Evans M R, Roberts R J, Ribeiro C D, Gardner D, Kembrey D
Department of Public Health Medicine, South Glamorgan Health Authority, Cardiff.
Epidemiol Infect. 1996 Dec;117(3):457-62. doi: 10.1017/s0950268800059112.
After a nursery school trip to a dairy farm, 20 (53%) of 38 children and 3 (23%) of 13 adult helpers developed gastrointestinal infection. Campylobacter jejuni was isolated from 15 primary cases and from 3 of 9 secondary household cases. A cohort study of the school party found illness to be associated with drinking raw milk (relative risk 5.4, 95% confidence interval 1.4-20.4, P = 0.001). There was a significant dose response relationship between amount of raw milk consumed and risk of illness (chi 2-test for linear trend 12.1, P = 0.0005) but not with incubation period, severity of symptoms or duration of illness. All 18 human campylobacter isolates were C. jejuni resistotype 02 and either biotype I (number 16) or biotype II (number 2). Campylobacter was also isolated from samples of dairy cattle and bird faeces obtained at the farm but these were of different resisto/biotypes. Educational farm visits have become increasingly popular in recent years and this outbreak illustrates the hazard of exposure to raw milk in this setting.
在一所幼儿园组织前往奶牛场的参观活动后，38名儿童中有20名（53%）以及13名成人助手中有3名（23%）出现了胃肠道感染。从15例原发性病例以及9例继发性家庭病例中的3例中分离出了空肠弯曲菌。对学校参观团进行的一项队列研究发现，患病与饮用生牛奶有关（相对风险为5.4，95%置信区间为1.4 - 20.4，P = 0.001）。饮用生牛奶的量与患病风险之间存在显著的剂量反应关系（线性趋势的卡方检验为12.1，P = 0.0005），但与潜伏期、症状严重程度或病程无关。所有18株人源弯曲菌分离株均为空肠弯曲菌抗性型02，生物型为I（16株）或生物型为II（2株）。在农场采集的奶牛和鸟类粪便样本中也分离出了弯曲菌，但这些菌株具有不同的抗性/生物型。近年来，教育农场参观活动越来越受欢迎，此次疫情说明了在这种情况下接触生牛奶的危害。
