Vo Thuan Huu, Nguyen Dat Van, Le Loan Thi Kim, Phan Lan Trong, Nuorti J Pekka, Tran Minh Nguyen Nhu
Institute of Hygiene and Public Health, 159 Hung Phu Street, District 8, 70000 Ho Chi Minh City, Vietnam.
Food Safety Agency of Binh Duong, 211 Yersine, Thu Dau Mot City, 72000 Binh Duong Province, Vietnam.
J Food Prot. 2014 Jul;77(7):1229-31. doi: 10.4315/0362-028X.JFP-13-519.
An outbreak of gastroenteritis occurred among workers of company X after eating lunch prepared by a catering service. Of 430 workers attending the meal, 56 were hospitalized with abdominal pain, diarrhea, vomiting, and nausea, according to the initial report. We conducted an investigation to identify the extent, vehicle, and source of the outbreak. In our case-control study, a case was a worker who attended the meal and who was hospitalized with acute gastroenteritis; controls were randomly selected from non-ill workers. Cases and controls were interviewed using a standard questionnaire. We used logistic regression to calculate adjusted odds ratios for the consumption of food items. Catering service facilities and food handlers working for the service were inspected. Food samples from the catering service were tested at reference laboratories. Of hospitalized cases, 54 fulfilled the case definition, but no stool specimens were collected for laboratory testing. Of four food items served during lunch, only "squash and pork soup" was significantly associated with gastroenteritis, with an adjusted odds ratio of 9.5 (95 % CI 3.2, 27.7). The caterer did not separate cooked from raw foods but used the same counter for both. Cooked foods were kept at room temperature for about 4 h before serving. Four of 14 food handlers were not trained on basic food safety principles and did not have health certificates. Although no microbiological confirmation was obtained, our epidemiological investigation suggested that squash and pork soup caused the outbreak. Hospitals should be instructed to obtain stool specimens from patients with gastroenteritis. Food catering services should be educated in basic food safety measures.
X公司的员工在食用了由一家餐饮服务公司提供的午餐后爆发了肠胃炎。根据初步报告，在430名就餐的员工中，有56人因腹痛、腹泻、呕吐和恶心而住院。我们开展了一项调查，以确定此次疫情的范围、传播媒介和源头。在我们的病例对照研究中，病例为就餐且因急性肠胃炎住院的员工；对照则从未患病的员工中随机选取。使用标准问卷对病例和对照进行访谈。我们采用逻辑回归计算食品消费的调整比值比。对餐饮服务设施以及为该服务工作的食品处理人员进行了检查。餐饮服务的食品样本在参考实验室进行了检测。在住院病例中，54人符合病例定义，但未采集粪便标本进行实验室检测。午餐提供的四种食品中，只有“南瓜猪肉汤”与肠胃炎有显著关联，调整比值比为9.5（95%可信区间3.2, 27.7）。餐饮商未将熟食和生食分开，而是使用同一个柜台处理两者。熟食在供应前在室温下保存了约4小时。14名食品处理人员中有4人未接受基本食品安全原则培训且没有健康证明。尽管未获得微生物学确认，但我们的流行病学调查表明，南瓜猪肉汤导致了此次疫情爆发。应指示医院从肠胃炎患者中采集粪便标本。应向食品餐饮服务机构传授基本食品安全措施。
