Foodborne disease outbreaks in United States schools
Foodborne disease outbreaks in United States schools
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DOI：
10.1097/00006454-200207000-00004
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发表时间：
2002-07-01
影响因子：
3.6
通讯作者：
Mead, PS
中科院分区：
文献类型：
--
作者：
Daniels, NA;Mackinnon, L;Mead, PS
背景本研究的目的是描述学校食源性疾病暴发的流行病学，并确定预防措施的目标。本文回顾了1973年1月1日至1997年12月31日，美国各州和地方卫生部门在中小学、大专院校发生的食源性疾病暴发的报告。对通过食源性疫情调查确定并随后报告给食源性疫情监测系统中疾病控制和预防中心的病人数据进行了检查。同时，还对食源性疾病暴发的数量和规模、病原体、传播媒介、食物制备场所以及与暴发相关的影响因素进行了分析。从1973年到1997年，各州和地方卫生部门报告了604起学校食源性疾病爆发。每年学校爆发的中位数为25起（范围9至44起）。在60%的暴发中，病因尚未确定，在45%的暴发中，特定的食物传播媒介尚未确定。沙门氏菌是最常见的病原体，占已知病因的爆发报告的36%。在604起疫情中，有333起（55%）在流行病学上确定了特定的食物传播媒介。最常涉及的媒介物是含有家禽的食品（18.6%）、沙拉（6.0%）、墨西哥食品（6.0%）、牛肉（5.7%）和不包括冰淇淋的乳制品（5.0%）。导致这些学校相关爆发的最常见的食物制备方法是食物储存和保持温度不当以及食物处理人员污染的食物。加强学校的食物安全措施将更好地保护学生和学校工作人员免受食源性疾病的爆发。感染控制政策，如食品处理人员在正确储存和烹饪食品方面的培训和认证，细致的洗手以及患有肠胃炎的食品处理人员的带薪病假，可以使美国学生的膳食更安全。
Background. The objective of this study was to describe the epidemiology of foodborne disease outbreaks in schools and to identify where preventive measures could be targeted.Methods. Reports by state and local health departments of foodborne disease outbreaks occurring in primary and secondary schools, colleges and universities from January 1, 1973, through December 31, 1997, were reviewed. Data from ill persons identified through foodborne outbreak investigations and subsequently reported to the Centers for Disease Control and Prevention in the Foodborne Outbreak Surveillance System were examined. The number and size of foodborne disease outbreaks, as well as the etiologic agents, food vehicles of transmission, site of food preparation and contributing factors associated with outbreaks were also examined.Results. From 1973 through 1997, states and local health departments reported 604 outbreaks of foodborne disease in schools. The median number of school outbreaks annually was 25 (range, 9 to 44). In 60% of the outbreaks an etiology was not determined, and in 45% a specific food vehicle of transmission was not determined. Salmonella was the most commonly identified pathogen, accounting for 36% of outbreak reports with a known etiology. Specific food vehicles of transmission were epidemiologically identified in 333 (55%) of the 604 outbreaks. The most commonly implicated vehicles were foods containing poultry (18.6%), salads (6.0%), Mexican-style food (6.0%), beef (5.7%) and dairy products excluding ice cream (5.0%). The most commonly reported food preparation practices that contributed to these school-related outbreaks were improper food storage and holding temperatures and food contaminated by a food handler.Conclusions. Strengthening food safety measures in schools would better protect students and school staff from outbreaks of foodborne illness. Infection control policies, such as training and certification of food handlers in the proper storage and cooking of foods, meticulous hand washing and paid sick leave for food handlers with gastroenteritis, could make meals safer for American students.