卢湾区细菌性食源性疾病的流行病学调查

发布时间：2018-11-08 20:18

【摘要】：目的：本研究通过回顾性资料分析、现况调查及病例对照研究,确定卢湾区细菌性食源性疾病的流行病学特点,探讨引起疾病的相关食品、行为、环境等危险因素,为采取有效的预防控制措施提供依据。方法：本调查采用回顾性调查、现况调查和危险因素调查相结合。第一部分流行病学调查资料采用2005年～2011年中国疾病预防控制信息系统和卢湾区疾病预防控制中心各年的工作报表和年鉴资料。各年人口资料来源于卢湾区公安局。第二部分现况调查采用横断面调查方法。第三部分危险因素调查采用病例对照研究方法。结果： 1、卢湾区的细菌性食源性疾病以散发为主,呈长期变异,发病季节明显,每年的7月-10月份为高发期,一般8月份达到全年最高。感染性腹泻和细菌性菌痢发病时间跨度都较广,3月～9月以感染性腹泻为主,10月至翌年1月以细菌性痢疾为主。 2、卢湾区的细菌性食源性疾病主要以感染性腹泻为主为70%以上,但无霍乱病例。2005年细菌性食源性疾病中年发病率第一位是细菌性痢疾,但感染性腹泻自2006年起取代细菌性痢疾成为首位。 3、卢湾区的细菌性食源性疾病在各年龄段均可发病,其中21岁～30岁最多为23.65%。职业分布以退休人员和在职人员为主达50%以上,男女问无显著性差异(P0.05)。下辖地区发病构成比从高到低依次是五里桥街道、淮海街道、打浦桥街道和瑞金街道。人口构成中流动人口发病比例最高在2005年为57.1%,随后逐年下降,在2007年达到最低值34.7%。2007年以后逐渐增加,至2011年达到56.3%。2005年至2011年间,发生细菌性食物中毒3起,发病数48人,无死亡病例,导致中毒的食品来源有餐饮食品、集体供餐、糕点,其中糕点引起的中毒人数最多为50%。 4、发病人群中有腹泻、呕吐症状的分别为100%和18.2%。平均每天腹泻4.4次、呕吐2.1次。发病持续时间一般在35小时。发病人群的治疗为：去医院就诊为36.4%,粪便送检为16%,服用过药物为70.5%。性别因素在医院就诊、用药、粪便送检等行为的差异具有统计学意义(P0.05)。女性均高于男性。 5、细菌性食源性疾病患者的用药行为中,止泻药的服用率最高为47.7%,其次是抗生素类为20.5%；服用医院配药、家庭自备药、药店药的分别是58.1%、41.9%和16.1%。 6、危险因素研究发现,发病前5天中接触过动物、到过外地、在外就餐、在外就餐次数3次及以上都是危险因素；每周用消毒液清洁厨房台面是保护因素。本地区细菌性食源性疾病的发病与上海中心城区气温呈明显的正相关。结论： 1、卢湾区的细菌性食源性疾病中食物中毒和属于甲、乙类传染病的细菌性食源性疾病得到了很好的控制,但属于丙类传染病的细菌性食源性疾病仍占较大比例,应进一步加强感染性腹泻的预防与控制。 2、卢湾区的细菌性食源性疾病发病季节明显,夏秋季是疾病的多发期。夏秋季节气温高,微生物容易在食物中生长繁殖,人们对致病菌引起的食源性疾病普遍易感。此外,在外就餐的青睐促使人们的饮食模式发生改变,频繁的外出旅游增加了人口流动性,加上饲养宠物等多种因素更易导致疾病的传播和流行。 3、细菌性食源性疾病的临床表现不典型且轻型病例多,所以大部分病例会以自行用药方法取代医院就诊,成为大量病例漏诊和误诊的因素。虽然细菌性食源性疾病引起的症状多为轻度,但频繁的发病也会增加个人、社会及国家的医保负担。 4、养成良好的就餐习惯和个人卫生是预防细菌性食源性疾病的关键。而且加强食品流通领域和餐饮企业加工环节的管理监督更有助于减少细菌性食源性疾病的发生。 5、细菌性食源性疾病监测目前尚处于起步发展阶段,加强致病菌的检测技术和溯源能力,扩大致病菌检测种类的覆盖面,深入开展主动监测、行为因素监测,评估细菌性食源性疾病风险,及时预防控制疾病的暴发。
[Abstract]:Purpose: The epidemiological characteristics of bacterial food-borne diseases in Luwan District were determined by retrospective data analysis, current status survey and case-control study, and the related food, behavior and environment of the disease were discussed. Factors, to be provided for effective prevention and control measures On the basis of. Methods: Retrospective investigation, status investigation, and safety were used for this survey Combined with the investigation of risk factors, the first part of the epidemiological investigation data is from 2005 to 2011 in China's disease prevention and control information system and the work of the disease prevention and control center of Luwan District. Report and yearbook information. Population information for each year From the Luwan District Public Security Bureau. The second part of the current investigation and production A cross-sectional survey method is used. The third part of the risk factors are investigated and used. case pair The results were as follows: 1. The bacterial food-borne diseases in the Luwan District were mainly distributed, with long-term variation, obvious disease season, and high in July-October of each year. The period of onset, in general, reached the highest in the year of August. The time span of infectious diarrhea and bacterial bacillary dysentery was wide, with infectious diarrhea as the main part in March to September, and 10 From the last month to January of the following year, bacillary dysentery was the main. 2. The bacterial food-borne diseases in Luwan district were mainly infectious diarrhea with more than 70%, but no cases of cholera. The first in the middle age of the bacterial food-borne disease in 2005 was bacillary dysentery, but the infectious diarrhea was self-contained. In 2006, the substitution of bacillary dysentery was the first. The bacterial food-borne diseases in Luwan District were all available in all ages. Disease, among which, 21 to 30 years of age is 23. 