Article(id=1241034442781815084, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202502127, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1739116800000, receivedDateStr=2025-02-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815268464, onlineDateStr=2026-03-18, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815268464, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815268464, creator=13701087609, updateTime=1773815268464, updator=13701087609, issue=Issue{id=1241034441380917539, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='11', pageStart='1921', pageEnd='2112', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815268130, creator=13701087609, updateTime=1773815340947, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241034746873049765, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241034746873049766, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2096, endPage=2100, ext={EN=ArticleExt(id=1241034443041861938, articleId=1241034442781815084, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Assessment of the burden and risk classification of Vibrio parahaemolyticus foodborne diseases in Liaoning Province, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the burden of foodborne diseases caused by Vibrio parahaemolyticus in Liaoning Province and to clarify the risk associated with different types of food, thereby assisting in foodborne disease prevention efforts.

Methods

Using surveillance data of foodborne disease cases from 2014 to 2023 in Liaoning Province, the population level of foodborne diseases burden caused by Vibrio parahaemolyticus was estimated using the disease burden pyramid model. The main food types contributing to Vibrio parahaemolyticus infections were also classified by attributable risk.

Results

Based on active surveillance data from sentinel hospitals, the multiple factor for Vibrio parahaemolyticus infections was found to be 86.50,indicating that for every reported case, approximately 87 cases occurred within the coverage area of the sentinel monitoring hospitals. Utilizing provincial case data, the multiple factor was 428.37 (95% CI: 424.05-432.62), suggesting that for each reported case, around 428 cases occurred across the province. It was estimated that from 2014 to 2023, there were a total of 440 448 (95% CI: 421 202-460 607) cases of Vibrio parahaemolyticus infections in Liaoning Province, with an annual incidence rate of approximately 103.41 per 100 000 people (95% CI: 98.85-108.11). Risk classification for various food items indicated that seafood posed the highest risk, accounting for 50.20% of infections, with shellfish being the highest-risk food type, followed by shrimp and watermelon.

Conclusion

Based on the multiple factor; it can be concluded that the burden of Vibrio parahaemolyticus infections in Liaoning Province is slightly higher than in other coastal regions. Seafood, particularly shellfish, is the primary cause of foodborne diseases associated with Vibrio parahaemolyticus in Liaoning Province. Continued enhancement of prevention and education efforts targeting key populations and regions is necessary to guide residents in the proper consumption of seafood, as well as to improve disease burden assessment work.

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目的

了解辽宁省副溶血性弧菌导致的食源性疾病负担状况,明确不同食物种类对感染造成的风险情况,为食源性疾病预防工作提供帮助。

方法

利用2014—2023年辽宁省食源性疾病病例监测数据,使用疾病负担金字塔模型估计副溶血性弧菌导致食源性疾病的人群负担水平,并对造成副溶血性弧菌感染的主要食品种类进行归因风险分级。

结果

基于哨点医院主动监测数据构建金字塔模型,副溶血性弧菌感染低估系数为86.50,即监测到1例副溶血性弧菌感染病例,哨点监测医院覆盖范围内共发生约87例病例;基于全省病例数据构建金字塔模型,副溶血性弧菌感染低估系数428.37(95%CI:424.05~432.62),即每监测到1例副溶血性弧菌感染病例,全省范围内共发生约428例病例。估计2014—2023年辽宁省全省共发生副溶血性弧菌感染440 448例(95%CI:421 202~460 607),年发病率约为103.41/10万(95%CI:98.85~108.11)。对导致副溶血性弧菌感染的各类食品进行风险分级,认为水产品造成的风险最高,50.20%的感染可归因于水产品,贝类是风险最高的食物种类,其次为虾类和西瓜。

结论

基于低估系数,可以认为辽宁省副溶血性弧菌感染负担水平略高于其他沿海地区,水产品,尤其是贝类,是导致辽宁省副溶血性弧菌食源性疾病的最主要原因,应继续加强对重点人群及地区的预防宣教工作,指导居民正确食用海产品,同时完善疾病负担评估工作。

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刁文丽,E-mail:
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于浩淼(2000—),女,硕士在读,研究方向:食品卫生

