一起食源性霍乱暴发的调查分析

An investigation of a food-borne outbreak of cholera

目的 查清霍乱暴发特征和因素 ,控制流行。方法 调查所有就餐及其接触者 ,同时肛拭采样培养鉴定霍乱弧菌 ,按《霍乱防治手册》的标准确诊病人 ;对疫点环境采样培养分离霍乱弧菌 ;并采取控制措施。结果 共发病 5 5例 ,死亡 1例 ,病原学诊断 5例 (稻叶型 ) ,临床诊断 5 0例。 3次聚餐者罹患率为 15 76% ,未就餐者为 0 80 % ,前者显著高于后者 (P <0 0 1) ;仅参加第 1、第 2、第 3次聚餐者罹患率分别为 17 5 0 %、0 0 0 %、3 0 3 % ,以第 1次为高 (P <0 0 5 )。结论 首次聚餐可能是导致暴发的主要原因 ,可能为首发病例带菌 ,操作拌凉菜污染食品所致 ,其次与疫情报告晚以及措施落实不及时有关。

Objective To investigate the characteristics and relative factors of the outbreak of cholera to control its spread Methods All people of three banquets and their contacts were investigated and rectal swabs were collected for isolation and identification of Vibrio cholerae Patients were diagnosed according to the Manual for the Control of Cholera Environmental samples in the epidemic focus were tested for V cholerae isolation Results A total of 55 cases were reported, including 1 case of death, 5 cases diagnosed as serotype Inaba cholera by laboratory and 50 other cases diagnosed clinically Attack rates of diners of the banquets and others were 15 76% and 0 8% respectively ( P <0 005), but those of diners attending only 1st or 2nd or 3rd banquet were 17 5%, 0 0%, 3 0% with the attack rate of the 1st banquet diners being significantly higher than those of 2nd and 3rd( P <0 005) Conclusion The first banquet at which the first cholera case contaminated the food may be the main factor to lead to the outbreak Delayed reporting and implementing of control measures have also faciliated the outbreak