背景:食源性疾病是全球范围内日益增长的公共卫生问题,家庭是一个常见的环境。本研究旨在探讨浙江省家庭食源性疾病暴发疫情的流行病学特征,并提出有针对性的防控措施。
方法:采用描述性统计方法对2010-2022年浙江省食源性疾病暴发监测系统收集的家庭食源性疾病暴发数据进行分析。
结果:家庭食源性疾病暴发在研究期间呈上升趋势(Cox-Staurt趋势检验,p=0.01563<0.05)。这些疫情主要发生在6月至9月,62.08%(352/567)的所有报告疫情。11个县报告的疫情数量各不相同,最大为100,最小为7。家庭食源性疾病暴发具有广泛的病因。蘑菇毒素占所有病因的比例最大(43.39%),导致住院(54.18%)和死亡(78.26%)的比例最高。这种爆发是由于意外食用野生毒蘑菇引起的。细菌感染(16.23%)是第二常见的病因,沙门氏菌属。副溶血性弧菌是主要的病原体。这些爆发是由存储不当引起的,加工不当或多种因素的组合,涉及的食物主要是水生动物,鸡蛋和煮熟的肉。其他确定的病因包括植物毒素(9.52%),化学品(7.23%),动物毒素(3.70%),和病毒(1.76%)。在上述病因中,蘑菇毒素,细菌,动物毒素具有季节性特征。对地区和病因的分析表明,在11个县中,各种病因的比例不同。野生蘑菇(43.39%),水生动物(9.88%),有毒植物(8.47%)是这些疫情中涉及的三大食物。导致家庭食源性疾病暴发的最常见因素是不可信和滥用(59.08%),其次是多重因素(7.58%),存储不当(7.41%),和加工不当(7.41%)。
结论:家庭食源性疾病暴发与缺乏食源性疾病预防知识密切相关。因此,公共卫生机构应加强居民的监测和健康教育,提高食品安全意识,有效减少家庭食源性疾病的发生。此外,政府有关部门及时宣传和预警,引入控制原材料中致病菌污染的标准,加强对销售可能危害健康的物质的监管,比如有毒的蘑菇和亚硝酸盐,也将有助于减少此类爆发。
BACKGROUND: Foodborne diseases are a growing public health concern worldwide and households are a common setting. This study aimed to explore the epidemiological characteristics of household foodborne disease outbreaks in Zhejiang Province and propose targeted prevention and control measures.
METHODS: Descriptive statistical methods were used to analyze household foodborne disease outbreak data collected from the Foodborne Disease Outbreaks Surveillance System in Zhejiang Province from 2010 to 2022.
RESULTS: Household foodborne disease outbreaks showed an upward trend during the study period (Cox-Staurt trend test, p = 0.01563 < 0.05). These outbreaks mainly occurred from June to September, with 62.08% (352/567) of all reported outbreaks. The number of reported outbreaks varied in 11 prefectures, with a maximum of 100 and a minimum of only 7. Household foodborne disease outbreaks had a wide spectrum of etiologic factors. Mushroom toxins accounted for the largest proportion of all etiologies (43.39 %) and caused the highest proportion of hospitalization (54.18%) and death (78.26%). Such outbreaks are caused by accidently eating wild poisonous mushrooms. Bacterial infection (16.23%) was the second most common etiology, with Salmonella spp. and Vibrio parahaemolyticus being the primary pathogens. These outbreaks were caused by improper storage, improper processing or a combination of factors, and the foods involved were mainly aquatic animals, eggs and cooked meat. Other identified etiologies included plant toxins (9.52%), chemicals (7.23%), animal toxins (3.70%), and viruses (1.76%). Among the above-mentioned etiologies, mushroom toxins, bacteria, and animal toxins had seasonal characteristics. Analysis of regions and etiologies revealed that the proportion of various etiologies was different in 11 prefectures. Wild mushrooms (43.39%), aquatic animals (9.88%), and toxic plants (8.47%) were the top three foods involved in these outbreaks. The most common factors contributing to household foodborne disease outbreaks were inedibility and misuse (59.08%), followed by multiple factors (7.58%), improper storage (7.41%), and improper processing (7.41%).
CONCLUSIONS: Household foodborne disease outbreaks were closely related to the lack of knowledge regarding foodborne disease prevention. Therefore, public health agencies should strengthen residents\' surveillance and health education to improve food safety awareness and effectively reduce foodborne diseases in households. In addition, timely publicity and early warning by relevant government departments, the introduction of standards to control the contamination of pathogenic bacteria in raw materials, and strengthened supervision of the sale of substances that may cause health hazards, such as poisonous mushrooms and nitrites, will also help reduce such outbreaks.