An estimation of foodborne illness in populations with HIV/AIDS infection,United States, 1987–93

The purpose of this research is to arrive at an approximation of the level of foodborne/waterborne illness in the United States for persons with HIV/AIDS infection and to determine trends in these patterns by age of patient. The National Hospital Discharge Survey in the United States is used to identify HIV/AIDS patients by ICD‐9–3CM codes. These codes are used to link these persons with codes for foodborne/waterborne illness. Odds ratios are calculated to estimate the elevated chance of foodborne/waterborne illness for this population. Analysis shows that hospital discharge certificates with mention of HIV/AIDS infection have 4–6 times greater chance of foodborne/waterborne illness than do certificates without mention of HIV/AIDS infection. When age is considered, relative risks increase to 8.6 times greater for HIV/AIDS patients. Trend data show increased in odds ratios from 1988 to 1993. These estimates establish the elevated association of foodborne/waterborne illness with HIV/AIDS patients discharged from hospitals in the United States and the risks are related to age and are increasing over the period.     

2006年中国食源性疾病暴发的监测资料分析

目的分析2006年中国食源性疾病暴发事件的流行病学特征。方法对全国食源性疾病监测网收集的2006年食源性疾病资料进行统计分析。结果2006年,18个监测地区共上报594起食源性疾病暴发事件,累计发病13849人,死亡67人。在病因清楚的事件中,微生物引起的食源性疾病暴发事件数和患者数最多,分别占48.3%和63.3%;化学物引起的暴发事件数和患者数分别占24.8%和15.5%;动植物引起的暴发事件数和患者数分别占23.5%和17.7%。结论全国食源性疾病监测网发现,微生物性食源性疾病是中国重要的公共卫生问题,今后仍然需要强化食源性疾病的报告意识。     

Norovirus and foodborne disease, United States, 1991-2000

Efforts to prevent foodborne illness target bacterial pathogens, yet noroviruses (NoV) are suspected to be the most common cause of gastroenteritis. New molecular assays allow for better estimation of the role of NoV in foodborne illness. We analyzed 8,271 foodborne outbreaks reported to the Centers for Disease Control and Prevention from 1991 to 2000 and additional data from 6 states. The proportion of NoV-confirmed outbreaks increased from 1% in 1991 to 12% in 2000. However, from 1998 to 2000, 76% of NoV outbreaks were reported by only 11 states. In 2000, an estimated 50% of foodborne outbreaks in 6 states were attributable to NoV. NoV outbreaks were larger than bacterial outbreaks (median persons affected: 25 versus 15), and 10% of affected persons sought medical care; 1% were hospitalized. More widespread use of molecular assays will permit better estimates of the role of NoV illness and help direct efforts to control foodborne illness.     

Fortune and foreigners: toward an epidemiology of food (borne illness)

Studies comparing incidence of foodborne illness among different population subgroups are complicated by biases inherent in routinely available data. Even when we account for these biases, our understanding of the epidemiology of foodborne illness is hampered by a lack of empirical evidence on how social and cultural factors influence risk, and how this risk is modified by the acquisition of immunity. An epidemiology of foodborne illness must include the epidemiology of food and the complex pathways by which it results in illness, as well as an understanding of the acquisition and prevalence of immunity to foodborne pathogens. Only then can we correctly interpret studies of incidence and risk factors, and their implications for control of foodborne illness.     

我国大城市15岁及以上居民门诊费用及其影响因素分析

目的 分析我国大城市１５岁及以上居民就诊费用及其变化趋势,探讨影响居民门诊费用的因素,为卫生改革和控制医药费用进一步上涨提供参考依据。方法 利用１９９３年和１９９８年二次国家卫生服务调查１５岁及以上患者两周就诊情况的资料,采用描述性分析和建立对数线性回归模型的方法。结果 地区、年龄、性别、文化程度、收入水平、医疗保障制度、疾病别的次均就诊费用存在差异。结论 性别、疾病种类、医疗保健制度、收入、恩格     

