1起网售蛋糕引起沙门菌食物中毒事件的调查与分析
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摘要
目的通过1起食物中毒事件的发生原因和可疑危险因素来源调查,总结沙门菌食物中毒的现场流行病学调查方法。方法调查2017年5月6日晚参与平湖街道某社区某巷8号家中聚会的人中出现发热(≥37.5℃)伴腹痛或腹泻(≥3次/d且形状改变)者,通过72 h进餐史及回顾性队列研究查找可疑餐次,对可疑食物加工场所进行重点现场卫生学调查,采集相关可疑食物和病例等标本进行实验室检测。结果事发地为深圳龙岗区某居民住宅地,事发当天共有13人参与一场家庭生日聚会,聚餐菜品主要为自家烧制,生日蛋糕是患者通过微信公众号网购的某西饼店的提拉米苏,聚餐后8人发病,所有患者发病前均食用过蛋糕。患者发病时间段2017年5月7日6时30分至5月8日18时0分。病例年龄5～68岁,其中6例为确诊病例,2例疑似病例,症状主要为腹痛(100%)、发热(100%)、腹泻(87.5%)、呕吐(37.5%)。5月6日晚的蛋糕(P=0.007)是本次疑似食物中毒的暴露食物。现场采集剩余食品及病例肛拭子检测为肠炎沙门氏菌阳性。蛋糕制作师傅对操作不熟导致巴氏消毒步骤无效是此次食物中毒的污染环节。结论食用未完全消毒灭菌的蛋糕是本次食物中毒的主要原因。建议及早针对生产销售各环节进行详细现场卫生学调查,结合线索及时对实施卫生执法措施可防止类似事件再次发生。
Objective Through a case study of the casue and suspected risk factor of food poisoning to summarized the field epidemiological investigation method for Salmonella food poisoning. Methods We investigated the people who got fever(≥37.5℃), meanwhile stomachache or diarrhea( ≥3 times per day and stool character change) when participate in the No. 8 of a lane of Pinghu street community evening meeting in May 6, 2017. The suspicious meal was chased according to the 72 hours dietary and retrospective cohort study. On-site hygiene survey on suspicious food processing sites was conducted. Food samples were collected for laboratory testing. Results The outbreak happened in a residence of Longgang district. It was a birthday party with home-made food and a tiramisu ordered online which have 13 man participate in. All of 8 patients who feel sick between May 7 6:30 and May 8 18:00 in 2017 have eaten the cake. The cases between 5 and 68 years old include 6 confirmed cases and 2 clinical cases and the major symptoms were abdominal pains(100%), fever( 100%), diarrhea(87.5 %) and vomiting( 37.5%). The cake bought in May 6 was suspected as food poisoning exposure meal(P=0.007).Salmonella enteritidis was detected in the residual food and anus swab samples from patients. The main reason for contamination was that the chef failed in the pasteurization process in making the cake. Conclusions The food poisoning was caused by cake processing. It is necessary to conduct a comprehensive on-site hygiene investigation immediately and execute the health law enforcement according to some clues that can prevent food poisoning.
Objective Through a case study of the casue and suspected risk factor of food poisoning to summarized the field epidemiological investigation method for Salmonella food poisoning. Methods We investigated the people who got fever(≥37.5℃), meanwhile stomachache or diarrhea( ≥3 times per day and stool character change) when participate in the No. 8 of a lane of Pinghu street community evening meeting in May 6, 2017. The suspicious meal was chased according to the 72 hours dietary and retrospective cohort study. On-site hygiene survey on suspicious food processing sites was conducted. Food samples were collected for laboratory testing. Results The outbreak happened in a residence of Longgang district. It was a birthday party with home-made food and a tiramisu ordered online which have 13 man participate in. All of 8 patients who feel sick between May 7 6:30 and May 8 18:00 in 2017 have eaten the cake. The cases between 5 and 68 years old include 6 confirmed cases and 2 clinical cases and the major symptoms were abdominal pains(100%), fever( 100%), diarrhea(87.5 %) and vomiting( 37.5%). The cake bought in May 6 was suspected as food poisoning exposure meal(P=0.007).Salmonella enteritidis was detected in the residual food and anus swab samples from patients. The main reason for contamination was that the chef failed in the pasteurization process in making the cake. Conclusions The food poisoning was caused by cake processing. It is necessary to conduct a comprehensive on-site hygiene investigation immediately and execute the health law enforcement according to some clues that can prevent food poisoning.
引文
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[7]章英,黄运红,陈应平,等.一起家庭用餐引起沙门氏菌食物中毒的调查[J].现代预防医学,2009,36(20):3859-3862.
[8]陈跃华,吴柏峰,林坤立,等.一起凉拌米粉引起的沙门氏菌食物中毒的调查报告[J].实用预防医学,2007,14(2):443.
[9]茹建国,张莹,杨浩峰,等.一起不明原因食物中毒事件的调查与研究[J].医学动物防制,2017,33(8):869-871.
[10]王志伟,肖新才,谢朝军,等.一起食用蛋糕引起集体食品安全事件案例的分析[J].医学动物防制,2018,34(6):604-605.
[2]Kim YJ,Moon HJ,Lee SK,et al.Development and validation of predictive model for Salmonella growth in unpasteurized liquid eggs[J].Korean J Food Sci Anim Resour,2018,38(3):442-450.
[3]曾彪,王超,薛一凡,等.一起跨地区肠炎沙门氏菌食物中毒事件的流行病学调查与溯源[J].现代预防医学,2016,43(19):3479-3482.
[4]Zielicka-Hardy A,Zarowna D,Szych J,et al.Ensuring safety of home-produced eggs to control salmonellosis in Poland:lessons from an outbreak in September 2011[J].Euro Surveill,2012,17(47).pii:20319.
[5]Gregg MB.现场流行病学[M].第3版.北京:人民卫生出版社,2011.
[6]陈琼,孙军红,梁洪军,等.一起沙门菌食物中毒的调查分析[J].实用预防医学,2013,20(6):716-718.
[7]章英,黄运红,陈应平,等.一起家庭用餐引起沙门氏菌食物中毒的调查[J].现代预防医学,2009,36(20):3859-3862.
[8]陈跃华,吴柏峰,林坤立,等.一起凉拌米粉引起的沙门氏菌食物中毒的调查报告[J].实用预防医学,2007,14(2):443.
[9]茹建国,张莹,杨浩峰,等.一起不明原因食物中毒事件的调查与研究[J].医学动物防制,2017,33(8):869-871.
[10]王志伟,肖新才,谢朝军,等.一起食用蛋糕引起集体食品安全事件案例的分析[J].医学动物防制,2018,34(6):604-605.