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沙门氏菌蔓延
作者:USMedEdu
发表时间:2008-06-19
更新时间:2008-06-19
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美国疾病控制和预防中心18日说,美国最近又新确认了106名沙门氏菌病患者,使患者总数达到383人。
  
该中心一位发言人介绍说,这106名患者是在10多天前或更早的时候染病的,但卫生部门直到18日才得到他们的检查结果。经确认,这些患者最早染病的时间是4月10日,最晚的染病时间是6月5日。

  这位发言人说,虽然6月5日后没有发现新患者,但这并不说明疫情已经结束。今年4月以来,美国多个地区陆续报告发现沙门氏菌病患者。据最新统计,沙门氏菌病疫情已经蔓延到美国30个州。患者中至少48人因病情严重住院,其中1人死亡。

  沙门氏菌病是由沙门氏菌引发的肠道感染病。沙门氏菌是通过食物传播的一种病菌,禽肉、禽蛋是引起人类感染的主要感染源。此外,猪肉、牛肉、谷类、水果和蔬菜也可携带这种病菌。患者的临床表现包括头痛、恶心、腹痛、呕吐、腹泻、发热等。



Investigation of Outbreak of Infections Caused by Salmonella Saintpaul
States with persons with the outbreak strain of Salmonella Saintpaul, by state of residence.


CDC is collaborating with public health officials in many states, the Indian Health Service, and the U.S. Food and Drug Administration (FDA) to investigate an ongoing multi-state outbreak of human Salmonella serotype Saintpaul infections. An epidemiologic investigation comparing foods eaten by ill and well persons has identified consumption of raw tomatoes as the likely source of the illnesses. The specific type and source of tomatoes is under investigation; however, the data suggest that illnesses are linked to consumption of raw red plum, red Roma, or round red tomatoes, or any combination of these types of tomatoes, and to products containing these raw tomatoes.

Since April, 383 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 30 states and the District of Columbia: Arkansas (2 persons), Arizona (26), California (8), Colorado (2), Connecticut (2), Florida (1), Georgia (8), Idaho (3), Illinois (34), Indiana (8), Kansas (9), Kentucky (1), Maryland (10), Michigan (3), Missouri (9), New Hampshire (1), New Mexico (70), New York (9), North Carolina (1), Ohio (3), Oklahoma (5), Oregon (4), Pennsylvania (2), Tennessee (4), Texas (131), Utah (2), Virginia (17), Vermont (1), Washington (1), Wisconsin (5), and the District of Columbia (1). These were identified because clinical laboratories in all states send Salmonella strains from ill persons to their State public health laboratory for characterization. The marked increase in reported ill persons is not primarily due to a large number of new infections. The number of reported ill persons increased markedly mainly because some states improved surveillance for Salmonella in response to this outbreak and because laboratory identification of many previously submitted strains was completed. Among the 243 persons with information available, illnesses began between April 10 and June 5, 2008. Patients range in age from <1 to 88 years; 47% are female. At least 48 persons were hospitalized. No deaths have been officially attributed to this outbreak. However, a man in his sixties who died in Texas from cancer had an infection with the outbreak strain of Salmonella Saintpaul at the time of his death. The infection may have contributed to his death.

Only 3 persons infected with this strain of Salmonella Saintpaul were identified in the country during the same period in 2007. The previous rarity of this strain and the distribution of illnesses in all U.S. regions suggest that the implicated tomatoes are distributed throughout much of the country. Because of inherent delays in reporting and because many persons with Salmonella illness do not have a stool specimen tested, it is likely many more illnesses have occurred than those reported. Some of these unreported illnesses may be in states that are not on today’s map.

Clinical features of Salmonella Infection
Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12-72 hours after infection. Infection is usually diagnosed by culture of a stool sample. The illness usually lasts 4-7 days. Although most people recover without treatment, severe infections may occur. Infants, elderly persons, and those with impaired immune systems are more likely than others to develop severe illness. When severe infection occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sites, and can cause death. In these severe cases, antibiotic treatment may be necessary.

