the detection rate was 15. 63%（ 389/2 489） for Norovirus,2. 54%（ 283/11 141） for Salmonella,1. 32%（ 147/11 167） for Diarrheagenic E. coli,0. 08%（ 9/11 153） for Shigella,0. 06%（ 6/9410） for Vibrio parahaemolyticus,and 0. 00%（ 0/201） for Yersinia nterocolitica.Norovirus,Salmonella and Diarrheagenic E. coli were more common foodborne than Shigella,Vibrio parahaemolyticus and Yersinia enterocolitica in Jilin Province（ P〈0. 05）. The detection rate of Norovirus in the first quarter（ 31. 00%） was the highest in the year; the detection rate of Salmonella in the second and third quarters（ 3. 78%,3. 12%） were higher than the first and fourth quarters; the detection rate of Diarrheagenic E. coli in the second and third quarters（ 1. 32%,1. 69%） were also higher than the first and fourth quarters; the detection rates of Shigella and Vibrio parahaemolyticus in the third quarter（ 0. 14 %,0. 15%） were the highest. Norobvirus detection rates were higher in over 85 year-old group and under 5 year-old group（ 20. 00%,18. 90%）,the detection rates of Salmonella and Diarrheagenic E. coli were the highest in under 5 year-old group（ 3. 38%,1. 75 %）. The detection rate of foodborne pathogens in 2015 was higher than those in 2013 and 2014（ P〈0. 05）,and the detection rate was lower in the fourth quarter than the other three quarters（ P〈0. 05）. The detection rate had no significant difference between genders（ P〈0. 05）. Those under 5 years old,commercial service staff,urban residents had the highest detection rate of foodborne pathogens（ P〈0. 05）. Conclusion Since 2013,pathogen detection rate of foodborne disease in Jilin Province has been increasing year by year. The detection rates in the first,second and third quarters were higher than the fourth quarter. Norovirus,Salmonella and Diarrheagenic E. coli were main pathogens,and those under 5 years old and commercial service staff were vulnerable group.