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目的通过调查1起由聚餐引起的霍乱疫情,查找传染源和传播方式,为今后类似疫情提供防控依据。方法制定统一病例定义,开展病例主动搜索,对就餐人员就餐情况开展回顾性队列研究,采集环境及病例标本进行实验室检测。结果 2013-07-02,四川省乐山市犍为县报一起聚餐引起霍乱暴发疫情,经调查92名就餐者中发生15例病例和3例健康带菌者,15例病例中疑似病例9例,实验室诊断病例5例,死亡1例临床诊断病例,罹患率16.0%(15/92)。病例主要表现为无痛性腹泻,均为水样便,呕吐,腓肠肌疼痛及恶心,无发热。采集标本共104份,检出8株O139霍乱弧菌,其中5例病例大便样阳性。8株O139霍乱弧菌,经四川省疾病控制中心鉴定PFGE型别一致。7月2日,对6月27日就餐的92例就餐者开展回顾性队列研究。结果显示6月27日中午的凉拌生姜为危险因素。结论该起疫情可能为宴席中使用的凉拌生姜受霍乱弧菌污染所致,污染来源可能是宴席中的甲鱼,通过盛放工具簸箕交叉污染凉拌生姜所致。
Objective To investigate the sources of cholera and the mode of transmission by investigating one cholera epidemic caused by the dinner and provide the basis for prevention and control of the similar epidemic in the future. Methods A unified case definition was developed, case searches were actively conducted, and a retrospective cohort study was conducted on the eating habits of dining staff. Environmental and case specimens were collected for laboratory testing. Results 2013-07-02, Leshan County, Sichuan Province, Chuiwei County reported a dinner together to cause an outbreak of cholera. After investigation, there were 15 cases and 3 healthy carriers in 92 diners, 9 cases of suspected cases in 15 cases, 5 cases were diagnosed and 1 case died of clinical diagnosis. The attack rate was 16.0% (15/92). Case showed mainly painless diarrhea, are watery stool, vomiting, gastrocnemius pain and nausea, no fever. A total of 104 specimens were collected and 8 strains of Vibrio cholerae O139 were detected, of which 5 cases were stool-like. 8 strains of Vibrio cholerae O139, identified by the Sichuan Provincial Center for Disease Control PFGE type consistent. On July 2, a retrospective cohort study was conducted on 92 diners who dine on June 27. The results showed that ginger salad at noon on June 27 was a risk factor. Conclusion The outbreak may be caused by the contamination of cholera with cholera ginger used in banquets. The source of pollution may be the turtle in the banquet, which is caused by the cross-contamination of the cold ginger by holding tools and dustpan.