Advice to consumers
At this time, FDA is advising U.S. consumers to limit their tomato consumption to those that are not the likely source of this outbreak. These include cherry tomatoes; grape tomatoes; tomatoes sold with the vine still attached; tomatoes grown at home; and red plum, red Roma, and round red tomatoes from specific sources listed at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html*. Consumers should be aware that raw tomatoes are often used in the preparation of fresh salsa, guacamole, and pico de gallo, are part of fillings for tortillas, and are used in many other dishes.

Consumers everywhere are advised to:

Refrigerate within 2 hours or discard cut, peeled, or cooked tomatoes.
Avoid purchasing bruised or damaged tomatoes and discard any that appear spoiled.
Thoroughly wash all tomatoes under running water.
Keep tomatoes that will be consumed raw separate from raw meats, raw seafood, and raw produce items.
Wash cutting boards, dishes, utensils, and counter tops with hot water and soap when switching between types of food products.
FDA recommends that U.S. retail outlets, restaurants, and food service operators offer only fresh and fresh cut red plum, red Roma, and round red tomatoes and food products made from these tomatoes from specific sources listed at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html#retailers*. Cherry tomatoes, grape tomatoes, and tomatoes sold with the vine still attached from any source may be offered.

FDA information on this investigation can be found at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html*

More information about Salmonella and this investigation can be found at:

Salmonella in tomatoes FAQs
New Mexico Department of Health (PDF – 191 KB)
Arizona Department of Health Services News Release - Tomatoes: Caution Urged*
Texas Department of State Health Services - News Update, June 13, 2008*
Kansas Identifies 3 Cases Linked to Multi-State Salmonella Outbreak*
Kentucky Cabinet for Health and Family Services Press Release*
Indiana State Department of Health Media Update on Salmonella Outbreak*
Maryland Department of Health and Mental Hygiene News Release*
Missouri DHHS: State health department issues cautions about tomatoes*
Ohio Department of Health: Salmonella Investigation (PDF – 67 KB)
Utah Department of Health: Health News*
Information on the safe handling of produce can be found at: www.cfsan.fda.gov/~dms/prodsafe.html.*

Previous Updates on this Outbreak
June 16, 2008
June 12, 2008
June 9, 2008
June 7, 2008
June 5, 2008
June 2, 2008
* Links to non-Federal organizations found at this site are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. CDC is not responsible for the content of the individual organization Web pages found at these links.

Please note: Some of these publications are available for download only as *.pdf files. These files require Adobe Acrobat Reader in order to be viewed. Please review the information on downloading and using Acrobat Reader software.

Page last modified: June 18, 2008
Content Source: National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)

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1   [dokknife 于 2008-06-25 09:32:48 提到] [FROM: 10.]
Investigation of Outbreak of Infections Caused by Salmonella Saintpaul



Related to the Outbreak of Salmonella Saintpaul infections associated with tomatoes.Information updated as of 9 am, June 24, 2008

Click Here for Advice to Consumers

CDC is collaborating with public health officials in many states, the Indian Health Service, and the U.S. Food and Drug Administration (FDA) to investigate an ongoing multi-state outbreak of human Salmonella serotype Saintpaul infections. An epidemiologic investigation comparing foods eaten by ill and well persons has identified consumption of raw tomatoes as the likely source of the illnesses. The specific type and source of tomatoes is under investigation; however, the data suggest that illnesses are linked to consumption of raw red plum, red Roma, or round red tomatoes, or any combination of these types of tomatoes, and to products containing these raw tomatoes.

