发光类脐菇中毒事件调查分析

目的 分析云南省元谋县一起毒蘑菇中毒事件的流行病学调查结果和实验室毒蘑菇鉴定的实验结果,对中毒病因进行确证.方法 收治中毒患者后,当地医务人员迅速开展中毒救治工作,疾控专业人员对患者携带的可疑毒蘑菇样本进行形态学和分子生物学鉴定,并对调查结果进行分析.结果 2015年8月1日,元谋县某电厂12名男性工人,一起食用了一种野生菌约100～200g,进食后10 min到0.5h出现症状.临床表现为不同程度出现恶心、呕吐、腹痛、腹泻,头晕、胸闷症状.4名症状较轻者门诊给予处理后拒绝治疗,3名患者给予机械洗胃,药用炭胃管注入保留等促进毒物排泄治疗,其他患者给予保肝等对症支持治疗.8名患者3～4d后病愈出院.现场采集的可疑毒蘑菇标本经鉴定确认为发光类脐菇(omphalotus olearius).结论 该中毒是一起由发光类脐菇引起的食物中毒事件.明确为由发光类脐菇导致的中毒在国内尚属首次报道.提示要加强对该种毒蘑菇的研究,并对当地群众开展毒针对性的预防和科普教育.

Investigation and analysis of a poisoning event caused by omphalotus olearius

Objective To study the identificantion and confirmation of the cause of a food poisoning event occurring in Yuanmou County,Yunnan Province of China with the epidemiological investigation and molecular biological assay.Methods After admission of the intoxicated patients,the emergency physicians gave the emergency medical care and rescue.The specialists of the Controlling Diseases Center of China (CDC) immediatelly made the identification of mushrooms and analysis of the results.Results A total of 12 workers ate a dish of wild mushroom picked nearby on August 1,2016.About 10 to 30 minutes after meal,they experienced nausea,vomit,dizziness,diarrhea,abdominal pain and feeling of chest tightness.After the preliminarily medical treatment,four of them refusedto be further treated because of their mild symptom,and were followed up in OPD.Three of them were further treated with gastric lavage and activated charcoal via a gastric tube,and other 5 patients were only treated with liver protection agents.Eight patients were monitored and observed for 3-4 days,in emergency medicine,and they discharged with recovered confirmed via telephone follow-up.CDC specialists identified the mushroom the patients consumed as omphalotus olearius.Therefore,this event was determined as a sudden acute poisonous mushroom poisoning event caused by O.olearius.Conclusions O.olearius produces some bioactive components.But the literature on its toxicity is rather rare.To our knowledge,this is the first to report an O.olearius intoxication event.And we identified this poison morphologically and phylogenetically.This event illustrated us that O.olearius needs further study.Besides,the scientific education in the prevention of mushroom poisoning to general public should be conducted.