一起食用苦蒲瓜引起的幼儿园幼儿中毒事件的调查与处理

来源 :中国食品卫生杂志 | 被引量 : 0次 | 上传用户:wangxd
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目的查明深圳市某幼儿园一起食物中毒事件的规模、致病来源,采取控制措施,为防止类似中毒事件的发生提出建议。方法按照病例定义开展病例搜索,采用描述性流行病学方法分析事件特征并找出病因线索,应用病例对照研究分析危险因素,通过采集留样食品、患者呕吐物和肛拭子、环境涂抹拭子进行微生物检测,市场调查商贩和市民对苦蒲瓜的认知。结果本次调查共搜索到病例21名,主要临床症状为呕吐80.95%(17/21)、腹泻71.42%(15/21)、腹痛61.90%(13/21)、头晕28.57%(6/21)、头痛14.29%(3/21)。潜伏期最短0.5 h,最长7.5 h,中位数为2.5 h。同时调查共同进餐未发病的42名人员作为对照组,病例对照研究表明本次事件的可疑食物为蒲瓜,病例组与对照组暴露比值比(OR)=266.00,95%可信区间(95%CI)=14.150~5 000.000。采集的22份样品均未检出金黄色葡萄球菌、蜡样芽胞杆菌、沙门菌、志贺菌、副溶血性弧菌和变形杆菌。尝试留样蒲瓜带有明显苦味。19.05%(4/21)的商贩和5.77%(3/52)的市民知道苦蒲瓜会引起食物中毒。结论本次食物中毒事件是由苦蒲瓜引起,建议幼儿园可使用其他蔬菜代替蒲瓜制作菜肴,各类饭店和家庭可先品尝再购买,卫生部门加强对商贩和市民的健康教育,防止中毒事件的发生。 Objective To find out the scale of food poisoning incidents in a kindergarten in Shenzhen and the origin of the disease and to take control measures to make suggestions for preventing similar poisoning incidents. Methods According to the case definition, the case search was conducted. Descriptive epidemiological methods were used to analyze the characteristics of the events and identify the etiological cues. Case-control studies were conducted to analyze the risk factors. Samples were taken from the samples, vomitus and anal swabs, Microbiological testing, market surveys traders and citizens on the understanding of bitter melon. Results A total of 21 cases were found in the survey. The main clinical symptoms were vomiting 80.95% (17/21), diarrhea 71.42% (15/21), abdominal pain 61.90% (13/21) and dizziness 28.57% (6/21) , Headache 14.29% (3/21). The shortest incubation period of 0.5 h, up to 7.5 h, the median was 2.5 h. At the same time, 42 persons who did not eat common meal were investigated as control group. The case-control study showed that the suspicious food in this case was Pachyrhizoma, the odds ratio (OR) = 266.00, 95% confidence interval (95% CI) = 14.150 ~ 5 000.000. Staphylococcus aureus, Bacillus cereus, Salmonella, Shigella, Vibrio parahaemolyticus and Proteus were not detected in all the 22 samples collected. Try to stay kind of melon with obvious bitterness. 19.05% (4/21) traders and 5.77% (3/52) citizens knew that S. meliloti caused food poisoning. Conclusion The food poisoning incident is caused by the bitter melon. It is suggested that kindergartens can use other vegetables instead of the melon to make dishes, and all kinds of restaurants and families can taste and then buy. The health department strengthens the health education to the traders and the citizens to prevent the poisoning. happened.
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