一起由空肠弯曲菌引起的食源性疾病事件调查

Field Epidemiological Investigation Investigation of an outbreak of food-borne disease caused by Campylobacter jejuni

目的调查2019年舟山市某学校发生的一起食源性疾病事件原因,为今后预防控制食源性疾病事件提供参考。方法开展病例搜索、个案调查和现场卫生学调查,采集10份病例、5份食堂工作人员和4份食物市场来源样本开展空肠弯曲菌及其他病原体检测,采用脉冲场凝胶电泳(PFGE)方法进行细菌分子分型。开展病例-对照研究,分析可疑餐次和可疑食物。结果本次疫情共搜索到疑似病例41例,其中男生27例(30.34%),女生14例(29.79%),年龄为(14.56±2.48)岁。临床症状主要表现为腹泻39例(95.12%)和腹痛32例(78.05%)和发热29例(70.73%)。实验室检测结果显示,5份病例粪便样本、1份食堂工作人员肛拭子样本、2份市售三黄鸡食物原材料样本均培养出空肠弯曲菌。PFGE结果显示,5份病例样本中的空肠弯曲菌具有同源性,与1份食堂人员和2份市售三黄鸡样本中的空肠弯曲菌不具有同源性。病例对照分析显示7日午餐E套餐(OR=3.275,95%CI:1.043~10.285)和9日午餐F套餐(OR=12.804,95%CI:4.224~38.812)为可疑暴露餐次。结论这是一起因空肠弯曲菌污染食物引起的食源性疾病事件,今后应加强对空肠弯曲菌的食品安全风险监测。

Objective To investigate a food-borne disease incident in a school of Zhoushan City in 2019,so as to provide references for the prevention and control of food-borne disease incidents in the future.Methods Case search,case investigation and field hygienic investigation were carried out.Samples from patients(10 samples),canteen staff(5 samples)and food market(4 samples)were collected for the detection of Campylobacter jejuni and other pathogens.Pulsed field gel electrophoresis(PFGE)method was used for bacterial molecular typing.A case-control study was conducted to analyze the suspected meals and foods.Results A total of 41 suspected cases were found in this epidemic,including 27 males(30.34%)and 14 females(29.79%),with an average age of(14.56±2.48)years old.The main clinical symptoms were diarrhea in 39 cases(95.12%),abdominal pain in 32 cases(78.05%)and fever in 29 cases(70.73%).Laboratory tests showed that Campylobacter jejuni was cultured in 5 stool samples from patients,1 anal swab from canteen staff and 2 samples of food raw material from commercial chickens.PFGE results showed that Campylobacter jejuni was homologous among the samples from 5 cases,but was not homologous among the samples from 1 canteen worker and 2 commercial chickens.Case-control analysis showed that set lunch E on 7th(OR=3.275,95%CI:1.043-10.285)and set lunch F on 9th(OR=12.804,95%CI:4.224-38.812)were suspected exposure meals.Conclusions This is a food-borne outbreak caused by Campylobacter jejuni contamination,and the food safety monitoring of Campylobacter jejuni should be strengthened in the future.