Edelstein Michael, Sundborger Camilla, Hergens Maria-Pia, Ivarsson Sofie, Dryselius Rikard, Insulander Mona, Jernberg Cecilia, Hutin Yvan, Wallensten Anders
Public Health Agency of Sweden and European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
Public Health Agency of Sweden, Stockholm, Sweden.
PLoS Curr. 2014 Jun 6;6:ecurrents.outbreaks.80bbab3af3232be0372ea0e904dcd1fe. doi: 10.1371/currents.outbreaks.80bbab3af3232be0372ea0e904dcd1fe.
In June-July 2013, six counties notified the Swedish Institute for Communicable Disease Control of enterohaemorrhagic E.coli (EHEC) infections among attendees at a hotel in Dalarna, Sweden. An outbreak control team investigated to identify the source and implement control measures. We included individuals who attended the hotel between June 19th-25th in a cohort. We asked them about animal contact, swimming, and consumption of food items during this time using a questionnaire. A confirmed case was an EHEC O157:H7 outbreak strain positive individual who developed abdominal pain or diarrhoea between June 20th-July 2nd. We described the outbreak in time, place and person, calculated risk ratios (RR) and 95% confidence intervals (CI). We investigated the kitchen, tested and traced back implicated food items. 172 individuals responded. We identified 19 confirmed cases (Median age: 17 years, 64% female) with symptom onset between June 22nd-27th. Eating green salad on June 20th was associated with illness (RR:3.7;CI:1.3-11). The kitchen mixed green salads without records and destroyed leftovers immediately. Hence we could not conduct trace-back or obtain microbiological confirmation. Green salad contaminated before entering the kitchen was the likely outbreak source. We recommended early collaboration with food agencies and better restaurant records to facilitate future investigations.
2013年6月至7月期间，瑞典6个县向瑞典传染病控制研究所通报了在瑞典达拉纳省一家酒店参会人员中发生的肠出血性大肠杆菌（EHEC）感染事件。一个疫情控制小组展开调查以确定源头并实施控制措施。我们将6月19日至25日期间入住该酒店的人员纳入一个队列。我们通过问卷调查询问他们在此期间与动物的接触情况、游泳情况以及食品的食用情况。确诊病例为感染EHEC O157:H7疫情菌株且在6月20日至7月2日期间出现腹痛或腹泻的个体。我们从时间、地点和人员方面描述了此次疫情，计算了风险比（RR）和95%置信区间（CI）。我们对厨房进行了调查，检测并追溯了相关食品。172人进行了回应。我们确定了19例确诊病例（中位年龄：17岁，64%为女性），症状出现时间为6月22日至27日。6月20日食用绿色沙拉与发病有关（RR：3.7；CI：1.3 - 11）。厨房在没有记录的情况下混合制作绿色沙拉，并立即销毁了剩余食物。因此我们无法进行追溯或获得微生物学确认。绿色沙拉在进入厨房之前被污染很可能是疫情源头。我们建议尽早与食品机构合作并完善餐厅记录，以便于未来的调查。
