一起麻辣烫汤汁引起急性亚硝酸盐中毒事件分析

Analysis of an acute nitrite poisoning incident caused by spicy hot pot soup

目的 调查一起因进食麻辣烫汤汁引起急性亚硝酸盐中毒事件,为预防控制亚硝酸盐中毒提供依据。方法 收集患者临床资料、运用现场流行病学调查、应用国标开展实验室亚硝酸盐定量检测等方法对本起中毒事件进行调查分析。结果 中毒患者为一名小学生,进食麻辣烫汤汁后短时间内出现呕吐、全身皮肤紫绀、大汗淋漓等以高铁血红蛋白血症为主的临床表现,经抢救治疗后患者痊愈出院。采集并检测患者呕吐物及进食的麻辣烫汤汁中亚硝酸盐含量分别为160 mg/kg和2 900 mg/kg,结合流行病学调查和临床诊断治疗,确诊为急性亚硝酸盐中毒。结论 进食麻辣烫汤汁引起急性亚硝酸盐中毒鲜见报道,麻辣烫汤汁存在长时间煮沸、浓缩和原料的频繁更换等特点,可能使得汤汁中的亚硝酸盐富集甚至超标,本起事件对进一步规范麻辣烫等食品安全管理有较大的公共卫生学意义。建议监管部门加强麻辣烫等相关食品的定期监测、安全监管和健康宣教,从而有效预防亚硝酸盐中毒。

Objective To investigate an acute nitrite poisoning incident caused by eating spicy hot pot soup,and to provide evidence for prevention and control of nitrite poisoning.Methods The poisoning incident was investigated and analyzed by collecting clinical data of patient,using field epidemiological investigation,and using national standard to carry out laboratory nitrite quantitative detection.Results The poisoning patient was a primary school student.After eating spicy hot pot soup,he developed the clinical manifestations of methemolibinemia such as vomiting,cyanosis of whole body skin and sweating in a short time.After rescue treatment,the patient was cured and discharged.After collecting and detecting,the nitrite content in vomit and spicy hot pot soup taken by the patient was 160 mg/kg and 2900 mg/kg,respectively.Combined with epidemiological investigation and clinical diagnosis and treatment,it was diagnosed as acute nitrite poisoning.Conclusion Acute nitrite poisoning caused by eating spicy hot pot soup was rarely reported.Spicy hot pot soup had the characteristics of long-term boiling,concentration and frequent replacement of raw materials,which might make nitrite in the soup rich or even exceed the standard.This incident had great public health significance for further standardizing the safety management of spicy hot pot and other foods.It was suggested that the regulatory authorities strengthened regular monitoring,safety supervision and health education of spicy hot pot and other related foods,in order to effectively prevent nitrite poisoning.