Strosnider Heather, Azziz-Baumgartner Eduardo, Banziger Marianne, Bhat Ramesh V, Breiman Robert, Brune Marie-Noel, DeCock Kevin, Dilley Abby, Groopman John, Hell Kerstin, Henry Sara H, Jeffers Daniel, Jolly Curtis, Jolly Pauline, Kibata Gilbert N, Lewis Lauren, Liu Xiumei, Luber George, McCoy Leslie, Mensah Patience, Miraglia Marina, Misore Ambrose, Njapau Henry, Ong Choon-Nam, Onsongo Mary T K, Page Samuel W, Park Douglas, Patel Manish, Phillips Timothy, Pineiro Maya, Pronczuk Jenny, Rogers Helen Schurz, Rubin Carol, Sabino Myrna, Schaafsma Arthur, Shephard Gordon, Stroka Joerg, Wild Christopher, Williams Jonathan T, Wilson David
National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA.
Environ Health Perspect. 2006 Dec;114(12):1898-903. doi: 10.1289/ehp.9302.
Consecutive outbreaks of acute aflatoxicosis in Kenya in 2004 and 2005 caused > 150 deaths. In response, the Centers for Disease Control and Prevention and the World Health Organization convened a workgroup of international experts and health officials in Geneva, Switzerland, in July 2005. After discussions concerning what is known about aflatoxins, the workgroup identified gaps in current knowledge about acute and chronic human health effects of aflatoxins, surveillance and food monitoring, analytic methods, and the efficacy of intervention strategies. The workgroup also identified public health strategies that could be integrated with current agricultural approaches to resolve gaps in current knowledge and ultimately reduce morbidity and mortality associated with the consumption of aflatoxin-contaminated food in the developing world. Four issues that warrant immediate attention were identified: a) quantify the human health impacts and the burden of disease due to aflatoxin exposure; b) compile an inventory, evaluate the efficacy, and disseminate results of ongoing intervention strategies; c) develop and augment the disease surveillance, food monitoring, laboratory, and public health response capacity of affected regions; and d) develop a response protocol that can be used in the event of an outbreak of acute aflatoxicosis. This report expands on the workgroup's discussions concerning aflatoxin in developing countries and summarizes the findings.
2004年和2005年，肯尼亚接连爆发急性黄曲霉毒素中毒事件，导致150多人死亡。作为回应，美国疾病控制与预防中心和世界卫生组织于2005年7月在瑞士日内瓦召集了一个由国际专家和卫生官员组成的工作组。在讨论了关于黄曲霉毒素的已知情况后，该工作组确定了当前在黄曲霉毒素对人类健康的急性和慢性影响、监测与食品监测、分析方法以及干预策略的有效性等方面的知识空白。该工作组还确定了一些公共卫生策略，这些策略可与当前的农业方法相结合，以填补现有知识空白，并最终降低发展中国家因食用受黄曲霉毒素污染的食品而导致的发病率和死亡率。确定了四个需要立即关注的问题：a）量化黄曲霉毒素暴露对人类健康的影响和疾病负担；b）编制一份清单，评估正在进行的干预策略的有效性，并传播其结果；c）发展和增强受影响地区的疾病监测、食品监测、实验室及公共卫生应对能力；d）制定一份在急性黄曲霉毒素中毒爆发时可使用的应对方案。本报告详述了该工作组关于发展中国家黄曲霉毒素问题的讨论情况，并总结了研究结果。
