自贡市2017年1起O139霍乱确诊病例的流行病学调查

目的 对自贡市2017年1例O139霍乱确诊病例进行流行病学调查和溯源,为疫情防控工作提供参考。方法 对病例及密切接触者进行调查,对全市水产市场、生活饮用水水源地和水产养殖聚集地开展霍乱监测。结果 从病例粪便中检出O139霍乱弧菌,RT-PCR检测菌株ctxAB毒力基因阳性。从病例就业的餐馆甲鱼供应水产经营部盛装活甲鱼水、病家厕所余水标本中均培养出O139霍乱弧菌。脉冲场凝胶电泳检测显示,病例粪便与病家厕所余水中所分离的霍乱弧菌相似度评价值为100%,与盛装活甲鱼水中所分离的霍乱弧菌相似度评价值为94.7%,为同源菌株。水产市场和外环境监测未发现霍乱阳性标本。结论 本病例在餐厅处理被O139霍乱弧菌污染的甲鱼过程中受到感染。被污染甲鱼来自外地,未构成本地传播。应加强餐饮业工作人员霍乱等传染病的基础知识和个人防护宣传,从业人员在处理高风险水产食材处理工作时应做好戴手套等防护措施 。

Investigation of a cholera case (O139 Vibrio cholerae positive) in Zigong, 2017

Objective To make an epidemiological investigation on a reported cholera case and implement control measures, so as to provide the reference for similar situation management. Methods An epidemical and tracing investigation was performed on a reported cholera case, and a cholera surveillance of aquaculture market, drinking water source, and aquaculture aggregated area was implemented. Results O139 Vibrio cholerae was isolated from the patient stool sample, which strain was RT-PCR test ctxAB virulence gene positive. O139 Vibrio cholerae was traced and isolated from the soft-shelled turtle preserve water collected from the soft-shelled turtle retailer and toilet samples collected from the patient's home. The pulsed field gel electrophoresis (PFGE) test showed that the similarity evaluation value between the Vibrio cholerae strain isolated from the patient′s stool and the strain isolated from the patient′s toilet water was 100%, and the similarity evaluation value between the Vibrio cholerae strain isolated from the patient′s stool and the strain isolated from soft-shelled turtle preserve water was 94.7%, and the results indicated that they were homologous strains. All aquatic products and environment surveillance samples were Vibrio cholerae negative. Conclusions The patient is infected by handling soft-shelled turtle in the restaurant. The contaminated soft-shelled turtle is imported from other city, and there is not local transmission. We should enforce the health education, including individual protection education of cholera for the restaurant workers. The persons with chronic digestive system diseases should avoid handling cholera high-risk aquatic product such as soft-shelled turtle.