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目的查明深圳市某公司一起食物中毒事件的疫情规模、致病因子,采取控制措施,为防止类似中毒事件发生提出建议。方法按照病例定义开展病例搜索,采用描述性流行病学方法分析事件特征并找出病因线索,应用病例对照研究分析危险因素。采用泡沫试验方法检测皂甙毒素,比较3种豆角未加工和煮沸后每5 min的毒素含量变化。结果本次调查共搜索到病例63名,主要临床症状为:恶心88.89%(56/63)、呕吐87.30%(55/63),呕吐最多的病例达15次,平均呕吐次数4.23次、头晕52.38%(33/63);腹痛33.33%(21/63),主要表现为上腹部隐痛特点;腹泻12.70%(8/63);头痛11.11%(7/63),潜伏期最短1.5 h,最长4.5 h,平均2.5 h。同时调查共同进餐未发病的162名对照组人员,病例对照研究表明本次事件的可疑食物为东北油豆角(OR=∞,P<0.001)。剩余东北油豆角和2份病人呕吐物中检出皂甙毒素阳性。3种豆角中,菜豆和豇豆煮沸10 min后,东北油豆角煮沸15 min后,皂甙毒素显示阴性。结论本次食物中毒事件是由未煮熟的东北油豆角中的皂甙毒素引起,提示集体单位制作豆角类菜品时,必须彻底加工至皂甙完全灭活后方可供餐。
Objective To find out the epidemic situation and the risk factors of a food poisoning incident in a company in Shenzhen City and to take control measures to make recommendations to prevent similar poisoning incidents. Methods According to the case definition, the case search was carried out. The descriptive epidemiological method was used to analyze the event characteristics and find out the cause clues. Case-control studies were conducted to analyze the risk factors. The foam test method was used to detect the saponin toxin. The changes of toxin content after 5 minutes of unprocessed and boiled soybean were compared. Results A total of 63 cases were found in the survey. The main clinical symptoms were as follows: nausea 88.89% (56/63), vomiting 87.30% (55/63), vomiting up to 15 times, average vomiting 4.23 times, dizziness 52.38 (33/63). The abdominal pain was 33.33% (21/63), which was mainly characterized by pain in the upper abdomen. Diarrhea was 12.70% (8/63), headache was 11.11% (7/63), the shortest incubation period was 1.5 hours and the longest was 4.5 h, an average of 2.5 h. At the same time, 162 control subjects who did not eat together were investigated. A case-control study showed that the suspicious food in this incident was northeast oil bean (OR = ∞, P <0.001). Soy saponin positive was detected in the remaining northeast oil beans and 2 patients with vomit. Three kinds of beans, beans and cowpea boiled 10 min, northeast oil bean boiling 15 min, saponin toxin showed negative. Conclusion The food poisoning event was caused by saponin toxin in uncooked oilseed oolong bean, suggesting that the collective unit should process the saponin completely inactivated before making it.