2004—2020年四川省学校食源性疾病事件流行病学分析

目的 了解2004—2020年四川省学校食源性疾病事件的流行病学特征,为有效防控学校食源性疾病事件提供科学依据。方法 对2004—2020年四川省通过网络直报的学校食源性疾病事件相关数据进行描述性流行病学分析。结果 2004—2020年,四川省共报告学校食源性疾病事件125起、发病病例2 945例、死亡病例6例。9月及4—6月是高发月份,该时期报告事件数占总数的60.80%。事件主要分布在小学与中学。可疑食品主要来源于学校食堂与野外,分别占事件总数的55.20%和28.80%。致病因素以有毒植物和微生物为主,分别占事件总数的40.80%和20.80%。结论 学校是食源性疾病的高发场所,应进一步加强学校食品安全工作并采取有针对性的措施防控学校食源性疾病事件。     

2012 - 2016年烟台市食源性疾病暴发事件流行病学特征分析

目的 探讨烟台市食源性疾病暴发事件的流行病学特征,为制定食源性疾病防控措施提供科学依据。方法 对2012 - 2016年通过国家食源性疾病暴发报告系统上报的食源性疾病暴发事件进行整理分析。 结果 2012 - 2016年,烟台市共发生食源性疾病暴发事件232起,发病1 282人,以20～59岁人群为主（79.33%,1 017/1 282）,无死亡病例;食源性疾病暴发事件主要发生在市中心和主要旅游景点区域,高发季节为第三季度,报告起数、病例数占全年总数的68.10%（158/232）和62.25%（798/1 282）,以8月份最高（110/232）;饮食服务单位（53.45%,124/232）是发生食源性疾病暴发事件的主要场所,其次是家庭（30.17%,70/232）,加工不当与误食误用是主要引发因素（12.93%,30/232）,水产品（29.55%,26/88）和自采野生蘑菇（18.18%,16/88）是主要原因食品,主要致病因素是有毒动植物（25/232）和致病微生物（21/232）。结论 烟台市食源性疾病防控形势严峻,特别是夏秋季节容易多发,应针对不同场所、主要因素和致病菌制定有效防控措施。     

Perspective on serum dioxin levels in the United States: an evaluation of the NHANES data

The Centers for Disease Control and Prevention released its third set of nationally representative data on serum levels of polychlorinated dibenzodioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and non-ortho and coplanar polychlorinated biphenyls (PCBs) in the United States collected during the 2003-2004 sampling period as part of the National Health and Nutrition Examination Survey (NHANES). We utilize the serum PCDD/F data from the three NHANES sampling periods spanning 1999-2004 to assess whether there are discernable temporal trends in the United States, either for the overall population or by age. We also compare population serum data to biomonitoring equivalents (BEs) derived for PCDDs/Fs/PCBs; BEs are estimates of the concentration of PCDD/Fs/PCBs corresponding to existing exposure guidance values estimated by various governmental agencies. The serum PCDD/F data from 1999 to 2004 provide evidence that levels in the US population are declining, mirroring international trends, although the lower levels are principally observable in the 2003-2004 time period. Examining the trend by population age, from the 1999 to 2004, PCDD/F serum levels decreased by 56% for the 12-to 19-year-old group and by 38% for the 20-to 39-year olds. A slight nonsignificant decrease was observed for 40-to 59-year olds and a slight significant increase was found for 60+ year olds. Interpretation of the data across time is complicated by certain aspects of the data unique to the various sampling time periods; thus, caution should be exercised when evaluating trend information. The population mean PCDD/F/PCB TEQ is approximately equal to the BE based on the Agency for Toxic Substances and Disease Registry's Minimum Risk Level and is approximately 2-4 times lower than the remaining BEs, placing the population mean at the border between medium and low priority levels. However, certain segments of the population have levels at the medium/high priority level (e.g., the 95th percentiles for ages 60 years and older).     

