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[儿童轻度沙门氏菌病:流行病学及预防考量]

[Minor salmonellosis in childhood: epidemiological and preventive considerations].

作者信息

Comi R, Filippini M

出版信息

Ann Ig. 1989 Nov-Dec;1(6):1743-60.

PMID:2484501
Abstract

The diffusion of so-called minor salmonellosis in Italy, 18,135 isolates in 1985 -and the serious illness that they may induce in correlation to age and state of health have moved the Authors to consider their epidemiology and discuss their prevention. The morbidity per 100,000 population, from about 10 in the early '70s, has grown to a peak of 22.22 in 1976 and, after having irregularly reduced to a value of 16.76 in 1984, has grown again to 22.23 in 1986. Travelling abroad, modern breeding technologies, animals and raw food trade among States are frequently indicated as the most important factors in spreading salmonellas. The rise of morbidity in Italy has indeed occurred in concomitance with the renewal of breeding activity realized by means of animals imported from abroad, and moreover, presence of strains of S. typhimurium identical to those which caused serious epidemic outbreaks in bovine and humans in Great Britain and other Countries of North Europe is now ascertained. Recently, cooked ham prepared with raw meat contaminated with two serotypes uncommon in Italy (S. corvallis and S. mbandaka), imported from Rumania and Holland, has been the cause of two foodborne outbreaks each showing both of the above contaminants. At present, salmonellosis is quite common in large urban areas and is supported by person-to-person spread; more than 50% of the yearly isolates occurs in childhood Number of cases, their ages, sex distribution, and relative morbidity, have been calculated in Tab. 1, 2, 3, 4. From 1976 to 1986 the withdraw of S. wien, the research of excretors, and the improvement of quality of life, are all factors that may have favoured the lowering of morbidity at age zero, while the increasing of the same index at the ages 1-5 and 6-10 may correlate to the high number of serotypes of Salmonella now endemic in Italy. The diffusion of fast-food and the habit, recently acquired in our Country, to buy at shop cooked foods ready to eat, may be involved too. Age distribution shows a highest number of isolates at age zero and a still high number at ages 1, 2, and 3. Throughout childhood morbidity is lower in females. From 1975 on, the percentage increase of number of children admitted for minor salmonellosis is also indicated by surveys held at many Hospitals in Italy.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

1985年,意大利所谓轻度沙门氏菌病的扩散——当年有18135株分离菌——以及它们可能因年龄和健康状况引发的严重疾病,促使作者们考虑其流行病学并讨论预防措施。每10万人口中的发病率,从70年代初的约10例,在1976年增至峰值22.22例,在不规则降至1984年的16.76例后,于1986年又增至22.23例。出国旅行、现代养殖技术、国家间的动物及生食贸易,常被指出是沙门氏菌传播的最重要因素。意大利发病率的上升确实与通过从国外进口动物实现的养殖活动恢复同时发生,此外,现已确定存在与在英国及北欧其他国家导致牛和人类严重疫情爆发的菌株相同的鼠伤寒沙门氏菌菌株。最近,从罗马尼亚和荷兰进口的、用受两种在意大利不常见血清型(科瓦利斯沙门氏菌和姆班达卡沙门氏菌)污染的生肉制作的熟火腿,引发了两起食源性疫情,每次疫情都显示出上述两种污染物。目前,沙门氏菌病在大城市地区相当常见,且存在人际传播;每年分离菌中超过50%出现在儿童期。病例数、年龄、性别分布及相对发病率已在表1、2、3、4中列出。从1976年到1986年,维也纳沙门氏菌的减少、排菌者的研究以及生活质量的改善,都是可能有利于降低零岁发病率的因素,而1 - 5岁和6 - 10岁年龄段该指标的上升可能与意大利目前流行的大量沙门氏菌血清型有关。快餐的普及以及我国最近养成的在商店购买即食熟食的习惯,可能也有影响。年龄分布显示零岁时分离菌数量最多,1岁、2岁和3岁时数量仍较高。在整个儿童期,女性发病率较低。自1975年起,意大利多家医院进行的调查也表明了因轻度沙门氏菌病入院儿童数量的百分比增长情况。(摘要截选至400字)

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