Snydman D R, Dienstag J L, Stedt B, Brink E W, Ryan D M, Fawaz K A
JAMA. 1981 Feb 27;245(8):827-30.
An outbreak of hepatitis, type A, affecting 30 employees of a large metropolitan department store was investigated using traditional case findings, a food preference questionnaire, and case-control methods. In addition, the new serological tests for IgM and IgG antibody to hepatitis A virus (anti-HAV) were employed to establish a serological diagnosis of hepatitis A infection, to define the control group, and to identify the index case, an asymptomatic food handler. Twenty-five of 25 cases tested had IgM anti-HAV, whereas none of 73 controls and one of 46 food handlers were IgM anti-HAV positive. This test eliminated three suspect cases that were diagnosed as hepatitis but that had atypical epidemiologic features. Epidemiologic and serological analysis confirmed the association of illness with eating in the employees' cafeteria and eating cold sandwiches.
利用传统病例发现法、食物偏好调查问卷和病例对照方法，对一家大型都市百货商店30名员工感染甲型肝炎的疫情进行了调查。此外，采用针对甲型肝炎病毒（抗-HAV）的IgM和IgG抗体新血清学检测来确诊甲型肝炎感染、确定对照组以及识别首例病例，即一名无症状的食品处理人员。25例检测病例中有25例抗-HAV IgM呈阳性，而73名对照者中无人抗-HAV IgM呈阳性，46名食品处理人员中有1人抗-HAV IgM呈阳性。该检测排除了3例被诊断为肝炎但具有非典型流行病学特征的疑似病例。流行病学和血清学分析证实，疾病与在员工自助餐厅就餐和食用冷三明治有关。
