从一起河鲀中毒调查探讨河鲀食用安全性的风险管理措施

目的通过一起河鲀中毒事件的流行病学调查和人群关于河鲀安全性的知识、态度、行为(KAP)调查,探讨河鲀食用安全的风险管理措施。方法通过病例搜索,调查病例家庭成员进食史及发病情况,采用回顾性队列研究分析发病的高危因素,制作调查问卷调查了解当地村民有关河鲀中毒的知识、态度和行为。结果共搜索到14例病例,其中1例死亡。症状主要为头晕(100%)、四肢无力(79%)、四肢肌肉麻痹和行走困难(71%)、口舌肢端麻痹(71%)等。食用河鲀是发病的危险因素,加工过程保留鱼肝共同煮食可增加中毒的危险(RR=1.8,95%CI=1.1~3.1)。KAP调查发现70%(33/47)的村民近3年曾进食过河鲀,其中88%(29/33)来源于市场或流动摊贩;98%(46/47)的村民知道河鲀有毒,94%(44/47)的村民知道国家法律禁止食用河鲀鱼,但仍有94%(44/47)的人认为其味道鲜美值得品尝。结论食用混杂于无毒河鲀中的有毒河鲀是导致本次食物中毒的主要原因。居民对河鲀安全性知晓率高但依从性差。

The food safety risk management measures on the puffer fish:discussion from an outbreak of puffer fish intoxication

To discuss the safety risk management measures for puffer fish from the investigation on an outbreak of puffer fish intoxication and a knowledge-attitude-practice (KAP) survey on the puffer fish safety.Methods The cases were searched and all of their family members were investigated on food exposure history. A cohort study was conducted to identify risk factors. A self-designed questionnaire was used for KAP investigation. Results 14 puffer fish poisoning cases (one case died) were identified. Clinical symptoms included dizziness (100%), weakness of limbs (79%), muscular paralysis of the limbs or walking difficulty (71%), orolingual numbness (71%), and so on. Eating poisonous puffer fish was the risk factor, and fish meat and fish liver cooked together was significantly associated with poisoning (RR=1.8,5%CI=1.1-3.1). The results of KAP showed that 70% (33/47) had puffer fish consumption in the last three years. 98% (46/47) knew the puffer fish was poisonous and 94% (44/47) knew the state law forbids eating puffer fish. Meanwhile 94% (44/47) of people considered the puffer a delicacy worth to eat. Conclusion This outbreak was caused by poisonous puffer fish consumption. Local residents had a high awareness of puffer safety, but a poor compliance to the prohibition of eating puffer fish.