Position of the Academy of Nutrition and Dietetics: Food and Water Safety

It is the position of the Academy of Nutrition and Dietetics that all people should have access to a safe food and water supply. The Academy of Nutrition and Dietetics supports science-based food and water regulations and recommendations that are applied consistently across all foods and water regulated by all agencies and incorporate traceability and recall to limit food- and waterborne outbreaks. Registered dietitian nutritionists and dietetic technicians, registered, are encouraged to participate in policy decisions, program development, and implementation of a food safety culture. Food safety affects all segments of the population in a global society, and, although the United States food and water system has many protections in place, food safety continues to be a public health concern. The Centers for Disease Control and Prevention estimates that one in six Americans are sickened, 128,000 are hospitalized, and 3,000 die annually from foodborne disease. Using the Centers for Disease Control and Prevention estimates for foodborne illness, it is estimated that the basic cost-of-illness averages $1,068/episode with a total annual cost of $51 billion. The food safety system is challenged by changing demographics, consumer preferences for convenience and variety, and issues of concern in the commercial food chain and in regulatory systems. The 2011-enacted Food Safety Modernization Act is an extensive expansion of federal food regulatory authority that mandates a risk-based food safety system approach and focuses on comprehensive science-based preventive measures across the total food safety system. Registered dietitian nutritionists and dietetic technicians, registered, have unique roles in promoting and establishing food safety cultures in foodservice settings, clinical practices, community settings, and in public venues because their training integrates food; science; and health, both preventive and therapeutic.     

甘肃省社区人群食源性疾病患病因素分析

目的了解甘肃省社区人群食源性疾病患病流行情况,并探索其影响因素,为制定疾病干预措施和合理配置卫生资源提供科学依据。方法采用分层随机抽样方法于2011年12月—2013年11月选取甘肃省3个调查点共4917户居民,完成4229份样本人群的调查,通过入户面对面访谈的形式,用调查问卷收集信息。结果食源性疾病加权月患病率为6.57%(95%CI=5.84%~7.30%),病例就诊率为70.67%(95%CI=65.29%~76.06%)。多因素logistic回归分析结果显示:年龄、文化程度、家庭年收入、季度、监测点对食源性疾病患病的影响差异有统计学意义(P<0.05)。结论甘肃省社区人群食源性疾病患病率较高,年龄、文化程度、家庭年收入、季度以及地域等因素对食源性疾病患病有影响。     

2003年中国食源性疾病暴发的监测资料分析

目的持续监测国家食源性疾病监测网覆盖地区人群食源性疾病发生状况。方法对2003年监测地区13个省上报食源性疾病资料进行回顾性分析。结果2003年共上报802起食源性疾病事件,涉及患者人数达17462人。微生物引起的食源性疾病事件和涉及人数最多,分别占总体的46·4%和60·4%,其中副溶血性弧菌(40·1%)是主要致病菌。化学物引起的食源性疾病事件和涉及人数分别占总体的24·1%和13·9%。结论应不断完善中国食源性疾病监测网络建设,作为监测食源性疾病的重要平台。     

Enhancing foodborne disease surveillance across Australia in 2001: the OzFoodNet Working Group.

In 2000, the OzFoodNet network was established to enhance surveillance of foodborne diseases across Australia. OzFoodNet consists of 7 sites and covers 68 per cent of Australia's population. During 2001, sites reported 15,815 cases of campylobacteriosis, 6,607 cases of salmonellosis, 326 cases of shigellosis, 71 cases of yersiniosis, 61 cases of listeriosis, 47 cases of shiga-toxin producing E. coli and 5 cases of haemolytic uraemic syndrome. Sites reported 86 foodborne outbreaks affecting 1,768 people, of whom 4.0 per cent (70/1,768) were hospitalised and one person died. There was a wide range of foods implicated in these outbreaks and the most common agent was S. Typhimurium. Sites reported two international outbreaks; one of multi-drug resistant S. Typhimurium Definitive Type 104 due to helva imported from Turkey, and one of S. Stanley associated with dried peanuts from China. The National Centre for Epidemiology and Population Health conducted a national survey of gastroenteritis. Preliminary data from interviews of 2,417 people suggests that the incidence of foodborne illness is significantly higher than previously thought. OzFoodNet initiated case control studies into risk factors for Campylobacter, Salmonella, Listeria, and shiga-toxin producing E. coli. OzFoodNet developed a foodborne disease outbreak register for Australia; established a network of laboratories to type Campylobacter; prepared a survey of pathology laboratories; reviewed Australian data on listeriosis; and assessed the usefulness of sentinel surveillance for gastroenteritis. This program of enhanced surveillance has demonstrated its capacity to nationally investigate and determine the causes of foodborne disease.     

