| Objective:Based on the data analysis of foodborne disease surveillance in Nanjing,Jiangsu Province from 2017 to 2019,the distribution,incidence and epidemic characteristics of foodborne diseases in Nanjing are understood,so as to provide a scientific basis for improving the ability of foodborne disease identification,early warning,traceability and prevention and control,as well as the development of targeted prevention and control measures.Methods:The basic information,clinical symptoms and signs,preliminary diagnosis,dietary exposure history and sample collection of foodborne disease surveillance cases in Nanjing from 2017to 2019 were collected.At the same time,the hospital has the ability to monitor the laboratory detection of samples for Salmonella,Vibrio parahaemolyticus,Shigella,diarrhea-causing Escherichia coli and five viruses such as norovirus,rotavirus,zaru virus,astrovirus,adenovirus pathogenic detection;Epidemiological investigation reports of foodborne disease outbreaks occurred during the period were collected to analyze the epidemiological characteristics of foodborne diseases and the distribution of pathogens.Results:(1)A total of 8886 cases of foodborne diseases were monitored in this study,including 4586male cases(51.61%)and 4300 female cases(48.39%).The age range was mainly from 25 to 44 years old,accounting for 3605 cases(40.57%).The most clear occupational distribution was the retiree(13.45%);The main clinical symptoms were digestive system symptoms,accounting for 99.55%of all cases.The incidence was mainly concentrated in the third quarter,with 4396 cases(49.47%).The most cases were 1771 in July,accounting for 19.93%.Among the self-reported suspicious exposure histories,meat and meat products accounted for 24.14%(2126 cases).Suspicious eating places were mainly distributed in families,accounting for 56.39%(4,958 cases).(2)In this study,a total of 4303 samples were tested for food-borne pathogenic bacteria,and 381strains of pathogenic bacteria were detected,with an overall detection rate of 8.85%.Among 1341samples,123 were detected positive,with an overall positive rate of 9.13%.The highest isolation rate of Vibrio parahaemolyticus was 3.74%(161/4303),and the highest positive rate of norovirus was5.79%(78/1347).There was statistical significance in the overall detection rate of pathogenic bacteria and the detection rate of Vibrio parahaemolyticus among different years(χ~2were 13.918 and 31.995,respectively,both P<0.001).The positive rates of rotavirus and adenovirus were significantly different among different years(χ~2were 6.556 and 6.126,respectively,P<0.05).The detection rate of pathogenic bacteria and viruses in 2017 was higher than that in other years.There were statistically significant differences in the detection rates of Salmonella and Vibrio parahaemolyticus among different age groups(χ~2were 43.405 and 66.960,respectively,P<0.001).,The isolation rate of pathogenic bacteria was the highest in the age group of 25-44 years old,which was 9.43%.There were significant differences in the positive rate of norovirus and the overall positive rate of norovirus among different age groups(χ~2were 11.504 and 20.385,both P<0.05).,he highest positive rate was 13.82%in the 0-4 year old group.The drug resistance rate of pathogenic bacteria to ampicillin was relatively high.The drug resistance rate of Vibrio parahaemolyticus was also higher than that of cefazoline.The serotypes of Salmonella were mainly Salmonella enteritidis and Salmonella typhimurium,and the detected Escherichia coli was mainly adhesive Escherichia coli.Cluster analysis of pathogenic bacteria showed that the genotypes were dispersed and no obvious aggregation was found.(3)A total of 58 outbreaks of foodborne diseases were reported in this study,including 829 cases of illness,31 hospitalizations and 1 death.The number of outbreaks reported in 2019 was the lowest.The outbreak events mainly occurred in July and August,accounting for 58.62%of the whole year.Most of the reported outbreaks occurred in Jiangning District,accounting for 48.28%.The main causes were pathogenic microorganisms and toxins(38 cases),accounting for 65.52%of all reports.The outbreaks mainly occurred in hotels and restaurants,accounting for 43.10%of all outbreaks.The scale of foodborne disease outbreaks was mainly less than 10 people,with a total of 29 cases,accounting for 50%of the total reported in the city.Conclusion:(1)Food-borne diseases in Nanjing show a clear seasonal trend.The third quarter is the focus of food-borne disease prevention and control.Retired people account for a relatively high proportion of the affected population,and targeted prevention and control strategies are required.In food safety risk monitoring,special monitoring of meat and meat products can be carried out,and food safety publicity and education in home places can be strengthened.(2)Vibrio parahaemolyticus has the highest detection rate of pathogenic bacteria in the active surveillance of food-borne diseases in Nanjing.Strengthen the monitoring and supervision of the food hygiene of seafood,and norovirus has been detected in children under 5 years of age.The highest rate,we need to develop a targeted strategy to increase the number and scope of monitoring.The status of antibiotic resistance requires attention and continuous monitoring.At the same time,these drugs should be used rationally in clinical treatment.(3)Food-borne disease outbreaks in Nanjing mainly occur in summer,mostly in hotels and restaurants,and are mainly caused by pathogenic microorganisms and toxins.It is necessary to formulate targeted publicity and training in the process of food safety and health education.The reporting of disease outbreaks is in urgent need of improvement. |
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