278起原因不明食源性疾病暴发事件分析

目的分析导致278起原因不明食源性疾病暴发事件的致病物质、污染原因、污染食品不明的原因,提出建议,为提高查明率提供参考。方法收集2010—2016年山西省食源性疾病暴发事件报告系统中报告的原因不明事件,采用Excel 2013软件进行数据导出、整理与分析。结果 2010—2016年山西省共报告食源性疾病暴发事件436起,其中原因不明278起,占63.76%;发病人数均小于100人,均属于一般食品安全事故;第三季度报告数最多,占40.65%(113/278);消化系统症状体征居多,有腹痛的占74.76%(1 303/1 743);发生场所排在第一位的为餐饮服务单位,占49.64%(138/278);仅有30.51%(83/272)的事件采集到样品,餐饮服务单位发生的事件中,食品、环境、患者、从业人员样品均采集到的事件仅占2.90%(4/138);137起多次共同进餐的事件,仅18.25%(25/137)调查了患者多餐次进餐情况,16.79%(23/137)调查了共同进餐未发病人员情况,1起事件进行了分析性研究;138起发生在餐饮服务单位的事件中,仅54.35%(75/138)开展了食品卫生学调查,且内容不全面。结论导致致病因子不明、可疑食品不明、污染原因和污染环节不明的因素包括事故调查机制不顺,诊断标准过时,不具备检验资质或检验设备和能力不足,样品采集数量、范围、质量不够,流行病学调查能力不足以及行政干预和社会因素的影响等。

Analysis of 278 unexplained foodborne disease outbreaks in Shanxi

Objective To analyze the pathogenic substance, cause of pollution, cause of unidentified food contamination of 278 outbreaks of unexplained foodborne disease, offer suggestions and provide reference for identifying the pathogenic substances. Methods The data of unexplained foodborne disease outbreaks between 2010-2016 from Foodborne Disease Outbreak Surveillance System was collected, and then sorted and analyzed with Microsoft Excel software. Results A total of 436 foodborne disease outbreaks were reported in Shanxi province from 2010-2016, among which 278(63.76%) were unexplained foodborne disease. These 278 events, with less than 100 patients each, all were general food safety accidents. 40.65%(113/278)of the events occurred in the third quarter. The symptoms of digestive system were the major clinical situation, and 74.76%(1 303/1 743)cases had with abdominal pain. The most common setting was catering service establishment (49.64%,138/278). 30.51%(83/272)of the events collected samples, while only 2.90%(4/138)collected all four types of samples(including food samples, patients'' biological specimens, employees'' biological specimens and environmental samples) in catering service establishment.There were 137 events occurring after people eating together many times, among which only 18.25%(25/137)investigated the multiple meals,16.79%(23/137)investigated unaffected person after sharing the same suspicious meals, and only one event carried on the analytical research. There were 138 events occurring in catering service establishment, among which only 54.35%(75/138)carried out investigations of food hygiene, but not comprehensive. Conclusion There were many events with unidentified pathogenic substance, unidentified cause of pollution, unidentified contaminated food as well as unidentified triggering link. The reasons for this included imperfect investigation mechanism, outdated diagnostic criteria, insufficient inspection equipment and ability, absent of qualification of food inspection, nonstandard sample collection, inadequate epidemiological investigation, administrative intervention as well as the influence of social factors.