Wainwright R B, Heyward W L, Middaugh J P, Hatheway C L, Harpster A P, Bender T R
Arctic Investigations Laboratory, Center for Infectious Diseases, Anchorage, Alaska 99501.
J Infect Dis. 1988 Jun;157(6):1158-62. doi: 10.1093/infdis/157.6.1158.
We reviewed records of all food-borne outbreaks of botulism in Alaska from 1947 through 1985. Fifty-nine confirmed or suspected outbreaks with 156 cases were reported. All outbreaks occurred in Alaska Natives and were associated with eating traditional Alaska Native foods. Forty-four (75%) of the outbreaks were laboratory confirmed and involved 133 persons. The overall annual incidence of confirmed or suspected botulism was 8.6 cases per 100,000 population. Seventeen persons died, an overall case-fatality rate of 11%. Type E toxin accounted for 32 (73%) laboratory-confirmed outbreaks; type A, six (14%); and type B, five (11%). Forty-one cases demonstrated botulinal toxin in one or more specimens (serum, gastric contents, or stool). Of the 41 botulinal toxin-positive persons, 38 (93%) had at least three of the commonly recognized pentad of signs or symptoms--nausea and vomiting, dysphagia, diplopia, dilated and fixed pupils, or dry mouth and throat--and 20 (49%) required respiratory assistance.
我们回顾了1947年至1985年阿拉斯加所有食源性肉毒中毒暴发事件的记录。共报告了59起确诊或疑似暴发事件，涉及156例病例。所有暴发事件均发生在阿拉斯加原住民中，且都与食用阿拉斯加原住民传统食物有关。其中44起（75%）暴发事件经实验室确诊，涉及133人。确诊或疑似肉毒中毒的总体年发病率为每10万人8.6例。17人死亡，总体病死率为11%。E型毒素导致32起（73%）经实验室确诊的暴发事件；A型毒素导致6起（14%）；B型毒素导致5起（11%）。41例患者的一个或多个标本（血清、胃内容物或粪便）中检测出肉毒杆菌毒素。在41例肉毒杆菌毒素呈阳性的患者中，38例（93%）至少出现了常见的五项体征或症状中的三项——恶心和呕吐、吞咽困难、复视、瞳孔散大固定或口干和咽喉干燥——20例（49%）需要呼吸支持。
