2015-2018年上海市浦东新区食源性疾病主动监测病原学及流行病学特征分析

Results of active surveillance of foodborne diseases in Pudong New Area of Shanghai,2015-2018

目的了解上海市浦东新区特定病原体食源性疾病的流行趋势和特征,为制定食源性疾病防控策略提供参考。方法采集2015—2018年于上海市浦东新区开展食源性疾病主动监测的数据,2家哨点医院采集以腹泻症状为主诉感染病例的粪便或肛拭子标本,进行副溶血性弧菌、沙门菌、志贺菌、致泻大肠埃希菌、空肠弯曲菌和诺如病毒检验,同时对患者进行相关信息采集、分析。结果共监测和采集2871例腹泻病例的粪便或肛拭子标本,病原体总体检出率为23.55%(676/2871),其中,诺如病毒为20.04%(97/484)、致泻大肠埃希菌为11.84%(340/2871)、空肠弯曲菌为7.21%(68/943)、副溶血性弧菌为4.01%(115/2871)、沙门菌为3.27%(94/2871)、志贺菌为0.28%(8/2871);第三季度的病原体检出率较高,呈现较明显的夏秋季高峰;可疑食物主要是混合/多种食品(41.12%,278/676),其次为水产动物及其制品(22.19%,150/676)和肉与肉制品(10.95%,74/676)。结论诺如病毒和致泻大肠埃希菌是上海市浦东新区腹泻病例的主要病原体,应进一步完善食源性疾病主动监测,对特定病原体阳性病例开展流行病学个案调查,为开展有效防控提供技术支持。

Objective To understand the epidemic trend and characteristics of foodborne diseases caused by specific pathogens in Pudong New Area of Shanghai,so as to provide scientific evidence for disease prevention and control.Methods From 2015 to 2018,the infectious cases with diarrhea as the main complaint were collected from the sentinel hospital of foodborne disease active monitoring in Pudong New Area of Shanghai.Stool or anal swab samples were collected and tested for Vibrio parahaemolyticus,Salmonella,Shigella,diarrheogenic Escherichia coli,Campylobacter jejuni and Norovirus.At the same time,the profiles were collected and analyzed.Results In 2015-2018,2871 stool or anal swab samples of diarrhea cases were monitored and collected.The positive rate of pathogens was 23.55%(676/2871),including Norovirus 20.04%(97/484),diarrheogenic Escherichia coli 11.84%(340/2871),Campylobacter jejuni 7.21%(68/943),Vibrio parahaemolyticus 4.01%(115/2871),Salmonella 3.27%(94/2871)and Shigella 0.28%(8/2871).The positive rate was higher in the third quarter,showing a significant peak in summer and autumn.Suspicious food was mainly mixed food(41.12%,278/676),followed by aquatic animals and their products(22.19%,150/676)and meat and meat products(10.95%,74/676).Conclusion Norovirus and diarrheogenic Escherichia coli were the main pathogens of diarrhea cases in Pudong New Area of Shanghai.We should further improve the foodborne disease active monitoring system,carry out detailed epidemiological case investigation for specific pathogen positive cases,and provide technical support for effective prevention and control.