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目的对六安市叶集区某学校一起食物中毒暴发事件进行调查,查找危险因素和传播途径,并提出针对性预防控制措施。方法按照病例定义开展病例搜索,对病例进行描述性分析,采用病例-对照研究方法,对调查对象的餐次、食物品类和进食份量等情况进行调查,分析危险餐次和中毒食物。对学校食堂晚餐留样食物、部分病例吐泄物、厨工肛拭子、食堂器具表面拭子等样品进行5种常规致病菌的实验室培养检测,同时对肉烧菜豆中皂苷和植物凝集素检测。结果 2014年1月20日在学校食堂进食晚餐共有776人,共搜索到79例疑似病例,罹患率为10.2%(79/776)。病例-对照研究结果显示,20日在学校食堂进食早餐和(或)中餐的学生均未发病,79例病例均进食过学校20日食堂晚餐,提示20日学校食堂晚餐为可疑餐次;食用肉烧菜豆和肉烧豆腐的师生发病风险分别是未食用者的32.08和2.22倍(OR=32.08、2.22),其他食物的差异无统计学意义。叉生分析结果显示,单独食用肉烧菜豆为发病危险因素(OR=22.67,95%CI:3.86~223.99)。食用肉烧菜豆的剂量反应关系分析显示,随着进食肉烧菜豆的数量增加,病例发病的可能性亦增大,且趋势卡方检验有统计学意义(P<0.01)。实验室检测结果显示,在20日晚餐样本和环境样本中未检出5种常规致病菌。结论该起食物中毒系因菜豆烹调不当所导致。建议学校建立健全食品卫生管理制度,严格落实管理措施及操作规范。
Objective To investigate the outbreak of food poisoning in a school in Yeji district of Lu’an City, find out the risk factors and routes of transmission, and put forward targeted prevention and control measures. Methods According to the case definition, the case search was carried out, and the case was analyzed descriptively. The case-control study was conducted to investigate the meal times, food categories and eating amount of the surveyed subjects, and to analyze the dangerous meals and the poisoned foods. Five kinds of routine pathogenic bacteria were detected in the laboratory canteen dinner samples, some cases of feces dumplings, kitchen workers anal swabs, canteen surface swabs and other samples, at the same time on the meat dish saponin and plant agglutination Su test. Results A total of 776 dinner dinners were taken in the school cafeteria on January 20, 2014, and a total of 79 suspected cases were searched. The attack rate was 10.2% (79/776). Case-control study showed that 20 students in the school cafeteria eating breakfast and / or lunch were not onset, 79 cases were eating 20-day school canteen dinner, suggesting that the school canteen dinners suspicious meals on the 20th; edible meat The risk of teacher-student burn bean and meat burning tofu were 32.08 and 2.22 times of those of non-food users (OR = 32.08, 2.22) respectively. There was no significant difference in other foods. The results of the fork test showed that the consumption of meat kidney beans alone was the risk factor (OR = 22.67, 95% CI: 3.86 ~ 223.99). The results of dose-response analysis of edible roasted Beans showed that with the increase of the number of roasted Beans, the incidence of cases was also increased, and the trend chi-square test was statistically significant (P <0.01). Laboratory tests showed that five routine pathogenic bacteria were not detected in dinner samples and environmental samples on the 20th. Conclusion The food poisoning caused by improper cooking beans. It is recommended that schools establish and improve the food hygiene management system and strictly implement the management measures and operating practices.