Jelastopulu Eleni, Venieri Danai, Komninou Georgia, Kolokotronis Theodoros, Constantinidis Theodoros C, Bantias Christos
Laboratory of Public Health, School of Medicine, University of Patras, Greece.
BMC Public Health. 2006 Oct 17;6:254. doi: 10.1186/1471-2458-6-254.
On the 20th September 2005, soldiers and staff at the Air Force base in Western Greece experienced an outbreak of acute gastroenteritis. The purpose of this study was to identify the agent and the source of the outbreak in order to develop control measures and to avoid similar outbreaks in the future.
A case-control analytical approach was employed with 100 randomly selected cases and 66 controls. Patients completed standardized questionnaires, odds ratios were calculated and statistical significance was determined using chi2 test. In addition, to identify the source of the infection, we performed bacteriological examination of food samples (included raw beef, cooked minced meat, grated cheese and grated cheese in sealed package) collected from the cuisine of the military unit.
More than 600 out of the 1,050 individuals who ate lunch that day, became ill. The overall attack rate, as the military doctor of the unit estimated it, was at least 60%. The overall odds ratio of gastroenteritis among those who had lunch was 370 (95% CI: 48-7700) as compared to those who didn't eat lunch. Among the symptoms the most prominent were watery diarrhoea (96%) and abdominal pain (73%). The mean incubation period was 9 h and the median duration of the symptoms was 21 h. In the bacteriological examination, Staphylococcus aureus was detected in a sample of raw beef (2,000 cfu per g) and in two samples of grated cheese; leftover cheese from lunch (7,800 cfu per g) and an unopened package purchased from the market (3,000 cfu per g).
The findings of this study suggest that the aetiological agent of this outbreak was S. aureus. The food vehicle was the grated cheese, which was mixed with the beef and served for lunch in the military unit. This outbreak highlights the capacity of enterotoxin-producing bacteria to cause short term, moderately-severe illness in a young and healthy population. It underscores the need for proper food handling practices and reinforces the public health importance of timely notification of such outbreaks.
2005年9月20日，希腊西部空军基地的士兵和工作人员爆发了急性肠胃炎。本研究的目的是确定疫情的病原体和源头，以便制定控制措施并避免未来发生类似疫情。
采用病例对照分析方法，随机选取100例病例和66例对照。患者填写标准化问卷，计算比值比，并使用卡方检验确定统计学意义。此外，为了确定感染源，我们对从军事单位食堂采集的食品样本（包括生牛肉、熟肉末、磨碎的奶酪和密封包装的磨碎奶酪）进行了细菌学检查。
当天吃午餐的1050人中，600多人患病。据该单位军医估计，总体发病率至少为60%。与未吃午餐的人相比，吃午餐的人患肠胃炎的总体比值比为370（95%置信区间：48-7700）。在症状中，最突出的是水样腹泻（96%）和腹痛（73%）。平均潜伏期为9小时，症状的中位持续时间为21小时。在细菌学检查中，在一份生牛肉样本（每克2000菌落形成单位）和两份磨碎奶酪样本中检测到金黄色葡萄球菌；午餐剩余的奶酪（每克7800菌落形成单位）和从市场购买的未开封包装（每克3000菌落形成单位）。
本研究结果表明，此次疫情的病原体是金黄色葡萄球菌。传播媒介是磨碎的奶酪，它与牛肉混合后在军事单位作为午餐供应。此次疫情凸显了产肠毒素细菌在年轻健康人群中引发短期、中度严重疾病的能力。它强调了正确食品处理做法的必要性，并强化了及时通报此类疫情的公共卫生重要性。
