Grotto I, Mandel Y, Ashkenazi I, Shemer J
Army Health Branch, IDF Medical Corps.
Harefuah. 1997 Oct 2;133(7-8):255-64, 336.
Acute infectious diseases of the gastrointestinal tract and food poisoning are problems of great importance in the Israel Defense Forces (IDF). They involve individual and epidemic morbidity, with impairment of health of individual soldiers and in the activities of units. Outbreaks of gastrointestinal infectious diseases must be reported to the IDF army health branch, which conducts epidemiological investigation. This study is based on data from yearly epidemiological reports for 1978-1989, and from a computerized database for the years 1990-1995. The incidence of outbreaks is characterized by an unstable trend. It was highest at the end of the 80's (68.3 per 100,000 soldiers on active duty) and lowest for the last 2 years (1994-1995, 36.3 per 100,000). The incidence of soldiers involved in food-borne outbreaks has been more stable, constantly declining during the course of the years. There was marked seasonality with a peak in the summer months. Sporadic morbidity was constant in 1990-1995, with a yearly attack rate of 60% in soldiers on active duty. Shigella strains were the leading cause of outbreaks until 1993, while in 1994-1995 their proportion decreased, with an increase in the proportion of Salmonella strains. As to Staphylococcus aureus, its role in causing food poisoning has been characterized by marked changes. Shigella sonnei replaced Shigella flexneri as the leading strain. 73.3% of outbreaks were small, with fewer than 40 soldiers involved, while 5.4% of outbreaks affected more than 100 soldiers. Outbreaks in which a bacterial agent was identified or which occurred in new-recruit bases were larger than those in which a bacterial agent was not identified, or which occurred in active field unit bases. In conclusion, the rates of infectious disease of the gastrointestinal tract are still high, although there has been a marked decrease since 1994. The incidence of outbreaks has also decreased, as well as the role of Shigella as a leading causative agent.
胃肠道急性传染病和食物中毒是以色列国防军（IDF）极为重要的问题。它们涉及个人发病和群体发病，会损害士兵个人健康并影响部队行动。胃肠道传染病暴发必须上报给IDF军队卫生部门，该部门会进行流行病学调查。本研究基于1978 - 1989年的年度流行病学报告数据以及1990 - 1995年的计算机化数据库。暴发的发生率呈现不稳定趋势。在80年代末最高（每10万名现役士兵中有68.3例），在最后两年（1994 - 1995年）最低（每10万名中有36.3例）。食源性暴发所涉及士兵的发生率较为稳定，多年来持续下降。存在明显的季节性，夏季月份达到高峰。1990 - 1995年散发病例发生率保持稳定，现役士兵的年发病率为60%。直到1993年，志贺氏菌菌株一直是暴发的主要原因，而在1994 - 1995年其比例下降，沙门氏菌菌株比例上升。至于金黄色葡萄球菌，其在引起食物中毒方面的作用发生了显著变化。宋内志贺氏菌取代福氏志贺氏菌成为主要菌株。73.3%的暴发规模较小，涉及士兵少于40人，而5.4%的暴发影响了100多名士兵。确定了细菌病原体的暴发或发生在新兵基地的暴发比未确定细菌病原体的暴发或发生在现役野战部队基地的暴发规模更大。总之，尽管自1994年以来胃肠道传染病发病率显著下降，但仍处于较高水平。暴发发生率以及志贺氏菌作为主要病原体的作用也有所下降。