Since April, 652 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 34 states and the District of Columbia. These were identified because clinical laboratories in all states send Salmonella strains from ill persons to their State public health laboratory for characterization. The increase in reported ill persons since the last update is not thought to be due to a large number of new infections. The number of reported ill persons increased mainly because some states improved surveillance for Salmonella in response to this outbreak and because laboratory identification of many previously submitted strains was completed. In particular, one new state, Nevada reported ill persons. The number of ill persons identified in each state is as follows: Arkansas (3 persons), Arizona (34), California (8), Colorado (5), Connecticut (4), Florida (1), Georgia (14), Idaho (3), Illinois (45), Indiana (9), Kansas (9), Kentucky (1), Maryland (18), Massachusetts (14), Michigan (4), Missouri (12), New Hampshire (1), Nevada (4), New Jersey (4), New Mexico (79), New York (18), North Carolina (1), Ohio (3), Oklahoma (17), Oregon (5), Pennsylvania (5), Rhode Island (2), Tennessee (5), Texas (293), Utah (2), Virginia (21), Vermont (1), Washington (1), Wisconsin (5), and the District of Columbia (1). Among the 325 persons with information available, illnesses began between April 10 and June 13, 2008. Patients range in age from <1 to 99 years; 50% are female. At least 71 persons were hospitalized. No deaths have been officially attributed to this outbreak. However, a man in his sixties who died in Texas from cancer had an infection with the outbreak strain of Salmonella Saintpaul at the time of his death. The infection may have contributed to his death.

Only 3 persons infected with this strain of Salmonella Saintpaul were identified in the country during the same period in 2007. The previous rarity of this strain and the distribution of illnesses in all U.S. regions suggest that the implicated tomatoes are distributed throughout much of the country. Because of inherent delays in reporting and because many persons with Salmonella illness do not have a stool specimen tested, it is likely many more illnesses have occurred than those reported. Some of these unreported illnesses may be in states that are not on today’s map.

Clinical features of Salmonella Infection
Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12-72 hours after infection. Infection is usually diagnosed by culture of a stool sample. The illness usually lasts 4-7 days. Although most people recover without treatment, severe infections may occur. Infants, elderly persons, and those with impaired immune systems are more likely than others to develop severe illness. When severe infection occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sites, and can cause death. In these severe cases, antibiotic treatment may be necessary.

Advice to consumers
At this time, FDA is advising U.S. consumers to limit their tomato consumption to those that are not the likely source of this outbreak. These include cherry tomatoes; grape tomatoes; tomatoes sold with the vine still attached; tomatoes grown at home; and red plum, red Roma, and round red tomatoes from specific sources listed at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html*. Consumers should be aware that raw tomatoes are often used in the preparation of fresh salsa, guacamole, and pico de gallo, are part of fillings for tortillas, and are used in many other dishes.

Consumers everywhere are advised to:

Refrigerate within 2 hours or discard cut, peeled, or cooked tomatoes.
Avoid purchasing bruised or damaged tomatoes and discard any that appear spoiled.
Thoroughly wash all tomatoes under running water.
Keep tomatoes that will be consumed raw separate from raw meats, raw seafood, and raw produce items.
Wash cutting boards, dishes, utensils, and counter tops with hot water and soap when switching between types of food products.
FDA recommends that U.S. retail outlets, restaurants, and food service operators offer only fresh and fresh cut red plum, red Roma, and round red tomatoes and food products made from these tomatoes from specific sources listed at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html#retailers*. Cherry tomatoes, grape tomatoes, and tomatoes sold with the vine still attached from any source may be offered.

FDA information on this investigation can be found at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html*

More information about Salmonella and this investigation can be found at:

Salmonella in tomatoes FAQs
Timeline for Reporting of Cases
New Mexico Department of Health (PDF – 191 KB)
Arizona Department of Health Services News Release - Tomatoes: Caution Urged*
Texas Department of State Health Services - News Update, June 13, 2008*
Kansas Identifies 3 Cases Linked to Multi-State Salmonella Outbreak*
Kentucky Cabinet for Health and Family Services Press Release*
Indiana State Department of Health Media Update on Salmonella Outbreak*
Maryland Department of Health and Mental Hygiene News Release*
Missouri DHHS: State health department issues cautions about tomatoes*
Ohio Department of Health: Salmonella Investigation (PDF – 67 KB)
Utah Department of Health: Health News*
Information on the safe handling of produce can be found at: www.cfsan.fda.gov/~dms/prodsafe.h
 
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