Ekman Claudio Cesar Jaguaribe, Chiossi Maria Fernanda do Valle, Meireles Luciana Regina, Andrade Júnior Heitor Franco de, Figueiredo Walter Manso, Marciano Maria Aparecida Moraes, Luna Expedito José de Albuquerque
Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brasil.
Rev Inst Med Trop Sao Paulo. 2012 Sep-Oct;54(5):239-44. doi: 10.1590/s0036-46652012000500001.
Foodborne diseases represent operational risks in industrial restaurants. We described an outbreak of nine clustered cases of acute illness resembling acute toxoplasmosis in an industrial plant with 2300 employees. These patients and another 36 similar asymptomatic employees were diagnosed with anti-T. gondii IgG titer and avidity by ELISA. We excluded 14 patients based on high IgG avidity and chronic toxoplasmosis: 13 from controls and one from acute disease other than T. gondii infection. We also identified another three asymptomatic employees with T.gondii acute infection and also anti-T. gondii IgM positive as remaining acute cases. Case control study was conducted by interview in 11 acute infections and 20 negative controls. The ingestion of green vegetables, but not meat or water, was observed to be associated with the incidence of acute disease. These data reinforce the importance of sanitation control in industrial restaurants and also demonstrate the need for improvement in quality control regarding vegetables at risk for T. gondii oocyst contamination. We emphasized the accurate diagnosis of indexed cases and the detection of asymptomatic infections to determine the extent of the toxoplasmosis outbreak.
食源性疾病是工业餐厅的运营风险。我们描述了一家拥有2300名员工的工厂中9例聚集性急性疾病暴发，这些疾病类似于急性弓形虫病。通过酶联免疫吸附测定法（ELISA）对这些患者以及另外36名类似的无症状员工进行了抗弓形虫IgG滴度和亲和力检测。基于高IgG亲和力和慢性弓形虫病，我们排除了14名患者：13名来自对照组，1名来自除弓形虫感染外的急性疾病组。我们还确定了另外3名无症状员工感染了急性弓形虫病且抗弓形虫IgM呈阳性，作为其余的急性病例。通过对11例急性感染患者和20名阴性对照进行访谈开展了病例对照研究。观察发现，食用绿色蔬菜而非肉类或水与急性疾病的发病率相关。这些数据强化了工业餐厅卫生控制的重要性，也表明需要改进对有弓形虫卵囊污染风险的蔬菜的质量控制。我们强调了对索引病例的准确诊断以及无症状感染的检测，以确定弓形虫病暴发的范围。
