Laboratory evidence of foodborne disease events and related problems in Gansu based on epidemiological survey reports
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摘要:
目的 分析甘肃省食源性疾病事件中实验室检验对其结论的支持力度,以及影响实验室检出的部分因素,为提升甘肃省食源性疾病事件调查结论的质量提供依据。 方法 收集2018—2020年甘肃省发病≥5例的食源性疾病事件的流行病学调查报告,对实验室检验或影响检出的有关信息进行整理,按照相关指南及标准的要求对结论进行评价。 结果 共收集102起事件的流行病学调查报告,47起明确致病因子种类,但仅有15起(31.91%)事件中致病因子获得充分的实验室证据支持,其中化学性事件占83.33%,细菌性和植物性及毒蘑菇中毒事件分别占24.00%和25.00%;另外55起诊断为不明原因事件,分析认为疾病预防控制中心接报及时性对事件处置中样品的可获得性有影响,且该类事件仅有23.08%的检测项目选择恰当。 结论 应重点加强细菌性、植物性及野蘑菇中毒事件处置中实验室检验工作,从加强事件调查中的采样工作和提高检测项目选择准确性两方面着手可降低不明原因事件比例。 Abstract:Objective To evaluate the laboratory evidence support in the identification of foodborne disease events and related factors in Gansu province, and provide evidence for improving the quality of investigation results of food-borne disease events. Methods Epidemiological survey reports of food borne disease events involving more than 5 patients in Gansu from 2018 to 2020 were collected, and information about laboratory tests or related factors were analyzed, and the conclusions of the reports were evaluated according to the requirements of relevant guidelines and standards. Results A total of 102 survey reports of foodborne disease events were collected, of which 47 had clear etiological conclusions, but only 15 (31.91%) had sufficient laboratory evidences. Chemical events accounted for 83.33%, and the proportions of bacterial and botanical or mushroom poisoning events were only 24.0% and 25.0%, respectively. The other 55 foodborne disease events were unexplained. The analysis suggested that the timely reporting to centers for disease control and prevention had an impact on the collection of samples in the event response, and only 23.08% of test items were appropriate. Conclusion It is necessary to strengthen the laboratory testing for bacterial and botanical or wild mushroom poisoning cases. The proportion of unexplained events can be reduced by improving the sample collection and detection item selection. -
Key words:
- Food-borne disease events /
- Laboratory evidence /
- Epidemiological survey
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表 1 25起细菌性事件实验室检测情况
Table 1. Laboratory testing of 25 bacterial events
实验室检测
结果检出微生物 事件数(起) 证据
充分证据
欠充分无证据 总计 致病菌阳性 沙门菌 3 7 0 10 志贺菌 2 0 0 2 金黄色葡萄球菌 0 2 0 2 蜡样芽孢杆菌 1 0 0 1 大肠埃希菌 0 1 0 1 变形杆菌和大肠埃希菌 0 1 0 1 致病菌阴性 0 0 1 1 未采样 0 0 7 7 合计 6 11 8 25 表 2 55起食源性不明原因事件中未采样原因分析
Table 2. Reasons for sampling failure for 55 unexplained foodborne disease events
事件分类 未采样原因 起数 占比(%) 未采集生物样(n=43) 未提及采样事宜 25 58.14 报告晚或样本已清理 11 25.58 医院未采到 5 11.63 已使用抗生素 2 4.65 未采集食物样(n=38) 未提及采样事宜 26 68.42 无剩余食物 9 23.68 因故未采 3 7.89 -
[1] Pezzino G. A guide to the implementation of the national electronic disease surveillance system (NEDSS) in state public health agencies[EB/OL]. (2001-04-02)[2022−04−15]. https://stacks.cdc.gov/view/cdc/11420. [2] Tauxe RV. Molecular subtyping and the transformation of public health[J]. Foodborne Pathog Dis, 2006, 3(1): 4–8. DOI: 10.1089/fpd.2006.3.4. [3] 李克莉, 冯子健, 金连梅, 等. 中国突发公共卫生事件实验室检测现状的研究[J]. 现代预防医学,2008,35(4):601–603,611. DOI:10.3969/j.issn.1003−8507.2008.04.001.Li KL, Feng ZJ, Jin LM, et al. Study on the current situation of laboratory examination for public health emergency events in China[J]. Mod Prev Med, 2008, 35(4): 601–603,611. DOI: 10.3969/j.issn.1003−8507.2008.04.001. [4] 中华人民共和国卫生部办公厅. 