Hedberg C W, Levine W C, White K E, Carlson R H, Winsor D K, Cameron D N, MacDonald K L, Osterholm M T
Acute Disease Epidemiology Section, Minnesota Department of Health, Minneapolis 55440-9441.
JAMA. 1992 Dec 9;268(22):3208-12.
To determine the source of an international outbreak of shigellosis associated with consumption of food served by a Minnesota-based airline.
Cohort studies of players and staff of a Minnesota-based professional football team and passengers on flights with a confirmed case of outbreak-associated Shigella sonnei infection.
Community- and industry-based studies conducted from October through November 1988.
Sixty-five football team players and staff, and 725 airline passengers in the cohort studies.
Twenty-one (32%) of 65 football players and staff developed shigellosis that was associated with consumption of cold sandwiches prepared at the airline flight kitchen (relative risk [RR], 17.1; 95% confidence interval [Cl], 2.4 to 120; P < .001). Confirmed or probable shigellosis was identified among 240 passengers on 219 flights to 24 states, the District of Columbia, and four countries between September 14 and October 13. An outbreak-associated strain of S sonnei was isolated from football players and staff, airline passengers, and flight attendants. Thirty (4.1%) of 725 passengers on 13 flights with confirmed cases had confirmed or probable shigellosis. Illness was associated with consumption of cold food items served on the flights and prepared by hand at the airline flight kitchen (RR, 5.7; 95% Cl, 1.4 to 23.5; P < .01).
This international outbreak of shigellosis was identified only because of the occurrence of an index outbreak involving a professional football team. Prevention of Shigella transmission in mass catering establishments may require reduction of hand contact in the preparation of cold food items or elimination of these items from menus.
确定一起与明尼苏达州一家航空公司提供的食物消费相关的国际志贺氏菌病暴发的源头。
对明尼苏达州一支职业橄榄球队的球员和工作人员以及有确诊的与暴发相关的宋内志贺氏菌感染病例的航班上的乘客进行队列研究。
1988年10月至11月进行的基于社区和行业的研究。
队列研究中的65名橄榄球队球员和工作人员以及725名航空公司乘客。
65名橄榄球队球员和工作人员中有21人（32%）患上了志贺氏菌病，这与食用在航空公司航班厨房制作的冷三明治有关（相对危险度[RR]，17.1；95%可信区间[CI]，2.4至120；P<.001）。在9月14日至10月13日期间飞往24个州、哥伦比亚特区和4个国家的219个航班上的240名乘客中发现了确诊或可能的志贺氏菌病。从橄榄球队球员和工作人员、航空公司乘客以及空乘人员中分离出了与暴发相关的宋内志贺氏菌菌株。在13个有确诊病例的航班上的725名乘客中有30人（4.1%）患有确诊或可能的志贺氏菌病。疾病与食用航班上提供的、在航空公司航班厨房手工制作的冷食有关（RR，5.7；95%CI，1.4至23.5；P<.01）。
仅因涉及一支职业橄榄球队的首例暴发事件才确定了这起国际志贺氏菌病暴发。在大规模餐饮场所预防志贺氏菌传播可能需要减少制作冷食时的手部接触或从菜单中去除这些食物。
