Lim Hyun-Sul, Min Young-Sun, Lee Hwan-Seok
Department of Preventive Medicine, College of Medicine, Dongguk University.
J Prev Med Public Health. 2005 Nov;38(4):457-64.
An outbreak of salmonellosis occurred among the students and staff of D primary school in Yeongcheon-si, 2004. This investigation was carried out to prevent any recurrence of this outbreak and to study the infection source and transmission of the salmonellosis.
The authors conducted a questionnaire survey among 1,205 students and staff members from D primary school about the ingestion of the school lunch and drinking water, and the manifestation of their symptoms. The author examined rectal swabs, the tap water and microorganism cultures, and we also investigated the dining facility and water supply facility.
The diarrheal cases were defined as the confirmed cases or the persons who had diarrhea more than one time with symptoms such as fever, vomiting and tenesmus. The diarrheal attack rate was 28.0%. Ingestion of fried bean curd with egg had a significantly high association with the diarrheal attack rate (p<0.05), and the relative risk of the fried bean curd with egg was 10.68 (95% CI=3.88-29.41), as was determined by logistic regression analysis. The bacterial counts in the tap water of the food preparation room and toilet (first floor) exceeded the maximum permissible counts. S. Enteritidis bacteria were only cultured from the fried bean curd with egg of all the supplied foods on September 3, 2004.
The major cause of salmonellosis was presumed to be the contaminated bean curd via contaminated tap water due to a water leak of a school water pipe. This contaminated bean curd was under prepared, which allowed the S. Enteritidis to survive and multiply prior to its ingestion.
2004年,荣州市D小学的学生和教职员工中发生了一起沙门氏菌病暴发事件。开展此次调查是为了防止该疫情再次发生,并研究沙门氏菌病的感染源和传播途径。
作者对D小学的1205名学生和教职员工进行了问卷调查,内容包括学校午餐和饮用水的摄入情况以及他们的症状表现。作者检查了直肠拭子、自来水和微生物培养物,还调查了餐饮设施和供水设施。
腹泻病例被定义为确诊病例或出现腹泻且伴有发热、呕吐和里急后重等症状超过一次的人员。腹泻发病率为28.0%。食用鸡蛋炒豆腐与腹泻发病率有显著的高相关性(p<0.05),经逻辑回归分析确定,鸡蛋炒豆腐的相对风险为10.68(95%CI=3.88-29.41)。食品制备室和厕所(一楼)的自来水中细菌计数超过了最大允许计数。仅在2004年9月3日供应的所有食品中的鸡蛋炒豆腐中培养出肠炎沙门氏菌。
推测沙门氏菌病的主要原因是学校水管漏水导致自来水污染豆腐,而这种受污染的豆腐烹饪不充分,使得肠炎沙门氏菌在食用前得以存活和繁殖。