《食品安全事故流行病学调查技术指南(2012年版)》[EB/OL]. (2012-06-11)[2022−04−15]. http://www.nhc.gov.cn/zwgkzt/pwsjd1/201206/55050.shtml.General Office of Ministry of Health of the People′s Republic of China. Technical guidelines for epidemiological investigation of food safety incidents (2012 edition) [EB/OL]. (2012-06-11)[2022−04−15]. http://www.nhc.gov.cn/zwgkzt/pwsjd1/201206/55050.shtml. [5] 金培刚, 丁钢强, 顾振华. 食源性疾病防制与应急处置[M]. 上海: 复旦大学出版社, 2006.Jin PG, Ding GQ, Gu ZH. Prevention and control of foodborne diseases and emergency response[M]. Shanghai: Fudan University Press, 2006. [6] 冶晓燕, 景雪梅, 彭沛穰, 等. 甘肃陇南尖山自然保护区常见毒蘑菇及其中毒类型[J]. 中国食用菌,2020,39(2):11–14. DOI:10.13629/j.cnki.53−1054.2020.02.003.Ye XY, Jing XM, Peng PR, et al. Common poisonous fungi and its poisoning type in Jianshan nature reserve of Longnan in Gansu province[J]. Edible Fungi China, 2020, 39(2): 11–14. DOI: 10.13629/j.cnki.53−1054.2020.02.003. [7] 姚进喜, 蓝弘, 何健, 等. 甘肃省2004-2012年毒蘑菇中毒事件分析[J]. 中国食物与营养,2014,20(2):17–19. DOI:10.3969/j.issn.1006−9577.2014.02.004.Yao JX, Lan H, He J, et al. Analysis on poisonous mushroom poisoning in Gansu province from 2004 to 2012[J]. Food Nutr China, 2014, 20(2): 17–19. DOI: 10.3969/j.issn.1006−9577.2014.02.004. [8] 中国医师协会急诊医师分会, 中国急诊专科医联体, 中国医师协会急救复苏和灾难医学专业委员会, 等. 中国蘑菇中毒诊治临床专家共识[J]. 中华急诊医学杂志,2019,28(8):935–943. DOI:10.3760/cma.j.issn.1671−0282.2019.08.004.Emergency Physicians Branch of the Chinese Medical Doctor Association, China Federation of Emergency Medical Specialists, and the Professional Committee of Emergency Recovery and Disaster Medicine of the Chinese Medical Doctor Association, et al. Consensus of Clinical Experts on Diagnosis and Treatment of Mushroom Poisoning in China[J]. Chin J Emerg Med, 2019, 28(8): 935–943. DOI: 10.3760/cma.j.issn.1671−0282.2019.08.004. [9] 吴晓旻, 任婧寰, 王霄晔, 等. 2018年第二季度全国食物中毒事件流行特征分析[J]. 疾病监测,2019,34(7):640–644. DOI:10.3784/j.issn.1003−9961.2019.07.014.Wu XM, Ren JH, Wang XY, et al. Epidemiological characteristics of food poisoning event in China, 2018[J]. Dis Surveill, 2019, 34(7): 640–644. DOI: 10.3784/j.issn.1003−9961.2019.07.014. [10] 任婧寰, 王霄晔, 吴晓旻, 等. 2018年第三季度全国食物中毒事件流行特征分析[J]. 疾病监测,2019,34(8):741–745. DOI:10.3784/j.issn.1003−9961.2019.08.014.Ren JH, Wang XY, Wu XM, et al. Epidemiological characteristics of food poisoning in China, July-September, 2018[J]. Dis Surveill, 2019, 34(8): 741–745. DOI: 10.3784/j.issn.1003−9961.2019.08.014. [11] 倪文思, 王秀琴, 袁秀娟, 等. 2010-2016年宁夏食源性疾病暴发事件流行特征分析[J]. 现代预防医学,2018,45(11):1967–1970,1991.Ni WS, Wang XQ, Yuan XJ, et al. Epidemiological characteristic of foodborne disease in Ningxia, 2010−2016[J]. Mod Prev Med, 2018, 45(11): 1967–1970,1991. [12] 孙亮, 陈莉莉, 廖宁波, 等. 2006年-2017年浙江省食源性疾病暴发监测资料分析[J]. 中国卫生检验杂志,2019,29(15):1874–1877.Sun L, Chen LL, Liao NB, et al. Analysis of foodborne disease outbreak surveillance data in Zhejiang province, 2006−2017[J]. Chin J Health Lab Technol, 2019, 29(15): 1874–1877. [13] 牛蓓, 陈磊, 罗晓燕, 等. 2016-2018年河北省食物中毒事件流行特征分析[J]. 现代预防医学,2020,47(8):1381–1384.Niu B, Chen L, Luo XY, et al. Epidemiological characteristics of food poisoning in Hebei province from 2016 to 2018[J]. Mod Prev Med, 2020, 47(8): 1381–1384. [14] 美国食源性疾病暴发应对促进委员会. 食源性疾病暴发应对指南[M]. 杨杏芬, 吴蜀豫, 译. 北京: 人民卫生出版社, 2011: 23.Foodborne Disease Outbreak Response Promotion Committee of USA. Guidelines for foodborne disease outbreak response[M]. Yang XF, Wu SY, trans. Beijing: People's Medical Publishing House, 2011: 23. -

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