Desenclos J C, Klontz K C, Wilder M H, Nainan O V, Margolis H S, Gunn R A
Division of Field Epidemiology, Centers for Disease Control, Atlanta.
Am J Public Health. 1991 Oct;81(10):1268-72. doi: 10.2105/ajph.81.10.1268.
In August 1988 we investigated a multistate outbreak of hepatitis A caused by Panama City, Florida, raw oysters.
Cases of hepatitis A (HA) with onset in July-August 1988 were identified among persons who ate seafoods harvested in the coastal waters of Panama City, Florida. We conducted a case-control study, using eating companions of case-patients, and calculated attack rate (AR) per 1000 dozen raw oysters served. Enzyme immunoassay (EIA) and a polymerase chain reaction (PCR) technique were performed on samples of raw shellfish obtained from Panama City coastal waters.
Sixty-one case-patients were identified in five states: Alabama (23), Georgia (18), Florida (18), Tennessee (1), and Hawaii (1). We found an increased risk of HA for raw oyster eaters (odds ratio = 24.0; 95% confidence interval = 5.4-215.0; P less than .001). The AR of HA in seafood establishments was 1.9/1000 dozen raw oysters served. The EIA and PCR revealed HA virus antigen and nucleic acid in oysters from both unapproved and approved oyster beds, in confiscated illegally harvested oysters, and in scallops from an approved area.
The monitoring of coastal waters and the enforcement of shellfish harvesting regulations were not adequate to protect raw oyster consumers. More emphasis should be placed on increasing public awareness of health hazards associated with eating raw shellfish.
1988年8月，我们调查了由佛罗里达州巴拿马城的生牡蛎引发的多州甲型肝炎疫情。
在食用了佛罗里达州巴拿马城沿海水域捕捞的海产品的人群中，确定了1988年7 - 8月发病的甲型肝炎（HA）病例。我们进行了一项病例对照研究，以病例患者的饮食同伴作为对照，并计算了每供应1000打生牡蛎的发病率（AR）。对从巴拿马城沿海水域采集的生贝类样本进行了酶免疫测定（EIA）和聚合酶链反应（PCR）技术检测。
在五个州共识别出61例病例患者：阿拉巴马州（23例）、佐治亚州（18例）、佛罗里达州（18例）、田纳西州（1例）和夏威夷州（1例）。我们发现食用生牡蛎者感染甲型肝炎的风险增加（优势比 = 24.0；95%置信区间 = 5.4 - 215.0；P < 0.001）。海产品经营场所中甲型肝炎的发病率为每供应1000打生牡蛎1.9例。EIA和PCR检测在未经批准和已批准的牡蛎养殖场的牡蛎中、没收的非法捕捞牡蛎中以及来自批准区域的扇贝中均检测到甲型肝炎病毒抗原和核酸。
沿海水域监测和贝类捕捞法规的执行不足以保护生牡蛎消费者。应更加重视提高公众对食用生贝类相关健康危害的认识。