Listeria monocytogenes: A Continuing Challenge

As a leading cause of death from a foodborne pathogen, Listeria monocytogenes continues to cause sporadic cases and outbreaks of illness. The most recent of these outbreaks in the United States involved consumption of hot dogs, with 101 cases of illness and 21 deaths reported to the Centers for Disease Control and Prevention for the years 1998-1999. Epidemiologic analysis determined that contamination levels in hot dogs were remarkably low (0.3 CFU [colony-forming units] L monocytogenes serotype 4b/g). That same year, manufacturers of hot dogs and luncheon meats collectively recalled more than 500,000 pounds of product owing to possible Listeria contamination. This article, through focus on issues such as reexamination of zero-tolerance policies, improvements in detection and enumeration procedures, the impact of epidemiologic innovations, and measures needed to further reduce the incidence of listeriosis will highlight why L monocytogenes remains a continuing challenge for the food industry.     

福建省2006-2010年老年人死亡病例分析

目的分析福建省老年人死亡原因、地区分布及医疗卫生机构报告情况。方法把60岁及以上统计为老年人,利用福建省医疗卫生机构2006-2010年通过《死因登记报告信息系统》报告的个案数据及中国疾病预防控制信息系统发布的常住人口数信息进行统计分析。结果死因类别前5位分别为心脑血管疾病、肿瘤、慢性呼吸系统疾病、伤害和诊断不明;第7位的内分泌代谢疾病和第10位的精神疾病女性死亡率高于男性,其它死因类别男性死亡率高于女性;各年龄组男性死亡率均高于女性;且死亡率随年龄增加呈上升趋势;2008-2010年各卫生机构报告死亡病例多于2006年和2007年,乡镇级报告增加明显;5年标化死亡率前3位分别为厦门、龙岩和南平,后3位分别为宁德、福州和漳州。结论了解福建省老年人主要死因及性别、年龄组别、各级别报告机构、地区等分布情况,为福建省今后防治老年人疾病提供依据。     

2002～2005年广西食品中沙门氏菌的监测与分析

目的了解广西食品中沙门氏菌的污染状况,初步确定易受污染的食品,为防范由沙门氏菌引起的食物中毒和食源性疾病监测提供科学依据。方法在广西南宁等6个城市建立食品污染物监测点,定期随机采集6类农贸市场的食品,检验方法按照中国疾病预防控制中心营养与食品安全所统一的沙门氏菌检验方法进行。结果2002~2005年共监测6类食品1872份,检出沙门氏菌128株,检出率为6.84%,分属6个群、19个血清型。结论在广西食品中不同程度受到沙门氏菌的污染,以生畜禽肉污染严重。应加强畜、禽类屠宰、运输、加工过程的卫生管理和监测,减少食源性疾病的发生。     

Domestic and travel-related foodborne gastrointestinal illness in a population health survey

Routine surveillance data underestimate incidence of foodborne gastrointestinal (FGI) illness and provide little information on illness related to travel. We analysed data from the Welsh Health Survey to estimate population incidence, and to examine risk factors for FGI and factors associated with consulting a doctor. Reported frequency of any FGI in the 3 months before interview was 20.0% [95% confidence interval (CI) 19.5-20.4; equivalent to 0.8 episodes per person-year], and for travel-related FGI was 1.6% (95% CI 1.5-1.8). In the final model, sex, age group, marital status, self-reported health, long-term illness, smoking and alcohol consumption were all independent predictors of FGI. People who consulted a doctor were likely to be older, in poorer health, taking regular medication, or to report mental illness. FGI is common but risk factors for illness and consultation differ and impressions of the epidemiology of the disease based on surveillance data are therefore distorted.     

