摩洛哥拉巴特一所培训机构食源性多病原体疾病暴发调查：病例对照研究

Outbreak Investigation of a Multipathogen Foodborne Disease in a Training Institute in Rabat, Morocco: Case-Control Study.

作者信息

Moumni Abdou Houda, Dahbi Ilham, Akrim Mohammed, Meski Fatima Zahra, Khader Yousef, Lakranbi Mohammed, Ezzine Hind, Khattabi Asmae

机构信息

Field Epidemiology Training Program, Ecole Nationale de Santé Publique, Ministry of Health, Rabat, Morocco.

Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Amman, Jordan.

出版信息

JMIR Public Health Surveill. 2019 Sep 25;5(3):e14227. doi: 10.2196/14227.

DOI:10.2196/14227

PMID:31573941

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6785723/

Abstract

BACKGROUND

On June 18, 2017, the public health service was alerted about 43 students in the training institute in Rabat who were admitted to the emergency room for acute gastroenteritis following the uptake of a meal a day before.

OBJECTIVE

This study aimed to investigate the foodborne disease outbreak by confirming the outbreak, identifying the source of contamination, and recommending control measures.

METHODS

We conducted a case-control study. Cases and controls were selected in a ratio of 1:1. We defined a case as any member of the training institute who attended the Ramadan buffet in the institute's restaurant and who had presented, in the weekend of June 16 to 20, 2017, symptoms of diarrhea or vomiting with at least one of the following signs: abdominal pain, fever, headache, nausea, and dizziness. A control was defined as anyone who attended the Ramadan buffet in the institute's restaurant but had not presented any symptoms from June 16 to 20, 2017. We conducted a bivariate and multivariable analysis. Stools of ill students were collected, and a food specimen was collected for bacterial testing.

RESULTS

A total of 50 cases and 50 controls were selected. Among the cases, males were predominant (43/50, 86%); the median age was 21 years. A total of 47 cases sought medical care. There were no hospitalizations and no deaths. The episode was short with an estimated average incubation period of 9 hours. The epidemic curve oriented toward a common source of contamination. Among food items, briwates were strongly associated with the illness with an odd ratio of 14.23 (95% CI 5.04-40.04; P<.001). Laboratory testing of briwates showed presence of Escherichia coli O157 and Staphylococcus aureus.

CONCLUSIONS

This foodborne disease outbreak was likely caused by briwates that was contaminated with S aureus and E coli. We recommended strengthening hygiene measures. Food handling techniques should be taught as part of continuous professional development for food handlers.

摘要

背景

2017年6月18日，公共卫生服务部门接到警报，拉巴特一所培训机构的43名学生因前一天用餐后出现急性肠胃炎被送往急诊室。

目的

本研究旨在通过确认疫情、确定污染源并推荐控制措施来调查食源性疾病暴发。

方法

我们进行了一项病例对照研究。病例和对照按1:1的比例选取。我们将病例定义为该培训机构中参加了学院餐厅斋月自助餐的任何成员，且在2017年6月16日至20日周末出现腹泻或呕吐症状，并伴有以下至少一种体征：腹痛、发热、头痛、恶心和头晕。对照定义为参加了学院餐厅斋月自助餐但在2017年6月16日至20日未出现任何症状的任何人。我们进行了双变量和多变量分析。收集了患病学生的粪便，并采集了一份食品样本进行细菌检测。

结果

共选取了50例病例和50名对照。病例中男性占主导（43/50，86%）；中位年龄为21岁。共有47例病例寻求医疗护理。无住院病例和死亡病例。病程较短，估计平均潜伏期为9小时。流行曲线指向一个共同的污染源。在食品项目中，briwates与疾病密切相关，比值比为14.23（95%可信区间5.04 - 40.04；P<0.001）。briwates的实验室检测显示存在大肠杆菌O157和金黄色葡萄球菌。