一起致泻性大肠埃希菌所致食源性疾病事件调查

Investigation on a case of foodborne disease caused by diarrheagenic Escherichia coli

目的对一起发生在学校的食源性疾病事件进行调查,分析可疑餐次、可疑食物和可能的致病菌,为今后学校内食品安全的防控和类似食源性疾病事件调查提供参考。方法根据事件特点建立病例定义,查阅校医务室记录、附近医院门急诊记录和全市食源性疾病监测网络开展病例主动搜索。通过现场流行病学调查、卫生学调查和实验室检测,查找本次事件的可疑食品、致病因子。结果该事件共搜索到病例36例,罹患率为6.57%(36/548),症状以腹痛(100.00%)、腹泻(100.00%)、恶心(27.77%)为主,平均潜伏期为11.25(5~18)h。采用病例对照研究进行现场流行病学调查,结果显示中餐食品“熟烧鹅”为可疑暴露食物(0R=11.458,95%CI:1.489~88.192);卫生学调查显示食物处理环节存在交叉污染可能,且中餐烧制完成后在室温中存放时间过长(>4h);采集27份肛拭子标本检测,其中9份致泻性大肠埃希菌阳性(分型为肠致病性大肠埃希菌EPEC)。结论该起事件为一起致泻性大肠埃希菌污染导致的食源性疾病事件,食物在处理环节受到交叉污染。学校应加强食品安全管理,防范食源性疾病事件发生。

Objective This paper aims to investigate a foodborne disease incident that occurred in a school,analyze suspicious meals,suspicious foods,and possible pathogenic bacteria,and provide reference for the prevention and control of food safety in schools and similar foodborne disease incidents in the future.Methods A case definition was established based on the charac-teristics of the event,and active case search was conducted by consulting the records of the schools medical room,outpatient and emergency records of nearby hospitals,and the municipal foodborne disease monitoring network.The suspicious food and pathogenic factors of this incident were found through field epidemiological investigation,hygiene investigation and laboratory test.Results A total of 36 cases were found in this event,with an incidence of 6.57%(36/548).The main symptoms were abdomi-nal pain(100%),diarrhea(100%)and nausea(27.77%).The average latency was 11.25(5-18)hours.A case-control study was used to conduct field epidemiological investigation.The results showed that Roast Goose was the suspiciously exposed food(0R=11.458,95%Cl:1.489-88.192).The hygiene survey showed that there was a possibility of cross contamination in the food processing process,and the Chinese food was stored at room temperature too long(>4 h)after being cooked;27 anal swab samples were collected for detection,of which 9 were positive for diarrheagenic Escherichia coli(EPEC).Conclusion This is a foodborne disease event caused by diarrheagenic Escherichia coli contamination,and the food was cross-contaminated during processing.Schools should strengthen food safety management and prevent foodborne disease incidents.