Choi Kum-Bal, Lim Hyun-Sul, Lee Kwan, Ha Gyoung-Yim, Jung Kwang-Hyun, Sohn Chang-Kyu
Department of Preventive Medicine, Dongguk University College of Medicine, Gyeungju, Korea.
J Prev Med Public Health. 2011 Mar;44(2):65-73. doi: 10.3961/jpmph.2011.44.2.65.
In July 2 2010, a diarrhea outbreak occurred among the workers in a company in Gyeungju city, Korea. An epidemiological investigation was performed to clarify the cause and transmission route of the outbreak.
We conducted a questionnaire survey among 193 persons, and we examined 21 rectal swabs and 6 environmental specimens. We also delegated the Daegu Bukgu public health center to examine 3 food service employees and 5 environmental specimens from the P buffet which served a buffet on June 30. The patient case was defined as a worker of L Corporation and who participated in the company meal service and who had diarrhea more than one time. We also collected the underground water filter of the company on July 23.
The attack rate of diarrhea among the employees was 20.3%. The epidemic curve showed that a single exposure peaked on July 1. The relative risk of attendance and non-attendance by date was highest for the lunch of June 30 (35.62; 95% CI, 2.25 to 574.79). There was no specific food that was statistically regarded as the source of the outbreak. Bacillus cereus was cultured from two of the rectal swabs, two of the preserved foods and the underground water filter. We thought the exposure date was lunch of June 30 according the latency period of B. cereus.
We concluded the route of transmission was infection of dishes, spoons and chopsticks in the lunch buffet of June 30 by the underground water. At the lunch buffet, 50 dishes, 40 spoons, and chopsticks were served as cleaned and wiped with a dishcloth. We thought the underground water contaminated the dishes, spoons, chopsticks and the dishcloth. Those contaminated materials became the cause of this outbreak.
2010年7月2日,韩国庆州市一家公司的工人中发生了腹泻疫情。开展了一项流行病学调查以查明疫情的原因和传播途径。
我们对193人进行了问卷调查,并检测了21份直肠拭子和6份环境样本。我们还委托大邱北区公共卫生中心对3名食品服务员工以及来自6月30日提供自助餐的P自助餐厅的5份环境样本进行检测。病例定义为L公司的一名工人,其参加了公司餐饮服务且腹泻超过一次。我们还于7月23日采集了该公司的地下水过滤器。
员工中腹泻的罹患率为20.3%。疫情曲线显示单次暴露于7月1日达到高峰。6月30日午餐的出勤和未出勤相对风险最高(35.62;95%置信区间,2.25至574.79)。没有哪种特定食物在统计学上被视为疫情源头。从两份直肠拭子、两份保存食品和地下水过滤器中培养出了蜡样芽孢杆菌。根据蜡样芽孢杆菌的潜伏期,我们认为暴露日期为6月30日午餐。
我们得出结论,传播途径是6月30日午餐自助餐中的餐具、勺子和筷子被地下水污染。在午餐自助餐中,50个盘子、40把勺子和筷子是用洗碗布清洗并擦拭后提供的。我们认为地下水污染了盘子、勺子、筷子和洗碗布。这些受污染的物品成为了此次疫情的源头。