沙门氏菌和副溶血性弧菌引起的食源性疾病暴发事件中病例临床症状分布特征比较

Comparison of clinical symptom distribution characteristics in the cases from outbreaks of foodborne diseases caused by salmonella and vibrio parahaemolyticus

目的通过对沙门氏菌和副溶血性弧菌引起的食源性疾病暴发事件中病例的主要临床症状分布特征的研究,探讨在处置此类暴发事件时,通过流行病学调查(流调)得到相关病例的临床症状发生率,根据不同致病菌引起的不同临床症状分布特征,初步推测出病因的可行性。方法在中国知网数据库、万方数据库、维普期刊数据库下载2007-2023年发表的有关沙门氏菌和副溶血性弧菌食源性疾病暴发事件流调报告的文献,使用SAS9.4软件统计分析暴发事件中5种临床症状分布特征。结果共纳入有效文献60篇。沙门氏菌引起的食源性疾病暴发事件的病例中,腹痛、呕吐、恶心的发生率符合正态分布(P均>0.05),(x±s)分别为(79.85%±13.59%)、(36.90%±21.68%)和(46.59%±16.80%);腹泻、发热的发生率不符合正态分布(P均<0.05),M(P25,P75)分别为96.25%(83.58%,100.00%)、78.10%(50.00%,90.28%);症状发生率的特点是:腹泻率>腹痛率/发热率>恶心率>呕吐率。副溶血性弧菌引起的食源性疾病暴发事件的病例中,恶心和发热的发生率符合正态分布(P均>0.05),(x±s)分别为(55.11%±22.42%)、(24.75%±15.64%);腹泻、腹痛、呕吐发生率不符合正态分布(P均<0.05),M(P25,P75)分别为100.00%(96.30%,100.00%)、92.76%(84.38%,96.72%)、46.95%(33.71%,53.70%);临床症状发生率的特点是:腹泻率>腹痛率>恶心率>呕吐率>发热率。结论在食源性疾病暴发事件中,临床症状的分布特征可以作为食源性疾病的判断依据之一,可以根据临床症状分布特征,初步推测病因,提高事件的处置效率。

Objective By studying the distribution characteristics of clinical symptoms in the cases from outbreaks of foodborne diseases caused by salmonella and vibrio parahaemolyticus,this research aims to explore the occurrence rates of clinical symptoms in relevant cases through epidemiological investigations during the management of such outbreaks.Based on the different distribution characteristics of clinical symptoms caused by different pathogens,the feasibility of the etiology can be preliminarily inferred.Methods The literatures relevant to the epidemiological investigation report on the outbreaks of foodborne diseases caused by salmonella and vibrio parahaemolyticus and published in the China National Knowledge Infrastructure(CNKI)database,Wanfang Database,and VIP Journal Database between 2007 and 2023 were included in the analysis.The study utilized SAS 9.4 software to statistically analyze the distribution characteristics of five clinical symptoms in cases from the outbreaks.Results A total of 60 effective literature were included.In the outbreak of foodborne diseases caused by salmonella,the incidences of abdominal pain,vomiting,and nausea fllowed a normal distribution(all P>0.05),with(x±s)being(79.85%±13.59%),(36.90%±21.68%),and(46.59%±16.80%),respectively;the incidences of diarrhea and fever did not follow a normal distribution(all P<0.05),with M(P2s,Prs)being 96.25%(83.58%,100.00%)and 78.10%(50.00%,90.28%),respectively,the symptom incidences had the characteristics as follows,diarrhea rate>abdominal pain rate/fever rate>nausea rate>vomiting rate.In the outbreak of foodborne diseases caused by vibrio parahaemolyticus,the incidences of nausea and fever symptoms followed a normal distribution(all P>0.05),with(x+s)being(55.11%±22.42%)and(24.75%±15.64%),respectively;the incidences of diarrhea,abdominal pain,and vomiting did not follow a normal distribution(all P<0.05),with M(P2s,Ps)being 100.00%(96.30%,100.00%)92.76%(84.38%,96.72%)、46.95%(33.71%,53.70%),respectively;the symptom incidences had the characteristics as follows,diarrhea rate>abdominal pain rate>nausea rate>vomiting rate>fever rate.Conclusions In the outbreaks of foodborne diseases,the distribution characteristics of clinical symptoms can serve as one of the criteria for determining foodborne diseases.Based on the distribution characteristics of clinical symptoms,we can preliminarily infer the cause and improve the efficiency of event management.