苏州市某区一起副溶血性弧菌引起的食源性疾病暴发的流行病学分析

Epidemiological analysis on a foodborne disease outbreak caused by Vibrio parahaemolyticus in a district of Suzhou City

目的查明2018年10月7-10日苏州市某区职工培训中心学员食源性疾病暴发的病原体和发生原因,为预防类似事件的发生提供参考依据。方法于2018年10月7-10日,采用现场流行病学调查方法,描述病例的临床表现,开展病例对照研究调查可疑餐次、可疑食物,并采集病例肛拭子等样品进行实验室检测。结果此次事件共有病例29例,罹患率为3.91%,临床表现为腹泻(89.7%)、腹痛(72.4%)、头痛(51.7%)、恶心(51.7%)、呕吐(51.7%)和发热(37.9%)。病例对照研究显示,可疑餐次为10月8日晚餐(OR=3.20,95%CI:1.05~9.71),可疑食物为剁椒鱼(OR=7.88,95%CI:1.44~43.14)。5份发病学员肛拭子样本中4份检出副溶血性弧菌,菌株脉冲场凝胶电泳(PFGE)图谱基本一致。结论经调查确定本次食源性疾病暴发事件是一起副溶血性弧菌引起的食源性疾病事件,肇事食物是剁椒鱼。餐厅需改善自身管理,生熟分开,严格消毒盛放熟食的容器具,并改善留样方法。加强管理部门合作,积极进行引发原因调查和溯源调查。

Objective To identify the pathogens and causes of a foodborne disease outbreak of a district training center in Suzhou from October 7 to 10,2018,provide a basis for the prevention of similar events. Methods From October 7 to 10,2018,a field epidemiological survey was carried out to describe the clinical manifestations,a case-control study was conducted to explore the suspicious meals and suspicious food,and anal swab and other samples of cases were collected for laboratory testing.Results There were 29 cases in the foodborne disease event,with the attack rate of 3.91%,and the main clinical symptoms were diarrhea(89.7%),stomachache(72.4%),headache(51.7%),nausea(51.7%),emesis(51.7%)and fever(37.9%). The case-control study showed that exposure to the dinner of October 8 was a risk factor(OR=3.20,95% CI: 1.05~9.71)and the suspicious food was chilli fish(OR=7.88,95%CI: 1.44~43.14). Four of five anal swab samples from patients were positive for Vibrio parahaemolyticus and PFGE analysis showed that it was the same clone strain. Conclusion The investigation indicates that the main cause of the foodborne disease outbreak is eating chilli fish contaminated by Vibrio parahaemolyticus. Restaurants need to improve their management,especially in the separation of raw and cooked and strictly disinfection for food containers. The food retention time should be improved. It is necessary to strengthen department cooperation and actively carry out cause investigation and traceability investigation.