安仁县2012年一起霍乱暴发疫情的流行病学分析

目的 查明安仁县2012年5月份发生的一起霍乱疫情规模、调查传染来源,以控制疫情蔓延. 方法 制定统一的病例定义,开展病例主动搜索,对就餐人员食用菜谱开展回顾性队列研究. 结果 共18人感染,其中有3例确诊病例,均参加了2012年4月29日一次农村家庭丧宴晚餐聚餐,未参加者未发病.对参加29日晚餐的373名就餐者开展回顾性队列研究,结果显示食用猪脚蒸鸡蛋为危险因素(RR=4.64,95％CI:1.08～19.9).在食品加工过程中甲鱼宰杀后和煮熟去壳鸡蛋共用器具盛装,部分去壳鸡蛋未再经油炸和蒸煮即直接与猪脚一起上酒席,存有交叉污染可能.结论 该起疫情为农村家庭丧宴中食品受O139霍乱弧菌污染所致,传染源为带菌的甲鱼,传播途径为甲鱼制作过程中污染了鸡蛋,经食用后引起发病.

Epidemiological Analysis on an Outbreak of Cholera in Anren County in 2012

Objective To investigate the epidemic situation and infection source of an outbreak of cholera occurred in Anren County in May,2012 so as to control its spread. 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 cholerae culture.We took stool samples or rectal swabs from all attendees for cholera culture and interviewed 373 banquet attendees about foods they ate at the banquet and kitchen workers about food preparation. Results Among 373 attendees,18 developed the cases after eating on April 29,2012,including 3 confirmed cases.The results of retrospective cohort study showed that eating braised pettitoes and eggs were the risk factor(RR=4.64,95% CI:1.08-19.9).During food preparation,the same utensil was used for fresh turtle meat and cooked eggs without washing between the processes.Some cooked eggs were stored for > l6 hours at room temperature in the utensil without cooking before consumption.There was the possibility of cross-contamination. Conclusions This outbreak was likely caused by poor food handling of commercially produced turtles contaminated with Vibrio cholerae O139.It is necessary to improve microbiological monitoring of aquatic food animals,and raise the awareness of good handling practices at mass gathering in rural areas.