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目的查明1起食物中毒发生的原因,提出相应的预防措施。方法通过查看医院就诊记录、公司医务室日志以及员工缺勤登记表进行病例搜索;采用统一的问卷对员工饮食情况进行调查,追溯调查可疑食物贮存和制作的详细过程,找出可能的污染环节。采集病例粪便、肛拭子、食品原料、环境样本等进行荧光定量PCR核酸检测和细菌分离培养;采用病例对照研究寻找可能危险因素。结果 2011年7月15日14时起,广州市番禺区某公司有43名员工陆续出现腹痛、腹泻等急性胃肠炎症状,末例病例发生于2011年7月16日13时。夜班员工罹患率为11.47%(43/375),878名日班员工无发病。木制品车间和涂装车间夜班员工罹患率分别为13.67%(19/139)和13.07%(23/176),明显高于其他车间1.67%(1/60)(P<0.05)。流行曲线呈点源暴露曲线特点。病例对照研究结果显示,7月15日早餐是危险餐次(OR=∞,OR 95%CI=10.58～∞),其中鸡蛋炒米粉是危险食物(OR=∞,OR 95%CI=11.64～∞)。从13例病例的粪便、肛拭子中检出同一血清型的肠炎沙门菌。引起污染的原因很可能为盛装备餐待售鸡蛋炒米粉的钢盆中,有1个曾经盛装过生鸡蛋浆而未清洗。结论该起事件为1起由肠炎沙门菌引起的食物中毒,原因是厨师操作不当,造成生熟食物交叉污染。
Objective To identify the causes of food poisoning and propose corresponding preventive measures. Methods A case search was conducted by examining the records of hospital visits, the log of the company’s medical office and the employee absence registration form. A unified questionnaire was used to investigate the employees’ diet and trace the detailed process of storage and production of suspicious foods to find possible pollution links. Collect faeces, anal swabs, food raw materials, environmental samples and other fluorescent quantitative PCR nucleic acid detection and bacterial isolation and culture; case-control study to find possible risk factors. Results At 14 o’clock on July 15, 2011, 43 employees from a company in Panyu District of Guangzhou City started to have symptoms of acute gastroenteritis such as abdominal pain and diarrhea. The last case occurred at 13 o’clock on July 16, 2011. Night workforce attack rate was 11.47% (43/375), 878 day-time employees without disease. The attack rates of night work staff in woodworking workshop and painting workshop were 13.67% (19/139) and 13.07% (23/176), respectively, which were significantly higher than those in other workshops (1.67%, 1/60) (P <0.05). Pop curve was point source exposure curve characteristics. Case-control study showed that breakfast was dangerous meal on July 15 (OR = ∞, OR 95% CI = 10.58 ~ ∞). Egg fried rice was a dangerous food (OR = ∞, OR 95% CI = 11.64 ~ ∞ ). Salmonella enteritidis of the same serotype was detected from the stool and anal swab of 13 cases. The cause of the contamination is likely to be that one of the steel baskets containing ready-to-eat egg fried rice noodles was once filled with raw chicken egg but not cleaned. Conclusion The incident was caused by 1 food poisoning caused by Salmonella enteritidis due to improper operation by chefs and cross-contamination of raw and cooked foods.