一起肠炎沙门菌引起的食物中毒调查分析

目的调查分析本次食物中毒的原因及可疑危险因素,提出有效的防控措施。方法2019-07成都市龙泉驿区疾病预防控制中心接报A医院收治了5名腹泻、发热患者,通过制定病例定义并搜索病例,个案调查描述病例的三间分布和临床特征,根据流行曲线推断可疑餐次,采用病例对照研究查找可疑食品,对事发场所进行现场卫生学调查,采集病例和厨工肛拭子、留样食品和环境涂抹样检测病原,使用R软件进行病例对照分析、计算OR值和95%CI,以P<0.05为差异有统计学意义。结果共搜索到病例26例,罹患率9.6%(26/270),主要临床症状为腹泻(100.0%)、发热(100.0%)、头晕(88.5%)、恶心(76.9%)、头痛等(73.1%),流行曲线提示点源暴露,潜伏期中位数为16.5 h,7月26日晚餐为可疑餐次,食用西红柿煨肉丸(OR值=8.94,95%CI=2.243~35.607)是发病的危险因素,5名患者肛拭子、1名厨师肛拭子及1份留样菜品西红柿煨肉丸检出肠炎沙门菌。结论本次事件是由肠炎沙门菌引起的食物中毒,建议加强集体食堂的监督与管理,提高食品的加工质控能力,防止此类事件再次发生。

An Epidemiological Investigation of Food Poisoning Caused by Salmonella Enteritidis

Objective To investigate and analysis the causes and suspicious risk factors of food poisoning,and to provide forward effective control suggestions.Methods In July 2019,there were five patients with diarrhea and fever symptom and they were treated in hospital A,these cases were reported to Longquanyi District Center for Desease Control and Prevention,Chengdu city.By developing case definitions and conducting case searches,epidemiological investigation was carried out to describe the distribution and clinical features of the cases,this research analyzed popular curve to find suspicious meals,a case-control study was conducted to find suspicious food,on-site hygiene survey was conducted of the canteen,and relevant samples were collected for laboratory testing.Results A total of 26 cases were found,the attack rate was 9.6%(26/270),and the clinical manifestations were mainly diarrhea(100.0%),fever(100.0%),dizziness(88.5%),nausea(76.9%)and headache(73.1%),the point source exposure was shown in the prevalence curve,the median incubation period was 16.5 hours,the dinner on July 26 was a suspicious meal,and the case-control results showed that the consumption of stewed meatballs with tomato sauce(OR=8.94,95%CI=2.243-35.607)was a risk factor for the disease,the Salmonella enteritidis was detected in five cases’anal swabs,one chef’s anal swabs and the sample food of stewed meatballs with tomato.Conclusion This incident was an food poisoning caused by Salmonella enteritidis.It is suggested to strengthen the supervision and management of the mess hall,and to improve the ability of food processing quality control to prevent occurrence of similar problems.