CAJ | 학술논문

目的：2012年5月3日，湖南省安仁县发生一起聚餐引起霍乱疫情，共发病10人，检出带菌者5人。为查清本次霍乱暴发的原因，寻找食物污染的危险环节，为采取科学防控措施提供依据。方法采用回顾性队列研究确定可疑餐次，采用病例对照研究方法查找可疑食物。数据分析采用Epi Info 3.5软件，计算RR、OR值。结果本次疫情的罹患率为2.8%（10/362），病原检出率为2.8%（7/248）。回顾性队列研究显示，4月29日晚餐为可疑餐次；病例对照研究显示，4月29日晚餐中“头碗”菜是霍乱发病的可疑危险食物。通过现场调查和厨师访谈发现，“头碗”菜中的“虎皮蛋”曾使用盛装过生甲鱼的筛子盛放过一段时间。结论根据流行病学调查结果和厨师访谈发现，使用盛装过生甲鱼的容器装“虎皮蛋”可能是导致疫情发生的原因。生熟不分可能导致多种疾病的传播，由“游厨”操办的农村聚餐应该得到有效监管。
목적：2012년5월3일，호남성안인현발생일기취찬인기곽란역정，공발병10인，검출대균자5인。위사청본차곽란폭발적원인，심조식물오염적위험배절，위채취과학방공조시제공의거。방법채용회고성대렬연구학정가의찬차，채용병례대조연구방법사조가의식물。수거분석채용Epi Info 3.5연건，계산RR、OR치。결과본차역정적리환솔위2.8%（10/362），병원검출솔위2.8%（7/248）。회고성대렬연구현시，4월29일만찬위가의찬차；병례대조연구현시，4월29일만찬중“두완”채시곽란발병적가의위험식물。통과현장조사화주사방담발현，“두완”채중적“호피단”증사용성장과생갑어적사자성방과일단시간。결론근거류행병학조사결과화주사방담발현，사용성장과생갑어적용기장“호피단”가능시도치역정발생적원인。생숙불분가능도치다충질병적전파，유“유주”조판적농촌취찬응해득도유효감관。
Objective To investigate an outbreak of cholera in May of 2012 in Hunan Province to find the suspected foods, the pathogenic agent, and defects in food handling, and recommend prevention measures. Methods We defined a case as any attendee to the village dinner party with diarrhea (≥3 times/ 24h) or positive cholera culture after the first meal from April 29th to 30th. In a case-control study, we compared exposures to each dish between 15 case-guests and 40 asymptomatic control-guests. We collected the suspected leftover foods and tested them for cholera. Results The attack rate was 2.8%( 10/362), and positive rate of cholera O139 was 2.8%( 7/248). All of these attacked and infected cases attended the dinner party on April 29th. The relative risks of participants were not higher than those of nonparticipants among the other five feasts. Thus we regarded the dinner on April 29th as the suspected meal, 93%(14/15) case-guests and 63%(25/40) control-guests had taken the first dish (OR=8.4, 95% CI: 1.03-378.42). The leftover foods had been heated repeatedly when we took samples for culture. All suspected leftover foods cultures were negative. On the basis of cholera agent surveillance result, we regard the soft-shelled turtles which was the only one seafood dish provided during the dinner as the suspected source of cholera. The deep-fried boiled eggs in the first dish were laid in the container which stored the raw pieces of soft-shelled turtles before. Conclusions The deep-fried boiled eggs in the first dish contaminated by the raw pieces of soft-shelled turtles was probably responsible for this outbreak of cholera. We recommend enhancing cholera agent surveillance and taking supervision on large-scale dinner parties in this county.