Investigation and analysis of a food poisoning incident caused by Vibrio parahaemolyticus / 上海预防医学

ObjectiveTo ascertain the causes of a food poisoning incident and provide references for the prevention of similar incidents in the future. MethodsCase investigation was conducted through field epidemiological investigation methods， and suspicious meals and foods were searched by the analytical epidemiological method. A food hygiene investigation was conducted in the establishment involved and samples of suspicious food， processing steps， and cases were collected for laboratory testing. ResultsA total of 91 individuals meeting the case definition were identified， resulting in an attack rate of 14.97% （91/608）. The main clinical manifestations included abdominal pain （97.80%）， diarrhea （84.62%）， nausea （62.64%）， vomiting （72.53%）， fever （12.09%）， and increased white blood cells （90.11%）. The peak incidence occurred from 16：00 to 18：00 on June 15. The epidemic curve showed a point-source exposure pattern， with an incubation period of 1 h minimum and 10 h maximum， and an average of 5 h. Analytical epidemiological studies indicated that lunch on June 15 was the suspicious meal （χ2=38.78， P<0.001）， and those who consumed cold-dressed tofu with preserved eggs had a significantly higher risk of falling ill compared to non-consumers （χ2=105.21， P<0.001）. Laboratory testing results revealed Vibrio parahaemolyticus detected in 1 employee’s anal swab and 18 cases’ anal swabs. Staphylococcus aureus was detected in 1 food ingredient and 1 case’s anal swab. The remaining samples tested negative. ConclusionThe cause of this food poisoning incident is Vibrio parahaemolyticus. The cause is the canteen’s supply of cold-dressed tofu with preserved eggs beyond its permissible business scope， potentially leading to cross-contamination during food processing. Regulatory authorities should strengthen routine law enforcement inspections and monitoring. Food service establishments should strengthen food safety awareness， standardize operational procedures in strict accordance with relevant national laws and regulations and food safety standards， and strive to reduce the occurrence of foodborne disease incidents at their source.

Introduction of the national technical plan for monitoring occupational health literacy of key population groups in 2022 / 中国职业医学

Occupational health literacy refers to the awareness and ability of workers to obtain basic knowledge of occupational health, practice healthy working styles and lifestyles, prevent the risk of occupational and work-related diseases, and maintain and promote their own health. In 2022, for the first time, China carried out nationwide monitoring for occupational health literacy of key populations. The National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention was responsible for technical support, formulating the National Technical Plan for Occupational Health Literacy Monitoring and Intervention of Key Populations, and formulating relevant requirements and specifications for monitoring purposes, monitoring scope and objects, sampling methods, monitoring content and methods, organization and implementation of field investigation, and quality control. In addition, the National Occupational Health Literacy Monitoring Questionnaire for Key Groups was provided, and the monitoring and intervention of occupational health literacy for key groups in the second- and third-key industries has been organized nationwide, so as to understand the occupational health literacy of the occupational population in China and provide important support for promotion of high-quality construction of healthy China.

Immunization program vaccination rates compared between field investigation and information system sample survey / 上海预防医学

Objective To assess the accuracy of immunization program vaccination rates through the immunization program information system by comparing immunization program vaccination rates among children between field investigation and information system sample survey in Shanghai. Methods From three districts in Shanghai， samples were stratified and randomly selected.The PPS sampling method (probability proportional to size) was used for 634 children aged 0-6 years for field investigation and 630 children aged 0-6 years were randomly selected for information system sample survey.The immunization program vaccination rates of children surveyed were investigated， statistically analyzed and compared. Results Statistically significant differences (P < 0.05) were found in the age composition and household registration composition of children sampled by the field investigation and information system sample survey.The national immunization program vaccination rate was 99.91% and timely vaccination rate was 94.29% by the field investigation.The national immunization program vaccination rate was 97.49% and timely vaccination rate was 87.90% by the information system sample survey.All 26 doses of immunization program vaccine surveyed had lower rates of coverage and timely vaccination in the information system sample survey than in the field investigation.Eighteen doses of vaccination rates by information system sample survey data were statistically significantly (P < 0.05) lower than those by field investigation and 20 doses of timely vaccination rates by information system sample survey data were statistically significantly (P < 0.05) lower than those by field investigation. Conclusion There are advantages and disadvantages to both field investigation and information system sample survey of immunization program vaccination rates.Field investigation and information system sample survey should be used in combination to evaluate the vaccination rate in future.

Survey and Consideration on the Current Situation of Pharmacy Management in Rural Community Health Service Station / 中国药房

OBJECTIVE:To survey the current situation of pharmacy management in rural community health service station, put forward some countermeasures and suggestions. METHODS:Questionnaire survey was conducted among pharmacy staff of 145 rural community health service stations in Huzhou Nanxun District,involving 15 related issues as personnel,drug storage enviro-ment and system implementation. The filed investigation was conducted in 112 service stations in respects of environment,drug dis-play,system implementation,outstock/instock record,maintenance record. Suggestions were put forward according to situation. RESULTS:145 questionnaires were sent and returned. Survey results showed that only 22 staff owned pharmacy educational back-ground in 145 stations,accounting for 15.17% of total. Among 112 stations visited,pharmacy management system was complete, but the satiations with complete instock records and maintenance record accounted for only 4.46% and 2.68% respectively. CON-CLUSIONS:At present,the problems exist in pharmacy management of rural community health service stations,such as pharmacy professionals absence,drug storage environment dissatisfaction and uncompleted drug management system. It is recommended to strengthen and improve pharmacy management of rural community health service station through establishing directional training mechanism,online procurement and offline distribution of drug and carrying out pharmacy standard construction,etc.

