一起食用苦蒲瓜引起的幼儿园幼儿中毒事件的调查与处理  

Investigation and disposal of a food poisoning incident caused by bitter Lagenaria siceria at a kindergarten

作　　者：周志峰[1] 李晓霞[2] 周洁[1] 游杰[3] 杨贵清[3] 夏伟[3] 

机构地区：[1]深圳市福田区疾病预防控制中心,广东深圳518040 [2]深圳市龙岗区疾病预防控制中心,广东深圳518100 [3]深圳市罗湖区疾病预防控制中心,广东深圳518020

出　　处：《中国食品卫生杂志》2015年第5期590-593,共4页Chinese Journal of Food Hygiene

摘　　要：目的查明深圳市某幼儿园一起食物中毒事件的规模、致病来源,采取控制措施,为防止类似中毒事件的发生提出建议。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,通过采集留样食品、患者呕吐物和肛拭子、环境涂抹拭子进行微生物检测,市场调查商贩和市民对苦蒲瓜的认知。结果本次调查共搜索到病例21名,主要临床症状为呕吐80.95%（17/21）、腹泻71.42%（15/21）、腹痛61.90%（13/21）、头晕28.57%（6/21）、头痛14.29%（3/21）。潜伏期最短0.5 h,最长7.5 h,中位数为2.5 h。同时调查共同进餐未发病的42名人员作为对照组,病例对照研究表明本次事件的可疑食物为蒲瓜,病例组与对照组暴露比值比（OR）=266.00,95%可信区间（95%CI）=14.150-5 000.000。采集的22份样品均未检出金黄色葡萄球菌、蜡样芽胞杆菌、沙门菌、志贺菌、副溶血性弧菌和变形杆菌。尝试留样蒲瓜带有明显苦味。19.05%（4/21）的商贩和5.77%（3/52）的市民知道苦蒲瓜会引起食物中毒。结论本次食物中毒事件是由苦蒲瓜引起,建议幼儿园可使用其他蔬菜代替蒲瓜制作菜肴,各类饭店和家庭可先品尝再购买,卫生部门加强对商贩和市民的健康教育,防止中毒事件的发生。Objective To find out the scale of the epidemic and the pathogenic source of a food poisoning incident at a kindergarten in Shenzhen,and provide recommendations for the prevention. Methods The cases were screened according to the case definition. The descriptive epidemiology was used to address epidemiologic characteristics and provide clue for etiology of the disease,while case-control study was used to analyze the risk factors. The food samples,vomitus,anal swabs and environment samples were collected for microbiological testing. The cognition of vendors and consumers to bitter Lagenaria siceria was investigated at the market. Results A total of 21 cases with clinical symptoms： vomiting（ 80. 95%,17 /21）,diarrhea（ 71. 42%,15 /21）,abdominal pain（ 61. 90%,13 /21）,dizziness（ 28. 57%,6 /21） and headache（ 14. 29%,3 /21） were found. The shortest,longest and median incubation period was 0. 5,7. 5,2. 5 hours,respectively. The diet history of 42 control cases was investigated. Case-control study showed that the Lagenaria siceria was the suspicious food（ OR = 266. 00,CI = 14. 15-5 000. 00）. Staphylococcus aureus,Bacillus cereus,Salmonella,Shigella,Vibrio parahaemolyticus and Proteus were not detected from 22 samples. In addition,the remaining lagenaria siceria tasted very bitter. Only 19. 05%（ 4 /21） of the vendors and 5. 77%（ 3 /52） of the residents knew that the bitter Lagenaria siceria could cause food poisoning. Conclusion The food poisoning incident was caused by bitter Lagenaria siceria. It was suggested childcare facilities should use other vegetables instead of Lagenaria siceria dishes and consumers should taste the Lagenaria siceria before buying it. At the same time the health sector should strengthen the health education of merchants and citizens to prevent the poisoning.

关 键 词：苦蒲瓜 幼儿园 食物中毒 食品安全 葫芦 

分 类 号：R725.9[医药卫生—儿科]