Surveillance for foodborne disease outbreaks--United States, 2008

Foodborne agents cause an estimated 48 million illnesses annually in the United States, including 9.4 million illnesses from known pathogens. CDC collects data on foodborne disease outbreaks submitted from all states and territories through the Foodborne Disease Outbreak Surveillance System. During 2008, the most recent year for which data are finalized, 1,034 foodborne disease outbreaks were reported, which resulted in 23,152 cases of illness, 1,276 hospitalizations, and 22 deaths. Among the 479 outbreaks with a laboratory-confirmed single etiologic agent reported, norovirus was the most common, accounting for 49% of outbreaks and 46% of illnesses. Salmonella was the second most common, accounting for 23% of outbreaks and 31% of illnesses. Among the 218 outbreaks attributed to a food vehicle with ingredients from only one of 17 defined food commodities, the top commodities to which outbreaks were attributed were poultry (15%), beef (14%), and finfish (14%), whereas the top commodities to which outbreak-related illnesses were attributed were fruits and nuts (24%), vine-stalk vegetables (23%), and beef (13%). Outbreak surveillance provides insights into the agents that cause foodborne illness, types of implicated foods, and settings where transmission occurs. Public health, regulatory, and food industry professionals can use this information to target prevention efforts against pathogens and foods that cause the most foodborne disease outbreaks.     

绵阳市2003～2006年细菌性食源性疾病检测结果分析

[目的]对绵阳市2003～2006年细菌性食源性疾病检测结果进行分析,了解病原菌分布特征及其发生规律,为实现对细菌性食源性疾病病原菌主动监控,制定我市食源性疾病暴发的预警、预防控制措施提供科学依据.[方法] 用GB/T4789-2003<食品卫生微生物学检验>、<临床细菌学>对采集的有关食源性疾病样本进行病原菌检验.[结果]我市细菌性食源性疾病病原菌主要为志贺菌,其次为金黄色葡萄球菌,第2、3季度为高发季节,中小学集体食堂为主要发生场所.[结论]针对我市细菌性食源性疾病的特点,在第2、3季度对中小学实施志贺菌、金黄色葡萄球菌的主动监控,加强卫生监督力度,加强集体食堂从业人员卫生知识培训是预防和减少我市细菌性食源性疾病发生的关键措施.     

Multistate outbreak of Salmonella typhimurium infections associated with eating ground beef--United States, 2004

Salmonella infections cause an estimated 1.4 million human illnesses and 400 deaths annually in the United States. Although the incidence of several other foodborne bacterial infections decreased substantially during 1996-2004, the incidence of Salmonella infections declined modestly. In September 2004, the New Mexico Department of Health received reports from the New Mexico Scientific Laboratory Division of eight Salmonella enterica serotype Typhimurium isolates that had indistinguishable pulsed-field gel electrophoresis (PFGE) patterns using XbaI and BlnI restriction enzymes. The patients were from three New Mexico counties and had onsets of illness during August 18-29. A review of PFGE patterns submitted to the National Molecular Subtyping Network for Foodborne Disease Surveillance (PulseNet) database for Salmonella revealed 31 indistinguishable patient isolates of S. Typhimurium from nine states (Colorado, Kansas, Minnesota, New Jersey, New Mexico, New York, Ohio, Tennessee, and Wisconsin) and the District of Columbia, with illness onset occurring during August 11-October 2, 2004. The S. Typhimurium isolates were susceptible to all antimicrobial agents tested. An investigation conducted by state health departments, CDC, and the U.S. Department of Agriculture Food Safety and Inspection Service (FSIS) identified ground beef purchased at a national chain of supermarkets as the source of S. Typhimurium infections. Traceback results indicated product originating from a common supplier; however, evaluators determined that plant practices conformed to FSIS production guidelines, and no product recalls were made. This report describes the investigation and underscores the risk for salmonellosis from contact with contaminated ground beef, despite regulatory directives to reduce Salmonella contamination in beef production. Reduced contamination and consumption of raw or undercooked meat and further education of the food service industry and consumers are critical to reducing foodborne salmonellosis.