2014年温州市317例食源性疾病病例流行病学调查研究

Epidemiological analysis of 317 cases with foodborne diseases in Wenzhou in 2014

目的了解哨点医院食源性疾病特定病原体分布情况及其流行病学特征,为食源性疾病防治提供依据。方法收集温州市食源性疾病监测哨点医院以腹泻症状为主诉且粪便或肛拭样本检测结果为病原体阳性的门诊和住院病例,进行临床症状、可疑食品暴露史调查,并对病原学检测结果进行分析。结果共收集317例病原体阳性食源性疾病病例,副溶血弧菌检出率最高,占67.91%(218/321)。检出7个血清群,O3:K6为优势血清型,呈现较明显的夏秋季高峰,成年人群中高发,尤其是26~35岁年龄段;其次为诺如病毒和沙门菌,分别有48株和44株,占14.95%(48/321)和13.71%(44/321)。0~5岁的儿童更易感染,全年均有检出,诺如病毒以GⅡ型为主,沙门菌以鼠伤寒沙门菌和肠炎沙门菌为主要血清型。所有患者均有不同程度的大便性状改变,水样便为主(96.85%)。可疑食品暴露史主要是水产及其制品、肉类、禽类及其制品以及蔬菜水果类。结论食源性疾病病例特定病原体分布情况、临床症状及可疑食品暴露史对食源性疾病的诊治、预防提供非常重要的意义,需完善食源性疾病监测网络,加快医疗机构信息化建设,提高临床实验室在监测过程中的支持作用,逐步完善食源性疾病监测、预警和控制体系。

Objective To understand the epidemiological characteristics of foodborne diseases, and to provide evidence for disease control and prevention. Methods A total of 317 outpatients and inpatients with clinically and laboratory confirmed foodborne diseases were collected from sentinel hospitals in Wenzhou, food exposure history was surveyed and pathogen testing results were analyzed. Results Out of total 317 fecal samples from clinical cases with foodborne diseases, the positive rate of Vibrio parahaemolyticus was the highest of 67.91%, followed by Norovirus （14.95 %） and Salmonella （13.71 %）. 7 serotypes of Vibrio parahaemolyticus were detected and the predominant one was 03 ： K6, summer and autumn were disease peak season and major- ity of cases were adults aged 26-35 years. Norovirus and Salmonella were usually detected in children under 5 years old. Type G Ⅱ Norovirus, Salmonella typhimurium and Salmonella enteritidis were the major bacteria types. More than 96.85% of patients had watery stools. Sea foods and aquatic products were found to be most common contaminated food sources, followed by meat, poultry and its products, fruits and vegetables. Con- clusions Since the clinical symptoms, pathogen test and suspicious food exposure are very important for the diagnosis, treatment and prevention for foodborne diseases, so we should enhance the monitoring network of foodborne diseases, speed up the information the foodborne diseases monitoring and control system should be improved.