广东省清远市清城区一起食源性疾病暴发调查

目的 对一起酒店婚宴食源性疾病暴发事件进行调查和分析,探索致病因素,提出防控措施,为类似事件处置提供参考。方法 对病例进行个案调查描述流行病学特征。开展病例对照研究探讨危险因素。开展现场卫生学调查,采集相关样品并进行实验室检验。结果 核实病例共90例,罹患率7.20%,均为参加同一婚宴（或进食了婚宴食物）的宾客。临床表现为发热（100.00%）、腹泻（98.89%）、腹痛（95.56%）、乏力（80.00%）、寒战（61.11%）、呕吐（37.78%）等,腹泻次数多为（10~20）次/d,大便性状为黄色或黄绿色水样。病例对照研究显示,国际炒饭（OR=90.00,95%CI:4.81~1 683.86）是危险食物。分别从28份病例大便或肛拭子、2份厨房助手肛拭子和7份留样食物样品中检出肠炎沙门菌,菌株具有同源性。结论 这是一起发生在酒店婚宴中由肠炎沙门菌污染引起的食源性疾病暴发事件。引起发病的餐次是2月14日谢刘婚宴,食物为国际炒饭。建议加强对餐饮服务单位特别是承接大型宴会酒店的监督管理,消除食品生产过程存在的安全隐患,预防类似事件的发生。

Investigation of an outbreak of foodborne diseases in Qingcheng District,Qingyuan, Guangdong

Objective To investigate and analyze an outbreak of foodborne diseases in a hotel wedding banquet, to explore the pathogenic factors, and to propose preventive and control measures, so as to provide a reference for the handling of similar incidents. Methods Case studies were conducted to describe epidemiological characteristics. We carry out case-control study to explore risk factors, and conduct on-site hygienic investigation, collect relevant samples and carry out laboratory tests. Results A total of 90 cases were confirmed, the incidence of which was 7.20%. They were all guests who participated in the same wedding banquet (or had eaten the wedding banquet food). The clinical manifestations were fever (100.00%), diarrhea (98.89%), abdominal pain (95.56%), fatigue (80.00%), chills (61.11%) and vomiting (37.78%). The frequency of diarrhea was (10-20) times per day, and the stool characteristics were yellow or yellow-green water. Case-control studies showed that international fried rice (OR = 90.00, 95% CI: 4.81-1 683.86) was a dangerous food. Salmonella enteritidis was detected from 28 stool or anal swab samples, 2 kitchen assistant anal swab samples and 7 food samples, the strains were homologous. Conclusion This is an outbreak of foodborne diseases caused by Salmonella enteritidis contamination at hotel wedding banquets. The meal that caused the disease was Xie Liu's wedding banquet on February 14. The food was international fried rice. It is suggested that the supervision and management of catering service units, especially large banquet hotels, should be strengthened so as to eliminate potential safety hazards in food production and prevent similar incidents.