20192022年武汉市食源性疾病监测结果分析

Surveillance analysis of foodborne diseases in Wuhan from 2019 to 2022

  • 摘要:
    目的 分析武汉市食源性疾病监测结果,了解武汉市食源性疾病的三间分布特征,为预防食源性疾病提供参考依据。
    方法 通过食源性疾病监测网络平台系统收集病例数据。采集部分腹泻病例的粪便、血液、肛拭子及呕吐物样本进行病原体检测,包括沙门菌、志贺菌、大肠埃希菌、副溶血弧菌和诺如病毒。
    结果 2019—2022年武汉市共上报食源性疾病病例14 733例。男、女性别比为1∶0.92。2019年的发病率为3.58人次·万人年-1,为4年中最高,2020年发病率为2.19人次·万人年-1,为4年中最低。发病高峰均在6—10月。江岸区、武昌区和蔡甸区等中心城区发病率较高。食源性疾病发病率最高的年龄段为20~岁,病原体总检出率最高的年龄段为0~岁;发病人群以学生、家务及待业人员和散居儿童为主。可疑食物以素食类食品、其他食品和荤食类食品为主。采集的3 499份生物样本中,1 820份样本同时进行诸如病毒检测,病原菌总检出率为22.89%(801/3 499),其中沙门菌和大肠埃希菌的检出率分别为19.23%(673/3 499)和3.03%(106/3 499),诺如病毒的检出率为4.12%(75/1 820)。进食了婴幼儿食品和乳类及蛋类食品的患者其生物样本的病原菌检出率较高,分别为53.33%和42.93%。就检出病原体而言,沙门菌在进食了婴幼儿食品和乳类及蛋类食品的病例的生物样本中检出率较高,大肠埃希菌在进食了乳类及蛋类食品和荤食类食品的病例的生物样本中检出率较高,副溶血弧菌和诺如病毒在进食了饮料酒水类食品的病例的生物样本中检出率较高。可疑食物多来源于餐饮服务业、零售或农贸市场、家庭自制。沙门菌、副溶血弧菌和大肠埃希菌均在6—9月检出较多,而诺如病毒在冬春季节检出较多。
    结论 武汉市0~29岁人群是食源性疾病的重点高发人群,沙门菌、大肠埃希菌和诺如病毒是武汉市食源性疾病的主要致病菌,市场监管部门应重点加强对婴幼儿食品的监管。

     

    Abstract:
    Objective To analyze the surveillance results of foodborne diseases in Wuhan to investigate the temporal, spatial, and demographic distribution of foodborne disease in Wuhan, so as to provide an evidence for the prevention and control of foodborne diseases.
    Methods Data were collected through the foodborne disease surveillance network system and analyzed statistically. Stool, blood, rectal swabs, and vomitus samples from some diarrhea cases were collected for pathogens detection, including Salmonella, Shigella, Escherichia coli, Vibrio parahaemolyticus, and norovirus.
    Results A total of 14 733 cases of foodborne diseases were reported in Wuhan from 2019 to 2022, with a male-to-female ratio of 1∶0.92. The highest incidence was 3.58 per 10 000 person-years in 2019 and the lowest was 2.19 per 10 000 person-years in 2020. The peak incidence occurred from June to October. Higher incidence rates were observed in central districts such as Jiang’an District, Wuchang District, and Caidian District. The age group with the highest incidence was 20‒29 years, while the age group with the highest total pathogen detection rate was 0‒9 years old. The affected population primarily included middle school students, household workers, and unemployed individuals, and children living at home. Suspected food sources were mainly vegetarian, other miscellaneous foods, and animal-based food. Of the 3 499 biological samples collected, 1 820 of them was conducted a detection for norovirus, the overall detection rate of pathogenic bacteria was 22.89% (801/3 499), with detection rates of Salmonella and Escherichia coli at 19.23% (673/3 499) and 3.03% (106/ 3 499), respectively. The detection rate of norovirus was 4.12% (75/1 820). The detection rate of pathogenic bacteria in biological samples of the patients who consumed infant food, milk, and egg-based foods was higher, at 53.33% and 42.93%, respectively. In terms of detected pathogens, the highest detection rate of Salmonella was found in the biological samples of patients who consumed infant food, milk, and egg-based foods, the highest detection rate of Escherichia coli was found in the biological samples of patients who consumed milk, egg, and animal-based foods, while Vibrio parahaemolyticus and norovirus had higher detection rates in patients who consumed beverages and alcoholic drinks. Suspected food sources were often found in food services, retail or farmer products markets, and homemade food. Salmonella, Vibrio parahaemolyticus, and diarrheagenic Escherichia coli were detected more frequently from June to September, while norovirus was detected more frequently in winter and spring.
    Conclusion The population aged between 0‒29 years in Wuhan is the key high-risk group for foodborne diseases. Salmonella, diarrheagenic Escherichia coli, and norovirus are the main pathogens causing foodborne diseases in Wuhan. Market supervision departments should focus on strengthening the regulation of infant food.

     

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