Vhiriri Eunice Paidamoyo, Irwin Yoland, Laubscher Richard, Tandlich Roman
Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa.
Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa; Noroff University College, Norway.
Am J Disaster Med. 2020;15(2):113-128. doi: 10.5055/ajdm.2020.0361.
During the 2017-2018 listeriosis outbreak in South Africa (SA), the total number of cases reached 1,060. In this study, the disaster management response to the 2017-2018 South Africa listeriosis outbreak is analyzed. The hazard was in part the contamination of a brand of a ready-to-eat (RTE) "polony" with a strain of Listeria monocytogenes ST6. The initial phase of the 2017-2018 listeriosis outbreak was characterized by a rapid increase in the number of detected human cases. The listeriosis outbreak was officially proclaimed in December 2017, resulting in listeriosis being added to the list of notifiable diseases in SA. The delay between onset and proclamation was a result of the difficulty in identifica-tion of the actual number of cases of listeriosis in the country. The response to the disaster included the coordination of the National Department of Health, the National Institute of Communicable Diseases (NICD), businesses/producers of the contaminated brand of RTE products, and the public. Some of these activities led to the removal of the contami-nated products from the retail sector in March 2018, resulting in a decrease in the number of cases found in SA. In re-sponse to the outbreak, the National Department of Health formed a multisector incidence response team and imple-mented the Emergency Response Plan. Impacts of future listeriosis outbreaks could be mitigated by the adoption of international listeriosis guidelines such as the WHO/FAO and FDA. Practical steps in this context should include setting a limit of L. monocytogenes in RTE products. WHO/FAO and FDA listeriosis policies which are described "zero toler-ance" where a limit of < 100 L. monocytogenes cells/g at the moment of consumption is acceptable can be adopted. Additional resources must be provided for research into infectious doses and the various routes of human exposure.
在2017 - 2018年南非李斯特菌病疫情爆发期间，病例总数达到1060例。在本研究中，分析了对2017 - 2018年南非李斯特菌病疫情爆发的灾害管理应对措施。此次危害部分源于一个即食（RTE）“波兰香肠”品牌被一株单核细胞增生李斯特菌ST6污染。2017 - 2018年李斯特菌病疫情爆发的初始阶段特点是检测到的人类病例数量迅速增加。该李斯特菌病疫情于2017年12月正式宣布，导致李斯特菌病被列入南非须通报疾病名单。发病与宣布之间的延迟是由于难以确定该国李斯特菌病的实际病例数。对此次灾害的应对措施包括国家卫生部、国家传染病研究所（NICD）、受污染即食产品品牌的企业/生产商以及公众之间的协调。其中一些行动导致受污染产品于2018年3月从零售部门下架，从而使南非发现的病例数有所减少。作为对疫情爆发的应对，国家卫生部组建了一个多部门发病应对小组并实施了《应急计划》。未来李斯特菌病疫情爆发的影响可通过采用国际李斯特菌病指南（如世界卫生组织/联合国粮食及农业组织以及美国食品药品监督管理局的指南）来减轻。在此背景下的实际步骤应包括设定即食产品中单核细胞增生李斯特菌的限量。可采用世界卫生组织/联合国粮食及农业组织以及美国食品药品监督管理局的李斯特菌病政策，这些政策描述为“零容忍”，即在消费时每克产品中单核细胞增生李斯特菌细胞数<100个的限量是可接受的。必须提供额外资源用于研究感染剂量以及人类接触的各种途径。
