Department of Public Health. University of Barcelona, Casanova 143, Barcelona 08036, Spain.
J Food Prot. 2010 Jan;73(1):125-31. doi: 10.4315/0362-028x-73.1.125.
The objective of this study was to evaluate the use of clinical-epidemiological profiles for classifying non-laboratory-confirmed outbreaks of foodborne disease (FBD) in Catalonia between 2002 and 2006 and for elucidating associations among factors contributing to these outbreaks. A total of 275 nonfamily outbreaks were studied, of which 190 (69.1%) were laboratory confirmed and 85 (30.9%) were not. In 176 (92.6%) of laboratory-confirmed outbreaks and 69 (81.2%) of non-laboratory-confirmed outbreaks, information was obtained on contributing factors (P = 0.009). In 72% of non-laboratory-confirmed outbreaks, the etiology was assigned by using clinical-epidemiological profiles; thus, 93% of outbreaks eventually were associated with an etiology. In laboratory-confirmed outbreaks, poor personal hygiene was positively associated with norovirus (odds ratio [OR], 2.69; 95% confidence interval [CI], 1.47 to 4.89; P = 0.0007) and negatively associated with Salmonella and Campylobacter (OR, 0.54; 95% CI, 0.33 to 0.89; P = 0.01), and an unsafe source was positively associated with Salmonella and Campylobacter (OR, 4.07; 95% CI, 1.72 to 10.09; P = 0.001) and negatively associated with norovirus (OR, 0.14; 95% CI, 0.04 to 0.58; P = 0.001). No differences were found among contributing factors associated with outbreaks with a laboratory-confirmed etiology and those associated with outbreaks with an etiology assigned according to the clinical-epidemiological profiles. Clinical-epidemiological profiles are useful for determining what prevention and control strategies are appropriate to the agents involved in each community and for designing outbreak investigations.
本研究旨在评估临床-流行病学特征在分类 2002 至 2006 年期间加泰罗尼亚地区未经实验室确认的食源性疾病（FBD）暴发中的作用，并阐明导致这些暴发的因素之间的关联。共研究了 275 起非家庭暴发事件，其中 190 起（69.1%）经实验室确认，85 起（30.9%）未经实验室确认。在 176 起经实验室确认的暴发事件和 69 起未经实验室确认的暴发事件中，均获得了相关因素的信息（P = 0.009）。在未经实验室确认的暴发事件中，72%的暴发事件通过临床-流行病学特征确定了病因，因此，93%的暴发事件最终与病因相关。在经实验室确认的暴发事件中，不良个人卫生与诺如病毒呈正相关（比值比 [OR]，2.69；95%置信区间 [CI]，1.47 至 4.89；P = 0.0007），与沙门氏菌和弯曲菌呈负相关（OR，0.54；95%CI，0.33 至 0.89；P = 0.01），不安全的水源与沙门氏菌和弯曲菌呈正相关（OR，4.07；95%CI，1.72 至 10.09；P = 0.001），与诺如病毒呈负相关（OR，0.14；95%CI，0.04 至 0.58；P = 0.001）。与经实验室确认病因的暴发相关的因素和根据临床-流行病学特征确定病因的暴发相关的因素之间未发现差异。临床-流行病学特征有助于确定针对每个社区涉及的病原体的适当预防和控制策略，并设计暴发调查。
