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目的调查一起疑似食物中毒事件的发生原因,为预防类似事件发生及处理提供参考依据。方法采用回顾性队列研究方法,制定病例定义,开展病例搜索,同时收集病例临床检查、检测、救治等临床信息,分析比较食用野蜂蜜人群发病风险与食用时间、食用量的关系。采集剩余野蜂蜜,进行可疑毒物成分检测。结果共发现12例病例,均为S村村民,其中危重率为58%(7/12),病死率为25%(3/12)。临床表现主要为腹痛(67%,8/12)、腹泻(58%,7/12)、呕吐(58%,7/12)、头晕(58%,7/12)、恶心(50%,6/12)和头痛(42%,5/12);58%(7/12)的病例存在肝、肾和心肌功能损害。流行曲线显示点源暴露模式。12名病例均食用了同一个蜂巢的野蜂蜜,食用蜂蜜者发病率为100%(12/12),未食用者未发病。食用者潜伏期中位数为21 h(潜伏期范围:5~29 h),食用量在1~6个手指之间,食用量与潜伏期呈负相关(Spearman秩相关系数rs=-0.69),差异有统计学意义(P<0.05)。实验室检测显示野蜂蜜中含有雷公藤及博落回2种有毒植物花粉。结论本起事件是一起食用含有雷公藤及博落回2种有毒花粉野蜂蜜引起的食物中毒事件。建议在有毒植物生长区范围内应考虑划定蜜蜂禁养区及禁养季节,广泛宣传并指导蜂农有效避开有毒花粉,以减少蜂蜜中毒的发生;此外,建议开展健康教育,提高消费者对野蜂蜜的整体认知。
Objective To investigate the causes of suspected food poisoning incidents and provide references for the prevention and treatment of similar incidents. Methods A retrospective cohort study was conducted to define the cases and carry out case searching. At the same time, clinical information such as clinical examination, detection and treatment were collected. The relationship between the risk of edible wild honey and edible time and consumption was analyzed. Collect the remaining wild honey, the detection of suspected toxic components. Results A total of 12 cases were found, all of which were villagers in village S, of which the critical rate was 58% (7/12) and the case fatality rate was 25% (3/12). The main clinical manifestations were abdominal pain (67%, 8/12), diarrhea (58%, 7/12), vomiting (58%, 7/12), dizziness (58%, 7/12) / 12) and headache (42%, 5/12). Liver, kidney and myocardial dysfunction occurred in 58% (7/12) of cases. Pop charts show point source exposure patterns. All 12 cases consumed wild honey with the same beehive. The incidence of honey consumption was 100% (12/12), and no euthanasia was found. The median incubation period was 21 h (latency range: 5-29 h). The consumption was between 1-6 fingers. The consumption was negatively correlated with latency (Spearman rank correlation coefficient rs = -0.69). The difference was Statistical significance (P <0.05). Laboratory tests show that wild honey contains Tripterygium and Botanica back two kinds of poisonous plant pollen. Conclusion The incident was caused by food poisoning caused by two kinds of poisonous pollen wild honey containing Tripterygium Wilfordii and Botanicus. It is suggested that beekeepers and forbidden areas should be delineated within the scope of the poisonous plant growth area to widely publicize and guide beekeepers to effectively avoid poisonous pollen so as to reduce the occurrence of honey poisoning. In addition, it is suggested that health education should be conducted to enhance consumers’ Wild honey as a whole cognition.