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首页> 外文学位 >Foodworkers as a source for Salmonella: A comprehensive review of the role of infected foodworkers in outbreaks of Salmonella in restaurants of Minnesota.
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Foodworkers as a source for Salmonella: A comprehensive review of the role of infected foodworkers in outbreaks of Salmonella in restaurants of Minnesota.

机译：食品工人是沙门氏菌的来源：对受感染食品工人在明尼苏达州餐馆沙门氏菌暴发中的作用的全面回顾。

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During 1993--1997, Salmonella enterica was the most common foodborne outbreak etiology reported to the Centers for Disease Control and Prevention; 38% of 357 Salmonella outbreaks occurred in commercial food establishments. However, the role of infected foodworkers in Salmonella outbreaks is unclear. The study objective was to characterize restaurant-associated Salmonella outbreaks in Minnesota, and the contribution of infected foodworkers.; Restaurant-associated salmonellosis outbreaks during 1995--2003 (n = 23) were reviewed. The median outbreak duration was 21 days. The median number of culture-confirmed patron-cases per outbreak was seven. The median incubation ranged from 9 hours--6 days. A specific food vehicle was implicated or suspected in 39% of outbreaks. Twelve percent (129/1,033) of foodworkers tested positive for Salmonella, and 53% were reportedly asymptomatic. Among symptomatic foodworkers, the median shedding duration was 30 days, vs. 3 days for asymptomatic foodworkers (p = 0.004). Positive environmental samples were recovered in four of 12 (33%) outbreaks. Outbreaks with positive environmental samples lasted 187 days, vs. 26 days of those without (p = 0.03), did not have an identified vehicle, and had a higher proportion of positive foodworkers (22% vs. 8%).; Salmonella shedding in the stool of foodworkers identified through routine surveillance was quantified. During 1997--2004, 110 culture-confirmed Salmonella foodworker-cases were identified. The median shedding duration (n = 85) was 27 days, but varied by serotype. Twenty (18%) foodworkers were part of outbreaks, including 12 at the restaurants where they worked. The identification of foodworker cases through surveillance often prompted initiation of investigations.; During 1997--2001, six outbreaks were identified in a restaurant chain. Four of five investigated outbreaks were characterized by few patron-cases over prolonged periods (53--517 days). Environmental contamination, infected foodworkers (4%--36%), and lack of identified vehicles were characteristic of four outbreaks. One outbreak associated with eggs had many infected patrons, few infected foodworkers (3%), and no environmental contamination.; Infected foodworkers identified through surveillance should raise a high index of suspicion of an outbreak. Prolonged outbreak durations suggest a persistent reservoir of contamination. Infected foodworkers likely serve as an important source for transmission; therefore, assessment of foodworker infection is essential for controlling restaurant-associated salmonellosis outbreaks.
机译：在1993--1997年期间，肠沙门氏菌是向疾病控制与预防中心报告的最常见的食源性暴发病因; 357例沙门氏菌暴发中有38％发生在商业食品企业中。但是，尚不清楚受感染的食品工人在沙门氏菌暴发中的作用。该研究的目的是描述明尼苏达州与餐馆相关的沙门氏菌暴发以及受感染的食品工人的贡献。回顾了1995--2003年间与餐厅相关的沙门氏菌病暴发（n = 23）。中位爆发时间为21天。每次暴发的经文化确认的赞助人病例中位数为七个。中位潜伏期为9小时至-6天。在39％的爆发中涉及或怀疑有特定的食物传播媒介。百分之十二（129 / 1,033）的食品工人沙门氏菌检测呈阳性，据报道53％无症状。在有症状的食品工中，中位持续时间为30天，而无症状的食品工中位数为3天（p = 0.004）。在12例暴发中有4例（33％）暴发了阳性环境样本。环境样本呈阳性的暴发持续了187天，而没有环境样本的暴发暴发了26天（p = 0.03），没有确定的传播媒介，阳性食物从业者比例更高（22％比8％）。对通过常规监测确定的食品工人粪便中的沙门氏菌数量进行了定量。在1997--2004年期间，确定了110个经过文化确认的沙门氏菌食品工人案例。中位数脱落持续时间（n = 85）为27天，但因血清型而异。二十名（18％）的食品工人是疫情的一部分，其中包括他们工作的餐厅中的12名工人。通过监视来识别食品工人的案例常常促使人们开始调查。在1997--2001年期间，在一家连锁餐厅中发现了6起暴发。在五个被调查的暴发中，有四个在较长时间内（53--517天）受到顾客保护。环境污染，受污染的食品工人（4％-36％）和缺乏可识别的媒介是四次暴发的特征。一次与鸡蛋有关的暴发有许多受感染的顾客，受感染的食品工人（3％）和没有环境污染。通过监视确定的受感染食品工人应提高对疫情的怀疑指数。暴发时间延长表明存在持续的污染源。受感染的食品工人可能是传播的重要来源。因此，对食品工人感染的评估对于控制与餐厅相关的沙门氏菌病暴发至关重要。

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