Ban Bozica, Vodopija Radovan, Petrović Mirjana Zagar, Matica Biserka
Sluzba za epidemiologiju, Zavod za javno zdravstvo Dr. Andrija Stampar, Zagreb, Hrvatska.
Acta Med Croatica. 2011 Mar;65(1):41-7.
In Croatia, salmonellosis is the leading cause of bacterial foodborne diseases. The aim of the study was to determine the incidence of the disease, patient breakdown by age and sex, the most frequently isolated Salmonella serotypes, the length of carriership, and the most frequent source of infection. It was a retrospective analysis, and the sources of data were reports and epidemiological questionnaires administered to those affected with the disease. During the 1990-2009 period, 4492 cases of salmonellosis were reported in the New Zagreb area. The average incidence was 179/100,000. From 2004 onwards, salmonellosis has been on a decrease in Western Europe countries and the USA, whereas in Croatia it is still the leading cause of bacterial food poisoning. The highest incidence is recorded in children up to the age of 1 year (880/100,000), due to low immunity and a lower infective dose. In the observed period (1990-2009), the most frequently isolated serotype was Salmonella enteritidis (84%), followed by Salmonella typhimurium (7%), Salmonella virchow (3%) and Salmonella hadar (2%). There was a slight female predominance (F:M ratio 1.2:1) in salmonellosis cases. All persons affected with the disease are placed under sanitary surveillance including bacteriological control of the stool. Acute carriership was recorded in 2557 (57%) subjects, whereas stool excretion of Salmonella for more than 90 days (chronic carriership) was present in 139 subjects. In nine (0.2%) subjects, chronic carriership was observed for more than a year. During carriership, 22,460 stool samples were examined, i.e. 5 samples per patient on an average. A total of 1033 (23%) subjects were hospitalized for 7 days on an average, whereas 359 persons stayed in day hospital (1-2 days). Out of 3592 (88.4%) subjects with symptoms of the disease reported on their own, Salmonella was detected by the examination of contacts in 413 (9.3%) and carriership proven in 127 (2.3%) subjects examined for sanitary certificate (persons under sanitary surveillance due to the work with food). There were 90% of sporadic cases and 10% of small outbreaks. The most common source of infection were eggs (32%), poultry (10%) and pastry (10%). The outbreaks were mostly confined to the families. Salmonellosis is a major public health and economic problem, as well as an issue pertaining to veterinary and human medicine. The best and most efficient way to prevent the spread of infection by food is reduction of salmonellosis in animal population.
在克罗地亚，沙门氏菌病是细菌性食源性疾病的主要病因。本研究的目的是确定该疾病的发病率、按年龄和性别划分的患者情况、最常分离出的沙门氏菌血清型、携带病菌的时长以及最常见的感染源。这是一项回顾性分析，数据来源是对该病患者的报告及流行病学调查问卷。在1990年至2009年期间，新萨格勒布地区报告了4492例沙门氏菌病病例。平均发病率为179/10万。自2004年起，西欧国家和美国的沙门氏菌病发病率一直在下降，而在克罗地亚，它仍是细菌性食物中毒的主要病因。1岁以下儿童的发病率最高（880/10万），这是由于其免疫力低且感染剂量较小。在观察期（1990年至2009年）内，最常分离出的血清型是肠炎沙门氏菌（84%），其次是鼠伤寒沙门氏菌（7%）、维尔肖沙门氏菌（3%）和哈达尔沙门氏菌（2%）。沙门氏菌病病例中女性略占优势（女性与男性比例为1.2:1）。所有患病者都接受卫生监测，包括对粪便进行细菌学检测。2557名（57%）受试者被记录为急性携带者，而139名受试者的粪便中沙门氏菌排泄超过90天（慢性携带者）。9名（0.2%）受试者的慢性携带病菌情况持续了一年以上。在携带病菌期间，共检查了22460份粪便样本，即平均每名患者检查5份样本。共有1033名（23%）受试者平均住院7天，而359人在日间医院停留（1至2天）。在自行报告有该病症状的3592名（88.4%）受试者中，通过对接触者的检查在413名（9.3%）受试者中检测到沙门氏菌，在接受卫生证书检查（因从事食品工作而接受卫生监测的人员）的127名（2.3%）受试者中证实有病菌携带。散发病例占90%，小规模暴发占10%。最常见的感染源是鸡蛋（32%）、家禽（10%）和糕点（10%）。疫情大多局限于家庭。沙门氏菌病是一个重大的公共卫生和经济问题，也是兽医和人类医学领域的一个问题。预防通过食物传播感染的最佳且最有效的方法是降低动物群体中的沙门氏菌病发病率。
