1起四季豆引发食源性疾病事件的调查

Survey on a food borne disease outbreak caused by green bean

目的查找桐庐县某单位发生的1起食源性疾病事件病因,提出控制措施,防止类似事件再次发生。方法开展病例搜索与个案调查,调查描述病例的临床表现和疾病分布特征,开展病例对照研究和现场卫生学勘查,采集可疑样品进行实验室检测,分析推断引发事件的可疑食物及有关危险因素。结果事件发生于2018年1月6日傍晚,共发现19例患者均为某单位员工,在发病前均有单位食堂共同就餐史,临床主要表现为恶心(占68.42%)、呕吐(89.47%)、腹痛(52.63%)、腹泻(36.84%)等症状,疑为群体性食源性疾病事件,推测事件发生当天(1月6日)的午餐为暴露餐次,发病潜伏期中位数为3.5h;该午餐菜谱分析结果显示,病例组(100.00%)和对照组(14.29%)间四季豆炒肉暴露率差异有统计学意义(OR=95.00,P<0.01),对午餐食用的四季豆炒肉样品作皂素定性检测结果阳性;现埸勘查和危害分析发现食堂在制作四季豆炒肉时,由于加工量大,烹饪时间过短,导致四季豆中的皂苷成分未被加热过程完全破坏。结论这是1起因共同食用加热不透的四季豆菜肴所致的皂苷中毒事件。

Objective To find out the risk factors of a food borne disease outbreak,and propose the control measures,so as to provide the occurrence of similar events.Methods The cases were searched and surveyed to investigate and describe the clinical manifestations and disease distribution characteristics,case-control study and field hygiene survey were conducted,the suspicious samples were collected for laboratory testing,and the suspicious food and related risk factors that caused the outbreak were analyzed and inferred.Results The outbreak occurred in the evening of January 6,2018,a total of 19 cases were found,all of them were the staff in a unit.Before the onset of the disease,there was a history of dining together in the unit canteen.The main clinical symptoms were nausea(68.42%),vomiting(89.47%),abdominal pain(52.63%)and diarrhea(36.84%),which considered as a food borne disease outbreak.It is presumed that lunch on the day of the incident(January 6)is an exposure meal,with a median incubation period of 3.5 h;the analysis results of the lunch menu showed that there was a significant difference in the exposure rate of green beans with pork between the case group(100.00%)and the control group(14.29%)(OR=95.00,P<0.01).The saponin detection of the green beans of lunch was positive;the field investigation and hazard analysis found that the saponin in the green beans was not completely destroyed by the heating process due to the large processing volume and short cooking time in the canteen.Conclusion This is a food-borne disease outbreak event caused by residual saponin in green beans because of the improper procession.