An outbreak of Salmonella Paratyphi A in a boarding school: a community-acquired enteric fever and carriage investigation.
An outbreak of Salmonella Paratyphi A in a boarding school: a community-acquired enteric fever and carriage investigation.
复制标题
一所寄宿学校爆发甲型副伤寒沙门氏菌：社区获得性肠热病和携带调查。
DOI：
10.1017/s0950268810001986
复制
发表时间：
2010
影响因子：
4.2
通讯作者：
Szu,SC
中科院分区：
文献类型：
--
作者：
Yang,HH;Gong,J;Zhang,J;Wang,ML;Yang,J;Wu,GZ;Quan,WL;Gong,HM;Szu,SC
甲型副伤寒沙门氏菌(SPA)正迅速成为东南亚肠热病的常见原因。2004年，中国的一所寄宿中学发生了一次大规模的SPA暴发。疑似病例394例，学生占95.5%。发病率最高的是最小的儿童(7年级)。151例血培养阳性者44例(29%)，54例直肠拭子阳性者4例(7.4%)，厨房工人3例。患者血清抗内毒素抗体几何平均水平高于正常人[35·25比5·20单位(EU)，P<；0·001]。一名厨房工人，直肠拭子阳性，血培养阴性，血清抗内毒素抗体水平高(529·65EU)，被确定为可能的SPA携带者。从水或食物样本中未分离出SPA。一项对学生习惯的调查表明，饮用生水是感染该病的主要原因。洗手是第二个最重要的因素。可能携带SPA的食品处理员也可能是一个风险因素。注意保持安全的供水、加强食品处理者的卫生和适当的洗手有助于防止今后发生类似的疫情。
Salmonella Paratyphi A (SPA) is rapidly becoming a common cause of enteric fever in South East Asia. A large outbreak of SPA occurred in a boarding middle school in China in 2004. There were 394 suspected cases; 95·5% were students. The highest incidence was in the youngest children (7th grade). Forty-four of 151 (29%) blood cultures and 4/54 (7·4%) rectal swabs were positive for SPA; three were from kitchen workers. The geometric mean levels of serum IgG anti-lipopolysaccharide (anti-LPS) from patients was higher than from healthy individuals [35·25 vs. 5·20 ELISA units (EU), P<0·001]. A kitchen worker with a positive rectal swab, negative blood culture and a high level of serum IgG anti-LPS (529·65 EU), was identified as a possible SPA carrier. No SPA was isolated from water or food samples. A survey of students' habits indicated drinking unboiled water as being the main reason for contracting the disease. Hand washing was the second most important factor. A food handler with possible SPA carriage could also have been a risk factor. Attention to maintaining a safe water supply, enhancing food-handler hygiene and proper hand washing can help to prevent similar outbreaks in the future.