65%. The occupational distribution is mainly for retirees and in-service personnel. There was no significant difference between men and women (P0.05). The incidence of the disease in the region was from high to low in order of five. The proportion of floating population in the population consists of 55.7% in 2005 and 34.7% in 2007. In 2007, it gradually increased to 56.3% in 2011. During the period from 2005 to 2011, the bacteria occurred. 3 cases of sex food poisoning, 48 people with no death, the food source of the poisoning has the catering food, the collective food supply, Pastry, in which the highest number of poisoning caused by the cake is 50%. 4. The population of the disease The symptoms of diarrhea and vomiting were 100% and 100%, respectively. 18. 2%. average daily diarrhea 4. 4 times, vomiting of 2. 1 times. The duration of the onset was generally 35 hours. The treatment for the onset population was: the treatment to the hospital was 36. 4% of feces, 16% for stool, and 72.5% for drug. The gender factor is in the hospital, medication, and feces. the difference between the act of being sent for inspection and the like There was no statistical significance (P0.05). The female was higher than that of the male. In the case of the patients with bacterial food-borne diseases, the administration rate of the antidiarrheal agent was 47.7%, followed by the antibiotic class of 25.5%. The hospital was given the medicine and the family was self-contained. The drug and drug store were 58.1%, 41.9% and 160.1%, respectively. 3 times and above are dangerous factors; cleaning the kitchen table with disinfectant is a protective factor. fine area The incidence of bacterial food-borne diseases is positively related to the temperature in the central city of Shanghai. The results are: 1. The food poisoning in the bacterial food-borne diseases of Luwan District and the source of bacterial food belonging to the class A and B. The disease is well controlled, but it belongs to the class C. The bacterial food-borne diseases of the disease still account for a large proportion, and the prevention of infectious diarrhea should be further strengthened and control. The season of bacterial food-borne diseases in Luwan District is obvious, and summer and fall are the multi-stage of disease. The seasonal temperature is high, the microorganisms are easy to grow and propagate in the food, and the food-borne diseases caused by the pathogenic bacteria are generally easy to feel. the propagation and the epidemic of the disease are more likely to be caused by the propagation of many factors, such as the raising of the mobility of the population and the raising of the pets. 3. The clinical manifestations of the bacterial food-borne diseases are not typical and light. In many cases, most of the cases will replace the hospital with the self-medication method, and become a large number of cases of missed diagnosis and misdiagnosis. The symptoms caused by bacterial food-borne diseases are mild, but the frequent occurrence will increase the individual, the medical insurance burden of the society and the state. 4. The formation of good eating habits and personal hygiene is the prevention of bacterial food-borne diseases. the key is to strengthen the management and supervision of the food circulation field and the processing links of the catering enterprises to help reduce the occurrence of bacterial food-borne diseases. 5. The monitoring of the bacterial food-borne diseases is still in the development stage, and the detection technology of the pathogenic bacteria is strengthened. The ability to trace the source and expand the detection of pathogenic bacteria
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R155.5

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