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目的为查明浙江省富阳市中学(大青校区)一起腹泻暴发事件的疫情规模、致病因子及其污染来源,控制疫情蔓延。方法制定统一的病例搜索一览表,采用查阅学校医务室门诊日志、富阳市人民医院和市中医医院门诊日志及住院记录等方式搜索该校在10月17-20日期间出现恶心、呕吐、发热(≥37.5℃)、腹痛、腹胀等临床症状的疑似病例,同时通过中国疾病预防控制中心的传染病自动预警信息系统等网络搜索该校在10月17-20日期间出现类似症状的病例。根据1∶4的比例分别选取疾病暴发期间食用过学校副食店销售的食物的病例和无任何临床症状的学生作为病例组和对照组,同时收集学生食物史、饮用水情况等信息进行病例对照研究。结果学校副食店销售的鸡蛋三明治面包为本次食品安全事件的致病因素,男女生罹患率差异有统计学意义(χ2=5.24,P=0.02);职业分布罹患率差异有统计学意义(χ2=6.54,P=0.01)。10份病例肛拭样本中检出O1,9,12:Hg,p,抗原模式为都柏林血清型沙门菌。经脉冲场凝胶电泳同源性检测,10株菌株条带完全一致。结论该起疫情为鸡蛋三明治面包中鸡蛋被都柏林沙门菌污染所致。
Objective To identify the outbreak of diarrhea outbreak in Fuyang City High School (Daqing Campus) in Zhejiang Province, the pathogenic factors and sources of pollution and control the spread of the epidemic. Methods A unified case search list was developed. The school searched nosocomial vomit fever (≥≥20) between October 17 and October 20 by referring to the outpatient clinic diary of the school clinic, outpatient diary log of Fuyang Municipal People’s Hospital, 37.5 ℃), abdominal pain, abdominal distension and other clinical symptoms of suspected cases, at the same time through the China Center for Disease Control and Prevention automatic infectious disease warning system and other networks to search for the school during October 17-20 similar symptoms. According to the ratio of 1: 4, the cases of food sold by school non-staple food stores and the students without any clinical symptoms during the disease outbreak were selected as the case group and the control group respectively. Meanwhile, case-control study was conducted by collecting the food history and drinking water condition of the students . Results The egg sandwich sandwich bread sold by the school non-staple foodstuffs was the causative factor of this food safety incident. There was a significant difference in the attack rates between male and female students (χ2 = 5.24, P = 0.02). There was significant difference in occupational distribution = 6.54, P = 0.01). O1, 9, 12: Hg, p were detected in 10 cases of anal swab samples, and the antigenic mode was Dublin serotype Salmonella. By pulse field gel electrophoresis homology detection, 10 strains of the same band. Conclusion The outbreak was caused by the contamination of Salmonella in Dublin with eggs in sandwich bread.