CAJ | 학술논문

目的分析云南省腾冲县一起毒蕈中毒事件的流行病学调查结果,为预防与控制类似毒蕈中毒事件提供借鉴. 方法接到中毒事件报告后,当地疾病预防控制中心(CDC)专业人员迅速赶往现场开展流行病学调查和毒物鉴定工作,并对调查结果进行分析. 结果 2012年6月30日15时左右,同一家庭的6人,包括祖父(例1,56岁)、祖母(例2,47岁)和4个孙女(例3～6,分别为8、8、7、1.5岁)一起食用了含“麻栗菌”(祖父当日自采)的午餐.次日凌晨4～6时,2个孙女(例3、5)和祖父母先后出现恶心、呕吐、腹泻,就诊于当地卫生院,给予对症治疗后返家；例4仅出现腹泻,未就医；例6仅进食少量菜汁,未出现明显症状.7月2日例3、5出现嗜睡、昏迷,6人均被送往腾冲县人民医院,诊断为群体性毒蕈中毒并上报当地CDC.例3在急诊科经抢救无效死亡；例1入院,例2急诊留观治疗,分别在中毒后第26、19天痊愈；其他3例患儿当日转诊省级医疗机构,中毒后第10～13天痊愈.CDC专业人员在事发当地采集的新鲜“麻栗菌”标本经鉴定确认为毒蕈条盖盔孢伞(Galerina sulciceps),而非当地俗称“麻栗菌”的可食性酒色蜡蘑(Laccaria vinaceoavellanea),明确该起事件为误采误食条盖盔孢伞导致的急性中毒事件. 结论条盖盔孢伞与酒色蜡蘑外观形态易混淆,故因误采误食导致中毒.专业机构应加强中毒信息管理,掌握不同地区毒蕈谱.应对医务人员进行毒蕈中毒诊断和救治知识的培训,并对普通群众开展预防常见毒蕈中毒的科普教育.
목적 분석운남성등충현일기독심중독사건적류행병학조사결과,위예방여공제유사독심중독사건제공차감. 방법 접도중독사건보고후,당지질병예방공제중심(CDC)전업인원신속간왕현장개전류행병학조사화독물감정공작,병대조사결과진행분석. 결과 2012년6월30일15시좌우,동일가정적6인,포괄조부(례1,56세)、조모(례2,47세)화4개손녀(례3～6,분별위8、8、7、1.5세)일기식용료함“마률균”(조부당일자채)적오찬.차일릉신4～6시,2개손녀(례3、5)화조부모선후출현악심、구토、복사,취진우당지위생원,급여대증치료후반가；례4부출현복사,미취의；례6부진식소량채즙,미출현명현증상.7월2일례3、5출현기수、혼미,6인균피송왕등충현인민의원,진단위군체성독심중독병상보당지CDC.례3재급진과경창구무효사망；례1입원,례2급진류관치료,분별재중독후제26、19천전유；기타3례환인당일전진성급의료궤구,중독후제10～13천전유.CDC전업인원재사발당지채집적신선“마률균”표본경감정학인위독심조개회포산(Galerina sulciceps),이비당지속칭“마률균”적가식성주색사마(Laccaria vinaceoavellanea),명학해기사건위오채오식조개회포산도치적급성중독사건. 결론 조개회포산여주색사마외관형태역혼효,고인오채오식도치중독.전업궤구응가강중독신식관리,장악불동지구독심보.응대의무인원진행독심중독진단화구치지식적배훈,병대보통군음개전예방상견독심중독적과보교육.
Objective To report the epidemiological investigation of a poisonous mushroom poisoning event occurring in Tengchong County,Yunnan Province in order to provide reference for preventing and controlling similar poisonous mushroom poisoning.Methods After receiving the report of poisoning event,the specialists in local Center for Disease Control and Prevention (CDC) hastened to the scene and they conducted epidemiological investigations,identification of poison and analysis of the results.Results Around 3 o'clock in the afternoon on June 30,2012,six members of a family comprising a grandfather (case 1,56-year-old),a grandmother (case 2,47-year-old),and four granddaughters (case 3,4,5,and 6 aged 8,8,7,and 1.5 years,respectively) ate a dish containing "malijun" for lunch,which was picked by the grandfather at that day.Around 4-6 o'clock the next morning,two granddaughters (cases 3 and 5) and the grandparents developed nausea,vomiting,and diarrhea successively and then presented to a local health center.They were treated with symptomatic therapy and then returned home.Case 4 experienced diarrhea only without seeking medical advice and case 6 just drank a little juice of the dish and she had no marked symptoms.On July 2,cases 3 and 5 developed lethargy and coma.All the six patients presented to the People's Hospital of Tengchong County and were diagnosed with group poisonous mushroom poisoning which was reported to local CDC.Case 3 died despite resuscitation attempts in the emergency department.Case 1 was admitted to hospital and case 2 was staying treatment in emergency department and both of them recovered on days 26 and 19 after poisoning,respectively.The other three kids were transferred to provincial medical institutions in the same day and recovered on days 10 to 13 after poisoning.The fresh sample of " malijun",which was picked bv specialists of CDC at the location,was identified as Galerina sulciceps rather than the edible mushroom Laccaria vinaceoavellanea which was commonly called " malijun " by local people.This event was determined as a sudden acute poisonous mushroom poisoning event caused by picking and eating Galerina sulciceps by mistaken.Conclusions The appearance of Galerina sulciceps may be easily confused with that of Laccaria vinaceoavellanea,thus,the poisoning may occur due to picking and eating by mistaken.Management of the information on poisoning should be enhanced,and the spectrum of poisonous mushrooms in different districts should be controlled by professional institutes.Medical staff should be trained to reinforce knowledge of diagnosis and treatment of poisonous mushrooms,and popular science education in the prevention of common poisonous mushrooms poisoning to general public should be conducted.