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目的通过一起河鲀中毒事件的流行病学调查和人群关于河鲀安全性的知识、态度、行为(KAP)调查,探讨河鲀食用安全的风险管理措施。方法通过病例搜索,调查病例家庭成员进食史及发病情况,采用回顾性队列研究分析发病的高危因素,制作调查问卷调查了解当地村民有关河鲀中毒的知识、态度和行为。结果共搜索到14例病例,其中1例死亡。症状主要为头晕(100%)、四肢无力(79%)、四肢肌肉麻痹和行走困难(71%)、口舌肢端麻痹(71%)等。食用河鲀是发病的危险因素,加工过程保留鱼肝共同煮食可增加中毒的危险(RR=1.8,95%CI=1.1~3.1)。KAP调查发现70%(33/47)的村民近3年曾进食过河鲀,其中88%(29/33)来源于市场或流动摊贩;98%(46/47)的村民知道河鲀有毒,94%(44/47)的村民知道国家法律禁止食用河鲀鱼,但仍有94%(44/47)的人认为其味道鲜美值得品尝。结论食用混杂于无毒河鲀中的有毒河鲀是导致本次食物中毒的主要原因。居民对河鲀安全性知晓率高但依从性差。
Objective To investigate the risk management measures of food safety in the river by investigating the epidemiological investigation of the poisoning in river grass and the population knowledge, attitude and behavior (KAP) about the safety of the river grass. Methods A case-based search was conducted to investigate the history of eating and the incidence of family members in the case. Retrospective cohort studies were conducted to analyze the risk factors for the incidence and questionnaire surveys were conducted to understand the knowledge, attitudes and behaviors of local villagers about the poisoning of comatose. Results A total of 14 cases were found, of which 1 died. The main symptoms were dizziness (100%), weakness in the limbs (79%), paralysis and walking difficulties in the limbs (71%), paralysis of the extremities (71%). The consumption of crabgrass is a risk factor for the disease. The process of preserving the fish liver together may increase the risk of poisoning (RR = 1.8, 95% CI = 1.1 ~ 3.1). KAP survey found that 70% (33/47) of the villagers had eaten rice pudding in the past three years, of which 88% (29/33) originated from markets or mobile vendors; 98% (46/47) 94% (44/47) of the villagers knew that national laws prohibit consumption of river mullet, but 94% (44/47) of them still think it tastes delicious. Conclusions It is the main cause of this food poisoning that the poisonous river gall mixed with non-toxic river gall is edible. Residents have a high awareness of river safety but poor compliance.