Hidden varicella outbreak, Luang Prabang Province, the Lao People’s Democratic Republic, December 2014 to January 2015

OBJECTIVE: To identify the etiology and risk factors of undifferentiated fever in a cluster of patients in Western Province, Solomon Islands, May 2014. METHODS: An outbreak investigation with a case control study was conducted. A case was defined as an inpatient in one hospital in Western Province, Solomon Islands with high fever (> 38.5 °C) and a negative malaria microscopy test admitted between 1 and 31 May 2014. Asymptomatic controls matched with the cases residentially were recruited in a ratio of 1:2. Serum samples from the subjects were tested for rickettsial infections using indirect micro-immunofluorescence assay. RESULTS: Nine cases met the outbreak case definition. All cases were male. An eschar was noted in five cases (55%), and one developed pneumonitis. We did not identify any environmental factors associated with illness. Serum samples of all five follow-up cases (100%) had strong-positive IgG responses to scrub typhus. All but one control (10%) had a moderate response against scrub typhus. Four controls had low levels of antibodies against spotted fever group rickettsia, and only one had a low-level response to typhus group rickettsia. DISCUSSION: This outbreak represents the first laboratory-confirmed outbreak of scrub typhus in the Western Province of Solomon Islands. The results suggest that rickettsial infections are more common than currently recognized as a cause of an acute febrile illness. A revised clinical case definition for rickettsial infections and treatment guidelines were developed and shared with provincial health staff for better surveillance and response to future outbreaks of a similar kind.

Ancient books on traditional Chinese medicine in Jiangsu Province and their systemization / 中华医学图书情报杂志

The ancient books on traditional Chinese medicine in Jiangsu Province were recorded and analyzed, fol-lowed by an introduction of their holdings in Jiangsu Province, and suggestions were put forward for their systemiza-tion, such as enforcing the role of special libraries of traditional Chinese medicine, promoting the general survey and report of ancient books on traditional Chinese medicine, and compiling《Jiangsu union catalogue of ancient books on traditional Chinese medicine》.

A survey on the agricultural profession-related injuries among 11 902 rural residents in Shandong province / 中华流行病学杂志

Objective To understand the prevalence and risk factors of agricultural activities related injuries among rural residents in Shandong province. Methods A retrospective investigation was conducted among agricultural profession-related workers in 20 villages with multistage cluster sampling method in Shandong province. Four times face-to-face interview were conducted by trained interviewers, including 32 students and local medical personnel under constructed questionnaires.Accidental injuries occurred in the activities or in the agricultural profession-related jobs were recorded, from May 1st 2009 to April 30st 2010. Data was input and analyzed by SPSS 13.0 statistical software. Results A total of 837 cases reported at least 1 job-related injury out of the 11 902 people who had been surveyed in one year. The crude incidence rate was 7.03% and the standardized incidence rate was 7.36%, higher in males (9.01%) than in females (4.10%), X2= 105.53, P=0.000.Children and adolescents (≤ 14 aged) had the higher incidence rate (9.50%), X2=9.70, P=0.008.People working in the area of commercial service related to agricultural products had the highest incidence rate (12.94%). In particular, those occupations that related to agricultural construction or materials appeared to have had higher incidence rates as 16.80% and 15.59% respectively, than other kinds of jobs (X2= 167.30, P=0.000). There were higher proportion of injuries occurred in the roads (28.79%), in the fields(28.08%) during labor work(38.00%) transportation(27.97%), respectively.The seasonality of agricultural injures mostly occurred between June and August, accounted for 47.43%. Major external causes related to injuries were instruments or tools (31.42%) being used,transportation (24.13%) and falls (20.19%). Wounds on limbs took the majority (56.39%). The accidental self-inflicted injury occupied 76.82%, while accidents to passive injuries occupied 11.47%,other kinds accounted for 11.71%. Most of the accidents caused mild or moderate damage, accounted for 60.22% and 30.34% respectively. 7 cases died of injuries, with the fatality rate as 0.84% and the mortality rate was 58.81 per one hundred thousand. 72 cases ended up in disability caused by injuries,with the morbidity rate as 6.05 per thousand. Answers to the major internal causes of injuries appeared to be: "did not know how to protect oneself" (29.87%) with females (45.41%) in particular,followed by "over fatigue" and "inappropriate treatment" which took the 2nd place in males. Major natural environmental factors of injuries would relate to "high air temperature and humidity but lower wind velocity"(14.93%), "unclear signs on the country road"(12.19%), "the sky was cloudy or dark"(10.87%), "slippery road caused by rain or snow" (10.51%), "kids were unintended" (10.27%) etc.Most of the wounded received treatment clinically (50.18%), with the percentile (P50) of medical cost as 182.76 RMB (Yuan). The proportion of inpatient was 27.72% and with percentile of time as P50=7.57 day and cost as P50=2840.00 RMB Yuan. The wounded had a rest of P50=5.9 days, with an indirect cost as P50=233.16 RMB Yuan. Conclusion The results of this study indicated that the incidence of agricultural profession-related injuries was high, with serious harm. Behavioral intervention and awareness of injuries should be enhanced, together with the improvement of environmental condition.