一起因误食毒蝇歧盖伞所致食源性疾病事件的调查与分析

Investigation and analysis of a foodborne disease incident caused by accidental ingestion of a Inosperma muscarium

目的查明广州市天河区2022年5月发生的一起食源性疾病事件的原因,为防止类似事件的发生提出相应防控措施。方法制定病例定义,应用个案调查表开展现场流行病学调查,登记病例的基本信息、发病经过、临床表现、发病前72h就餐史、饮用水卫生、可疑野生毒蘑菇来源和加工等情况;访谈主治医师了解临床检查、诊疗经过,电话跟踪病程;开展可疑毒蘑菇孳生地调查,从形态学上鉴定毒蘑菇种类;采用Excel 2013进行数据整理。结果本起事件共暴露11人,搜索并核实符合病例定义者10人,住院3人,罹患率90.9%(10/11),住院率30.0%(3/10)。病例均在餐后15min内发病,中位潜伏期为0.25h,主要临床表现为出汗、流涎、呕吐、腹痛和腹泻,伴腹胀、排尿次数增多,血液检查显示肝肾功能正常,经医院对症、支持治疗后全部痊愈,无重症和死亡病例,病程最长61.00h,最短13.00h,中位数13.00h。可疑野生毒蘑菇物种鉴定为毒蝇歧盖伞。结论误采误食野生毒蝇歧盖伞是引起本起事件的原因,毒蝇歧盖伞中毒所致的食源性疾病事件为广东省首次报道。以宣教为主,多部门联动、跨学科合作的是防止类似事件发生的重要措施。

Objective To identify the cause of a foodborne disease incident that occurred in May 2022 in Tianhe District,Guangzhou City,and to propose appropriate preventive and control measures to prevent the occurrence of similar incidents.Methods Case definitions were developed and case questionnaires were applied to conduct on-site epidemiologic investigations.The basic information of the cases,the onset of the disease,the clinical manifestations,the meal history of 72 hours prior to disease onset,drinking water hygiene,suspected sources and processing of wild poisonous mushrooms,etcetera were registered.The attending physician was interviewed about the clinical examination,diagnosis and treatment process,and the course of the disease was followed up by telephone.An investigation into the breeding grounds of suspected poisonous mushrooms was carried out to identify the types of poisonous mushrooms from a morphological perspective.Excel 2013 was used to organize the data.Results A total of 11 people were exposed in this incident totally,10 people who met the case definition were searched and verified,and 3 people were hospitalized,for an attack rate of 90.9%(10/11)and a hospitalization rate of 30.0%(3/10).All cases occurred within 15 minutes after meals,with a median incubation period of 0.25 hours.The main clinical manifestations were sweating,salivation,vomiting,abdominal pain and diarrhea,accompanied by increased abdominal distension and urination frequency.Blood tests showed normal liver and kidney function.After symptomatic and supportive treatment in the hospital,all of them recovered without serious and fatal cases.The longest duration of the disease was 61.00 hours,the shortest was 13.00 hours,and the median was 13.00 hours.The suspected wild poisonous mushroom was identified as Inosperma muscarium.Conclusion The incident is caused by the accidental picking and ingestion of Inosperma muscarium,which is the first reported incident of foodborne disease due to poisoning by Inosperma muscarium in Guangdong Province.Focusing on propaganda and education,multi-departmental linkage,and interdisciplinary cooperation are important measures to prevent the recurrence of similar incidents.