一起误食钩吻引起的食物中毒事件调查

Investigation on a Food Poisoning Incident Caused by Accidentally Eating Gelsemium elegans

目的:调查此次食物中毒事件波及范围和原因,并提出预防控制措施。方法:采用现场流行病学调查方法,开展病例搜索和个案调查,收集可疑餐次就餐食物及发病情况,开展回顾性队列研究,比较分析就餐食物与发病的关联性,现场勘查和访谈了解可疑食物的制作过程、原料来源等。同时采集病例血液、尿液、剩余食物等进行检测。结果:本次调查共发现7例病例(罹患率87.50%)。临床表现以头晕(71.43%)、恶心(42.86%)、眼睑下垂(42.86%)等神经系统中毒症状为主。流行曲线提示为点源暴露模式,平均潜伏期为64.20 min(范围:20~130 min)。回顾性队列研究分析结果表明,食用鸭汤与发病的AR为1,食用鸭汤与发病有统计学关联,且鸭汤进食量与临床分级呈现正相关(Spearman检验,r_(s)=0.96,P<0.05);在剩余鸭汤中检出了钩吻素甲。结论:该事件是一起误食含有“钩吻素甲”的鸭汤引起的聚集性食物中毒事件,中毒餐次为2月28日晚餐,致病食物为中草药炖鸭汤,毒素为钩吻素甲,中毒原因可能是患者所购“纸皮藤”中混入钩吻的根茎。

Objective:The scope and cause of the food poisoning incident are investigated,and prevention and control measures are put forward.Method:Field epidemiological investigation method was adopted to carry out case search and case investigation,collect suspicious meal food and incidence situation,carry out retrospective cohort study,compare and analyze the association between dining food and incidence,and investigate and interview to understand the production process and raw material sources of suspicious food.At the same time,blood,urine and remaining food of the cases were collected for testing.Result:Seven cases(disease rate of 87.50%)were found in this survey.Clinical manifestations were mainly dizziness(71.43%),nausea(42.86%),ptosis(42.86%)and other symptoms of neurological poisoning.The prevalence curve indicated that the model was point source exposure,and the average incubation period was 64.20 min(range:20~130 min).The results of retrospective cohort showed that AR was 1,there was a statistical correlation between eating duck soup and the disease,and the amount of eating duck soup was positively correlated with the clinical grade(Spearman test,r_(s)=0.96,P<0.05).Gelsemine was detected in the remaining duck soup.Conclusion:The event is a clustered food poisoning event caused by accidentally eating a duck soup containing“gelsemine”.The poisoning meal was dinner on February 28,the pathogenic food was duck soup stewed with herbal medicine,and the cause of the poisoning may come from the root of the“paper skin vine”purchased by the patient.