Reeve G, Martin D L, Pappas J, Thompson R E, Greene K D
Bureau of Epidemiology, Houston Health and Human Services Department, TX 77054.
N Engl J Med. 1989 Jul 27;321(4):224-7. doi: 10.1056/NEJM198907273210404.
We describe an outbreak of Shigella sonnei infection among 24 persons who had eaten raw oysters in restaurants in southeastern Texas within five days before the onset of symptoms. The oysters in all eight restaurants were supplied by the same dealer, but examination of a routine water sample collected six days before the probable time of contamination showed the waters where the oysters were harvested to be free of fecal contamination, making widespread sewage contamination unlikely. The suspect oysters were traced to a single boat. Stool swabs from that boat's oyster harvesters allowed the identification of one asymptomatic carrier who had a strain of S. sonnei (determined by colicin typing, plasmid analysis, and testing for susceptibility to antibiotics) that was similar to or the same as that infecting the patients. Although the source of this man's infection was unknown, he reported having eaten no oysters. Investigation revealed that 5-gallon (19-liter) pails were used as toilets aboard the oyster boats. Sewage collected in these pails was often dumped overboard into the harvesting area. We conclude that this outbreak of S. sonnei resulted from poor sanitary procedures that probably allowed stool from a carrier to contaminate oysters either just before or after they were taken aboard the boat.
我们描述了一起宋内志贺菌感染疫情，24名患者在出现症状前五天内在得克萨斯州东南部的餐厅食用了生牡蛎。所有八家餐厅的牡蛎均由同一经销商供应，但在可能的污染时间前六天采集的一份常规水样检测显示，牡蛎捕捞水域没有粪便污染，因此不太可能存在广泛的污水污染。追踪发现可疑牡蛎来自一艘船。对该船牡蛎采集者的粪便拭子检测发现一名无症状携带者，其携带的宋内志贺菌菌株（通过大肠杆菌素分型、质粒分析及抗生素敏感性检测确定）与感染患者的菌株相似或相同。尽管该男子的感染源不明，但他表示未食用过牡蛎。调查发现，牡蛎船上使用5加仑（19升）桶作为厕所。这些桶中收集的污水经常被倾倒在捕捞区域。我们得出结论，此次宋内志贺菌疫情是由于卫生程序不当导致的，可能是携带者的粪便在牡蛎上船前后污染了它们。
