Kubota Kunihiro, Iwasaki Emiko, Inagaki Shunichi, Nokubo Tomomi, Sakurai Yoshiharu, Komatsu Mayumi, Toyofuku Hajime, Kasuga Fumiko, Angulo Frederick J, Morikawa Kaoru
Division of Safety Information on Drug, Food, and Chemicals, National Institute of Health Sciences, Tokyo, Japan.
Foodborne Pathog Dis. 2008 Oct;5(5):641-8. doi: 10.1089/fpd.2008.0092.
To estimate the human health burden of foodborne infections caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus in Japan, an epidemiological study was conducted in Miyagi Prefecture. Laboratory-confirmed infections among patients with diarrhea caused by the three pathogens were ascertained from two clinical laboratories in the prefecture from April 2005 to March 2006. To estimate the number of ill persons who were not laboratory-confirmed, we estimated physician-consultation rates for patients with acute diarrhea by analyzing foodborne outbreak investigation data for each pathogen and the frequency at which stool specimens were submitted from a physician survey. Each factor was added to a Monte-Carlo simulation model as a probability distribution, and the number of laboratory-confirmed cases was extrapolated to estimate the total number of ill persons. The estimated incidence of foodborne infections per 100,000 per year in this region estimated by this model was 237 cases for Campylobacter, 32 cases for Salmonella, and 15 cases for V. parahaemolyticus. Simulated results indicate a significant difference between our estimated incidence and the reported cases of food poisoning in this region. An enhanced surveillance system is needed to complement the present passive surveillance on foodborne illnesses in Japan to identify food safety issues more precisely, and to monitor the effectiveness of risk management options.
为估算日本弯曲杆菌、沙门氏菌和副溶血性弧菌引起的食源性感染对人类健康造成的负担，在宫城县开展了一项流行病学研究。2005年4月至2006年3月期间，从该县的两个临床实验室确定了由这三种病原体引起腹泻的患者中经实验室确诊的感染病例。为估算未得到实验室确诊的患病人数，我们通过分析每种病原体的食源性疾病暴发调查数据以及医生调查中粪便标本送检频率，估算了急性腹泻患者的就诊率。将每个因素作为概率分布添加到蒙特卡洛模拟模型中，并外推实验室确诊病例数来估算患病人数的总量。该模型估算出该地区每年每10万人中食源性感染的发病率为：弯曲杆菌237例、沙门氏菌32例、副溶血性弧菌15例。模拟结果表明，我们估算的发病率与该地区报告的食物中毒病例数之间存在显著差异。需要加强监测系统，以补充日本目前对食源性疾病的被动监测，从而更精确地识别食品安全问题，并监测风险管理措施的有效性。
