Cáceres V M, Ball R T, Somerfeldt S A, Mackey R L, Nichols S E, MacKenzie W R, Herwaldt B L
Centers for Disease Control and Prevention, National Immunization Program, Atlanta, GA 30333, USA.
J Fam Pract. 1998 Sep;47(3):231-4.
Cyclospora cayetanensis is a recently recognized parasite that causes prolonged diarrheal illness. Its modes of transmission have not been fully determined, although some investigations before 1996 implicated water. Outbreaks of cyclosporiasis in the United States in 1996 and 1997 are evidence of the increasing incidence of this disease. This report describes an outbreak of cyclosporiasis in persons who attended a luncheon on May 23, 1996, near Charleston, South Carolina.
In this retrospective cohort study, we interviewed all 64 luncheon attendees and the chef regarding food and beverage exposures. A case of cyclosporiasis was defined as diarrhea (> or = 3 loose stools per day or > or = 2 loose stools per day if using antimotility drugs) after attending the luncheon. We identified sporadic cases of cyclosporiasis and traced the implicated food.
Of 64 luncheon attendees, 38 (59%) met the case definition. Persons who ate raspberries (relative risk [RR] = 5.4; 95% confidence interval [CI], 2.2-13.2) or potato salad (RR = 1.8; 95% CI, 1.2-2.6) were at significantly increased risk for illness. The population attributable risk percentages were 73% for raspberries and 20% for potato salad. Cyclospora oocysts were found in stools from 11 (85%) of the 13 case patients submitting specimens for testing. Implicated raspberries originated in Guatemala.
Our investigation is one of the first studies to implicate a specific food (raspberries) as a vehicle for transmission of Cyclospora. Because of the apparent increasing incidence of cyclosporiasis in the United States, family physicians should consider testing for Cyclospora in any patient with prolonged, unexplained diarrhea.
卡耶塔环孢子球虫是一种最近才被认识的可导致长期腹泻疾病的寄生虫。尽管1996年以前的一些调查认为水是其传播途径之一，但其传播方式尚未完全确定。1996年和1997年美国发生的环孢子球虫病暴发证明了这种疾病发病率的上升。本报告描述了1996年5月23日在南卡罗来纳州查尔斯顿附近参加午餐会的人群中发生的一次环孢子球虫病暴发。
在这项回顾性队列研究中，我们就食物和饮料暴露情况对所有64名午餐会参与者及厨师进行了访谈。环孢子球虫病病例定义为参加午餐会后出现腹泻（每天≥3次稀便，或使用止泻药时每天≥2次稀便）。我们确定了散发性环孢子球虫病病例并追踪了相关食物。
64名午餐会参与者中，38人（59%）符合病例定义。食用树莓（相对危险度[RR]=5.4；95%可信区间[CI]，2.2 - 13.2）或土豆沙拉（RR = 1.8；95%CI，1.2 - 2.6）的人患病风险显著增加。树莓和土豆沙拉的人群归因危险度百分比分别为73%和20%。在提交粪便标本进行检测的13例病例患者中，有11例（85%）的粪便中发现了环孢子虫卵囊。受牵连的树莓原产于危地马拉。
我们的调查是最早将一种特定食物（树莓）认定为环孢子球虫传播媒介的研究之一。由于美国环孢子球虫病的发病率明显上升，家庭医生应对任何患有长期不明原因腹泻患者考虑检测环孢子球虫。
