| 唐雪峰,刘伦光,马会来,朱保平,郝彩霞,吴晓燕,费宁,祝小平,张丽杰.四川省2009年一起因甲鱼被污染导致的霍乱暴发[J].Chinese journal of Epidemiology,2010,31(9):1050-1052 |
| 四川省2009年一起因甲鱼被污染导致的霍乱暴发 |
| Outbreak of cholera associated with consumption of soft-shelled turtles, Sichuan province, China, 2009 |
| Received:July 31, 2010 |
| DOI： |
| KeyWord: 霍乱 甲鱼 暴发 队列研究 |
| English Key Word: Cholera Turtles Outbreak Cohort study |
| FundProject:西安市科学技术计划 |
| Author Name | Affiliation | E-mail | | TANG Xue-feng | Chinese Field Epidemiology Training Program CFETP, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Sichuan Provincial Center for Disease Control and Prevention | | | LIU Lun-guang | Sichuan Provincial Center for Disease Control and Prevention | | | MA Hui-lai | Chinese Field Epidemiology Training Program CFETP, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | ZHU Bao-ping | Chinese Field Epidemiology Training Program CFETP, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | HAO Cai-xia | Sichuan Provincial Center for Disease Control and Prevention | | | WU Xiao-yan | Luzhou Municipal Center for Disease Control and Prevention | | | FEI Ning | Naxi District Center for Disease Control and Prevention | | | ZHU Xiao-ping | Sichuan Provincial Center for Disease Control and Prevention | | | ZHANG Li-jie | Chinese Field Epidemiology Training Program CFETP, Chinese Center for Disease Control and Prevention, Beijing 100050, China | zhang_li_jie@hotmail.com |
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| Abstract: |
| 目的 查明某镇卫生院报告发现1例疑似霍乱病例疫情规模、调查传染来源、控制疫情蔓延.方法 制定统一的病例定义,开展病例主动搜索,对就餐人员食用菜品情况开展回顾性队列研究.结果 共24人感染,其中10人发病,均参加了2009年7月14日一次午餐聚会,未参加者未发病.对参加14日午餐的265名就餐者开展回顾性队列调查,结果显示食用蒸甲鱼和花生米为危险因素,RR=3.6(95%CI:1.1～12)和RR=3.1(95%CI:1.2～8.0).在食品加工过程中,甲鱼宰杀与花生米共用盛装器具,甲鱼蒸煮时间45 min,花生米室温下存放超过16 h,甲鱼未熟及交叉污染花生米的可能性极大.结论 该起疫情为聚餐中食品受O139霍乱弧菌污染所致,传染源为体内带菌的甲鱼,传播途径为甲鱼蒸煮未熟透,且制作过程中污染了花生米,经食用后引起发病. |
| English Abstract: |
| Objective Vibrio cholera was extremely rare in Sichuan province (no cases in 2008). Any outbreak could indicate contamination through the food supply system. In July 2009, a hospital reported a cluster of 7 diarrhea patients; all attended the same banquet. One patient was confirmed to have Vibrio cholera (O139). We conducted this investigation to identify the source of this possible cholera outbreak. Methods We defined a suspect case as any banquet attendee with diarrhea ( ≥3 times/day). A confirmed case was a suspect case with a positive Vibrio cholera culture. We took stool samples or rectal swabs from all attendees for cholera culture and interviewed 272 banquet attendees about foods they ate at the banquet and kitchen workers about food preparation. Results 7.1% (24/337) of attendees developed cases within an average of 65 hours after eating. Three meals were served. All patients had the lunch whereas no patients only ate breakfast and/or dinner. Of 180 attendees who ate turtle meat 12% were case-patients, compared to 3.3% of 92 attendees who did not (RR=3.6,95%CI: 1.1-12). Of the 150 attendees who ate peanuts 13% were cases compared to 4.1%of 122 attendees who did not eat peanuts (RR=3.1,95%CI: 1.2-8.0). During preparation, the same utensil was used for fresh turtle meat and peanuts without washing in-between the process. Turtle meat and peanuts were stored for ＞ 16 hours at room temperature after cooking before consumption. All 33 turtles originated from commercial production in another province. Conclusion This outbreak was likely caused by poor food handling of commercially produced turtles. We proposed that to improve microbiologic monitoring of aquatic food animals, and raise the awareness of good handling practices at mass gathering in rural China. |
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