Gessner B D, Middaugh J P
Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, GA.
Am J Epidemiol. 1995 Apr 15;141(8):766-70. doi: 10.1093/oxfordjournals.aje.a117499.
Outbreaks of paralytic shellfish poisoning have occurred worldwide. The authors reviewed records at the Alaska Division of Public Health to determine the epidemiologic characteristics of this disease. To assess risk factors for illness, the authors conducted a case-control study. A case was defined as illness compatible with paralytic shellfish poisoning within 12 hours of the consumption of shellfish, and a control was defined as a non-ill participant at a meal in which at least one case occurred. The authors documented 54 outbreaks of paralytic shellfish poisoning involving 117 ill persons from 1973 to 1992. One person died, four (3%) required intubation, and 29 (25%) required an emergency flight to a hospital. Outbreaks occurred with multiple shellfish species, during all four seasons, and at many locations. During the case-control study, illness was not associated with the shellfish toxin level, method of preparation, dose, race, sex, or age; alcohol consumption was associated with a reduced risk of illness (odds ratio = 0.05; p = 0.03). Although paralytic shellfish poisoning causes significant illness, the authors could not identify risk factors with clear implications for prevention strategies. This suggests that shellfish from uncertified beaches should not be eaten. Alcohol may protect against the adverse effects of paralytic shellfish poison.
麻痹性贝类中毒已在全球范围内爆发。作者查阅了阿拉斯加公共卫生部的记录，以确定这种疾病的流行病学特征。为了评估发病的风险因素，作者进行了一项病例对照研究。病例定义为食用贝类后12小时内出现与麻痹性贝类中毒相符的病症，对照定义为在至少有一例病例发生的用餐中未患病的参与者。作者记录了1973年至1992年期间54起麻痹性贝类中毒事件，涉及117名患者。一人死亡，四人（3%）需要插管，29人（25%）需要紧急空运至医院。多类贝类都会引发中毒事件，四季皆有发生，且地点众多。在病例对照研究中，发病与贝类毒素水平、制备方法、剂量、种族、性别或年龄无关；饮酒与发病风险降低有关（比值比=0.05；p=0.03）。尽管麻痹性贝类中毒会导致严重疾病，但作者无法确定对预防策略有明确影响的风险因素。这表明不应食用来自未经认证海滩的贝类。酒精可能会预防麻痹性贝类毒素的不良反应。
