盧灣區(qū)細(xì)菌性食源性疾病的流行病學(xué)調(diào)查
發(fā)布時(shí)間：2018-11-08 20:18
【摘要】：目的： 本研究通過(guò)回顧性資料分析、現(xiàn)況調(diào)查及病例對(duì)照研究,確定盧灣區(qū)細(xì)菌性食源性疾病的流行病學(xué)特點(diǎn),探討引起疾病的相關(guān)食品、行為、環(huán)境等危險(xiǎn)因素,為采取有效的預(yù)防控制措施提供依據(jù)。 方法： 本調(diào)查采用回顧性調(diào)查、現(xiàn)況調(diào)查和危險(xiǎn)因素調(diào)查相結(jié)合。第一部分流行病學(xué)調(diào)查資料采用2005年～2011年中國(guó)疾病預(yù)防控制信息系統(tǒng)和盧灣區(qū)疾病預(yù)防控制中心各年的工作報(bào)表和年鑒資料。各年人口資料來(lái)源于盧灣區(qū)公安局。第二部分現(xiàn)況調(diào)查采用橫斷面調(diào)查方法。第三部分危險(xiǎn)因素調(diào)查采用病例對(duì)照研究方法。 結(jié)果： 1、盧灣區(qū)的細(xì)菌性食源性疾病以散發(fā)為主,呈長(zhǎng)期變異,發(fā)病季節(jié)明顯,每年的7月-10月份為高發(fā)期,一般8月份達(dá)到全年最高。感染性腹瀉和細(xì)菌性菌痢發(fā)病時(shí)間跨度都較廣,3月～9月以感染性腹瀉為主,10月至翌年1月以細(xì)菌性痢疾為主。 2、盧灣區(qū)的細(xì)菌性食源性疾病主要以感染性腹瀉為主為70%以上,但無(wú)霍亂病例。2005年細(xì)菌性食源性疾病中年發(fā)病率第一位是細(xì)菌性痢疾,但感染性腹瀉自2006年起取代細(xì)菌性痢疾成為首位。 3、盧灣區(qū)的細(xì)菌性食源性疾病在各年齡段均可發(fā)病,其中21歲～30歲最多為23.65%。職業(yè)分布以退休人員和在職人員為主達(dá)50%以上,男女問(wèn)無(wú)顯著性差異(P0.05)。下轄地區(qū)發(fā)病構(gòu)成比從高到低依次是五里橋街道、淮海街道、打浦橋街道和瑞金街道。人口構(gòu)成中流動(dòng)人口發(fā)病比例最高在2005年為57.1%,隨后逐年下降,在2007年達(dá)到最低值34.7%。2007年以后逐漸增加,至2011年達(dá)到56.3%。2005年至2011年間,發(fā)生細(xì)菌性食物中毒3起,發(fā)病數(shù)48人,無(wú)死亡病例,導(dǎo)致中毒的食品來(lái)源有餐飲食品、集體供餐、糕點(diǎn),其中糕點(diǎn)引起的中毒人數(shù)最多為50%。 4、發(fā)病人群中有腹瀉、嘔吐癥狀的分別為100%和18.2%。平均每天腹瀉4.4次、嘔吐2.1次。發(fā)病持續(xù)時(shí)間一般在35小時(shí)。發(fā)病人群的治療為：去醫(yī)院就診為36.4%,糞便送檢為16%,服用過(guò)藥物為70.5%。性別因素在醫(yī)院就診、用藥、糞便送檢等行為的差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。女性均高于男性。 5、細(xì)菌性食源性疾病患者的用藥行為中,止瀉藥的服用率最高為47.7%,其次是抗生素類為20.5%；服用醫(yī)院配藥、家庭自備藥、藥店藥的分別是58.1%、41.9%和16.1%。 6、危險(xiǎn)因素研究發(fā)現(xiàn),發(fā)病前5天中接觸過(guò)動(dòng)物、到過(guò)外地、在外就餐、在外就餐次數(shù)3次及以上都是危險(xiǎn)因素；每周用消毒液清潔廚房臺(tái)面是保護(hù)因素。本地區(qū)細(xì)菌性食源性疾病的發(fā)病與上海中心城區(qū)氣溫呈明顯的正相關(guān)。 結(jié)論： 1、盧灣區(qū)的細(xì)菌性食源性疾病中食物中毒和屬于甲、乙類傳染病的細(xì)菌性食源性疾病得到了很好的控制,但屬于丙類傳染病的細(xì)菌性食源性疾病仍占較大比例,應(yīng)進(jìn)一步加強(qiáng)感染性腹瀉的預(yù)防與控制。 2、盧灣區(qū)的細(xì)菌性食源性疾病發(fā)病季節(jié)明顯,夏秋季是疾病的多發(fā)期。夏秋季節(jié)氣溫高,微生物容易在食物中生長(zhǎng)繁殖,人們對(duì)致病菌引起的食源性疾病普遍易感。此外,在外就餐的青睞促使人們的飲食模式發(fā)生改變,頻繁的外出旅游增加了人口流動(dòng)性,加上飼養(yǎng)寵物等多種因素更易導(dǎo)致疾病的傳播和流行。 3、細(xì)菌性食源性疾病的臨床表現(xiàn)不典型且輕型病例多,所以大部分病例會(huì)以自行用藥方法取代醫(yī)院就診,成為大量病例漏診和誤診的因素。雖然細(xì)菌性食源性疾病引起的癥狀多為輕度,但頻繁的發(fā)病也會(huì)增加個(gè)人、社會(huì)及國(guó)家的醫(yī)保負(fù)擔(dān)。 4、養(yǎng)成良好的就餐習(xí)慣和個(gè)人衛(wèi)生是預(yù)防細(xì)菌性食源性疾病的關(guān)鍵。而且加強(qiáng)食品流通領(lǐng)域和餐飲企業(yè)加工環(huán)節(jié)的管理監(jiān)督更有助于減少細(xì)菌性食源性疾病的發(fā)生。 5、細(xì)菌性食源性疾病監(jiān)測(cè)目前尚處于起步發(fā)展階段,加強(qiáng)致病菌的檢測(cè)技術(shù)和溯源能力,擴(kuò)大致病菌檢測(cè)種類的覆蓋面,深入開(kāi)展主動(dòng)監(jiān)測(cè)、行為因素監(jiān)測(cè),評(píng)估細(xì)菌性食源性疾病風(fēng)險(xiǎn),及時(shí)預(yù)防控制疾病的暴發(fā)。
[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
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R155.5
本文編號(hào)：2319578
[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
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R155.5
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