惩教机构中的可预防疾病。1974年至1991年美国由食物传播的特定疾病暴发情况。
Preventable disease in correctional facilities. Desmoteric foodborne outbreaks in the United States, 1974-1991.
作者信息
Cieslak P R, Curtis M B, Coulombier D M, Hathcock A L, Bean N H, Tauxe R V
机构信息
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Ga, USA.
出版信息
Arch Intern Med. 1996 Sep 9;156(16):1883-8. doi: 10.1001/archinte.156.16.1883.
BACKGROUND
Various disease outbreaks have been reported among prisoners. Recent foodborne outbreaks in correctional facilities in Georgia and Delaware prompted us to review the epidemiological characteristics of such outbreaks reported in the United States.
METHODS
Foodborne outbreaks reported to the Centers for Disease Control and Prevention as part of routine surveillance from 1974 to 1991 were examined to identify outbreaks in jails, prisons, correctional facilities, and juvenile detention centers. Outbreak sizes, temporal trends, food vehicles, pathogens, and hygienic transgressions were analyzed.
RESULTS
Eighty-eight desmoteric foodborne outbreaks involving 14307 cases of illness were reported from 31 states and territories. The mean outbreak size was 163 cases, compared with a mean of 31 cases for the 9107 reported outbreaks not involving prisoners. No fatalities among prisoners were reported. No pathogen was identified in 47 (53%) of the 88 outbreaks Salmonella species accounted for 15 (37%) of 41 outbreaks of known cause from 1974 to 1991, Clostridium perfringens for 14 (34%), and Staphylococcus aureus for 9 (22%). Fourteen of 15 Salmonella outbreaks occurred from 1984 to 1991. Food vehicles were reported for 63 (72%) of the outbreaks. Beef and poultry each were implicated in 9 (14%) of these, followed by fish or poultry salads and Mexican food, which accounted for 6 outbreaks (10%). Food-handling errors were reported for 69 (78%) of the 88 outbreaks. Improper food storage was reported in 62 (90%) of these.
CONCLUSIONS
Foodborne outbreaks are reported regularly from correctional facilities in the United States. Outbreaks caused by Salmonella species, a special threat to prisoners with human immunodeficiency virus infection, seem to be increasing. Food production in correctional facilities should meet minimum safety standards, including sufficient refrigeration facilities, training of food handlers, and exemption of ill food handlers from work.
背景
已报告囚犯中发生了各种疾病暴发。佐治亚州和特拉华州惩教设施近期发生的食源性疾病暴发促使我们回顾美国报告的此类暴发的流行病学特征。
方法
对1974年至1991年作为常规监测一部分向疾病控制和预防中心报告的食源性疾病暴发进行检查，以确定监狱、教养所、惩教设施和青少年拘留中心中的暴发情况。分析了暴发规模、时间趋势、食物载体、病原体和卫生违规情况。
结果
来自31个州和地区报告了88起涉及14307例病例的食源性疾病暴发。平均暴发规模为163例病例，相比之下，9107起报告的不涉及囚犯的暴发平均为31例。未报告囚犯中有死亡病例。88起暴发中有47起（53%）未鉴定出病原体。1974年至1991年已知病因的41起暴发中，沙门氏菌属占15起（37%），产气荚膜梭菌占14起（34%），金黄色葡萄球菌占9起（22%）。15起沙门氏菌暴发中有14起发生在1984年至1991年。63起（72%）暴发报告了食物载体。牛肉和家禽各涉及其中9起（14%），其次是鱼或家禽沙拉以及墨西哥食物，各占6起（10%）。88起暴发中有69起（78%）报告了食品处理错误。其中62起（90%）报告了食物储存不当。
结论
美国惩教设施定期报告食源性疾病暴发。沙门氏菌属引起的暴发对感染人类免疫缺陷病毒的囚犯构成特殊威胁，且似乎在增加。惩教设施中的食品生产应符合最低安全标准，包括充足的冷藏设施、食品处理人员培训以及患病食品处理人员不得工作。
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