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目的通过一起O139霍乱疫情调查,分析发病原因,为霍乱防控提供科学依据。方法建立病例定义,开展病例搜索、卫生学调查和实验室检测。提出假设,开展回顾性队列研究,确定危险因素。结果 2名霍乱病例全部为午餐就餐者,罹患率3.4%。流行病学调查支持点源暴露的流行模式,食用哈密瓜是危险因素(RR=+∞,P<0.05)。该餐同批次“温水甲鱼”中检测出与病人同源O139霍乱弧菌。聚餐饭店食品加工器具生熟不分,存在交叉污染。碱性且不消毒的自备井水、湿热的环境和富含营养的食品为霍乱弧菌增殖适宜的条件。结论本次霍乱疫情是聚餐所致,带菌甲鱼通过食品加工器具污染了生食的水果是导致疾病的原因,提示需要认真做好农村聚餐及餐饮从业人员的监督管理,加强甲鱼等水产品市场管理和监测;不同品种的甲鱼带菌情况可能不同,采样检测时应注意区分品种;当地乡镇、农村自备井水在夏秋肠道病多发季节应开展消毒处理,减少疫情发生。
Objective To investigate the cause of cholera epidemic by investigating the epidemic situation of O139 and provide a scientific basis for prevention and control of cholera. Methods to establish case definitions, to carry out case searches, hygiene surveys and laboratory tests. Propose hypotheses, conduct a retrospective cohort study, and identify risk factors. Results All 2 cases of cholera were lunch diners with an attack rate of 3.4%. Epidemiological studies supported the epidemiological pattern of point-source exposure and consumption of cantaloupe was a risk factor (RR = + ∞, P <0.05). The same batch of the meal “warm turtle ” was detected in patients with homologous O139 Vibrio cholerae. Restaurant food processing equipment, raw and cooked, there is cross-contamination. Alkaline and non-sterile homemade well water, hot and humid environment and nutritious food for Vibrio cholerae proliferation appropriate conditions. Conclusion The cholera outbreak was caused by meal. The contaminated turtle contaminated raw fruits through food processing equipment is the cause of the disease. It suggests that we should conscientiously supervise the management of rural dinners and catering workers, strengthen the management of turtle and other aquatic products markets, Monitoring; different species of turtle carriage may be different, sample testing should pay attention to differentiate varieties; local township, rural-owned well water should be disinfected in summer and fall of intestinal infectious disease season to reduce the outbreak.