浙江省长兴县一起误食毒蘑菇中毒事件调查

Investigation on poisoning by mistaken eating of poisonous mushroom in Changxing Country, Zhejiang Province

目的调查分析浙江省长兴县一起毒蘑菇中毒事件中毒蘑菇的种类,分析事件发生原因,总结调查处置经验,为中毒患者的救治和中毒的预防提供借鉴。方法对中毒事件开展现场流行病学调查,对毒蘑菇样品进行形态学鉴定和分子系统学鉴定。结果本次毒蘑菇中毒事件共发病3人,其中1例重症,2例轻症,罹患率为100%,主要临床表现为恶心、呕吐、腹泻等症状,其中1例经短暂"假愈期"后出现严重横纹肌溶解中毒症状,血清肌酸激酶(CK)最高达318 200 U/L。毒蘑菇样品经形态学及分子系统学鉴定为亚稀褶红菇。结论本次事件是一起因误食亚稀褶红菇引起的毒蘑菇中毒事件。加强宣传教育,提升民众防范意识,提高医疗机构的诊断救治能力是预防毒蘑菇中毒的关键。

Objective To investigate the wild mushroom species causing a food poisoning in Changxing County, Zhejiang Province, analyze the causes of the incident and summarize the experience of investigation,purposed to provide references for prevention and proper treatment. Methods The epidemiological investigation, morphological identification and phylogenetic identification were used to analyze the poisoning event. Results Epidemiological investigation found that three patients were poisoned due to mushrooms picked by themselves, among which 1 case was severe and 2 cases were mild, and the attack rate was 100%. The main clinical manifestations were nausea, vomiting and diarrhea. One patient developed severe rhabdomyolysis poisoning after a short pseudo-recovery period. The highest level of serum creatine kinase(CK) was 318 200 U/L. The mushroom samples were identified as Russula subnigricans by morphological identification and phylogenetic identification. Conclusion This incident was a case of mushroom poisoning caused by accidental ingestion of Russula subnigricans. The key to prevent poisonous mushroom poisoning is to carry out publicity and education, enhance people’s awareness of prevention and improve the ability of medical institutions to diagnose and treat poisonous mushrooms.