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目的调查分析1起学校食源性肠炎沙门菌暴发事件的危险因素,提出控制及预防措施。方法采用描述性流行病学方法对该起事件的流行特征进行分析;采用病例对照研究方法进行可疑食物的调查;采集部分病例、厨工肛拭子和环境拭子样本进行病原菌的分离、血清学分型鉴定和脉冲场凝胶电泳分析。结果该起食源性疾病暴发首发病例发病时间为2009年6月9日,末例病例发病时间为6月12日,事件历时4 d,流行曲线提示该次事件符合点源暴发模式。共报告病例61例,均为寄宿生,走读生和教职工均无发病,其中男寄宿生发病12例,罹患率为3.9%(12/309),女寄宿生发病49例,罹患率为10.7%(49/460),女生的罹患率明显高于男生(P<0.01)。病例对照研究结果提示,6月9日早餐的鸡蛋三文治为引起发病的危险食品(OR=21.70,95%CI为8.50～55.50)。采集患者肛拭子25份、食堂厨工肛拭子14份、食堂冰箱和环境拭子11份,分别有19、5、1份样本检出同一血清型的肠炎沙门菌;脉冲场凝胶电泳法分析结果表明该25株肠炎沙门菌分离株具有完全相同的PFGE图谱。结论该事件为1起肠炎沙门菌污染食物引起的食源性疾病暴发事件,可疑中毒食物为6月9日早餐的鸡蛋三文治,卫生监管部门应重视对各类以鸡蛋为原料的食品的卫生监督。
Objective To investigate and analyze the risk factors of a school-borne food-borne enteritis enteritis (Salmonella typhimurium) outbreak and put forward the control and preventive measures. Methods The descriptive epidemiological method was used to analyze the epidemiological characteristics of the incident. The case-control study was conducted to investigate the suspicious foods. Some cases were collected, and samples of anal swabs and environmental swabs were collected for pathogen isolation. Serum scores Type identification and pulsed-field gel electrophoresis analysis. Results The onset of the first episode of foodborne illness was on June 9, 2009, the last case was on June 12, and the event lasted for 4 days. The epidemic curve suggested that the episode met the point source outbreak pattern. A total of 61 cases were reported, including boarders, students and faculty. There were 12 male boarders with attack rate of 3.9% (12/309) and 49 female boarders with attack rate of 10.7% (49 / 460), the incidence of girls was significantly higher than boys (P <0.01). Case-control study results suggest that the breakfast egg on June 9 was the risk food for the onset of disease (OR = 21.70, 95% CI 8.50 to 55.50). Twenty-five patients received anal swabs, 14 rectal swabs, 11 canteen refrigerators and environmental swabs, 19.5 and 1 samples of Salmonella enteritidis of the same serotype were detected respectively. Pulsed-field gel electrophoresis Analysis of the results showed that the 25 strains of Salmonella enteritidis have identical PFGE patterns. Conclusion The incident was an outbreak of foodborne illness caused by Salmonella enteritidis-contaminated food. Suspicious food poisoning was an egg sandwich for breakfast on June 9, and the health regulatory authority should pay attention to the hygiene supervision of all kinds of food with raw materials of eggs .