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于浩淼(2000—),女,硕士在读,研究方向:食品卫生

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Analysis of the pollution status of vibrio parahaemolyticus in seafood in Jiangsu Province from 2010 to 2020[J].Jiangsu Journal of Preventive Medicine, 2023, 34(1): 89-92.(In Chinese), articleTitle=Analysis of the pollution status of vibrio parahaemolyticus in seafood in Jiangsu Province from 2010 to 2020, refAbstract=null), Reference(id=1241050842799854158, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442781815084, doi=null, pmid=null, pmcid=null, year=2022, volume=16, issue=3, pageStart=510, pageEnd=518, url=null, language=null, rfNumber=[14], rfOrder=22, authorNames=Uguru H, Akpokodje OI, Sami R, journalName=J. Biobased?Mater. Bioenergy, refType=null, unstructuredReference=Uguru H, Akpokodje OI, Sami R, et al. Microbial quality and potential health risks assessment of frequently consume fresh fruits and nuts[J]. J. Biobased?Mater. 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Methods for probability estimation of the number of infection cases of Vibrio parahaemolyticus in the population

, figureFileSmall=null, figureFileBig=null, tableContent=
低估系数概率估计(Beta分布)实际病例数补充病例数(负二项分布)
报告率p5Beta~(报告人数+1,阳性人数-报告人数+1)S6Negbin~(S6,p5)
敏感度p4p4
S5=S6+Negbin~(S6,p5)Negbin~(S5,p4)
检测率p3Beta~(检测人数+1,采样人数-检测人数+1)S4=S5+Negbin~(S5,p4)Negbin~(S4,p3)
采样率p2Beta~(采样人数+1,就诊人数-采样人数+1)S3=S4+Negbin~(S4,p3)Negbin~(S3,p5)
就诊率p1Beta~(就诊人数+1,发病人数-就诊人数+1)S2=S3+Negbin~(S3,p2)Negbin~(S2,p1)
实际感染S=S2+Negbin~(S2,p1)
), ArticleFig(id=1241050836063801698, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442781815084, language=CN, label=表1, caption=

人群副溶感染实际病例数概率估计方法

, figureFileSmall=null, figureFileBig=null, tableContent=
低估系数概率估计(Beta分布)实际病例数补充病例数(负二项分布)
报告率p5Beta~(报告人数+1,阳性人数-报告人数+1)S6Negbin~(S6,p5)
敏感度p4p4
S5=S6+Negbin~(S6,p5)Negbin~(S5,p4)
检测率p3Beta~(检测人数+1,采样人数-检测人数+1)S4=S5+Negbin~(S5,p4)Negbin~(S4,p3)
采样率p2Beta~(采样人数+1,就诊人数-采样人数+1)S3=S4+Negbin~(S4,p3)Negbin~(S3,p5)
就诊率p1Beta~(就诊人数+1,发病人数-就诊人数+1)S2=S3+Negbin~(S3,p2)Negbin~(S2,p1)
实际感染S=S2+Negbin~(S2,p1)
), ArticleFig(id=1241050836181242220, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442781815084, language=EN, label=Table 2, caption=

The probability estimation of the infection probability of Vibrio parahaemolyticus in different age groups in Liaoning Province

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组
(岁)
监测数据概率估计(95%CI
病例数年发病率
(/10万)
病例数年发病率(/10万)
<110.05428(410~448)19.46(18.62~20.36)
1~400.0000.00
5~9170.107 280(6 803~7 801)43.85(41.97~45.87)
10~1480.053 426(3 208~3 671)20.90(19.50~22.38)
15~241350.3857 884(54 039~61 939)175.34(163.61~187.83)
25~444890.42209 668(195 623~224 311)178.24(170.42~186.41)
45~642990.20128 205(119 573~137 391)84.66(79.03~90.60)
≥65790.1133 873(31 625~36 228)45.67(42.69~48.93)
), ArticleFig(id=1241050836298682739, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442781815084, language=CN, label=表2, caption=

概率估计辽宁省不同年龄组副溶血性弧菌感染情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组
(岁)
监测数据概率估计(95%CI
病例数年发病率
(/10万)
病例数年发病率(/10万)
<110.05428(410~448)19.46(18.62~20.36)
1~400.0000.00
5~9170.107 280(6 803~7 801)43.85(41.97~45.87)
10~1480.053 426(3 208~3 671)20.90(19.50~22.38)
15~241350.3857 884(54 039~61 939)175.34(163.61~187.83)
25~444890.42209 668(195 623~224 311)178.24(170.42~186.41)
45~642990.20128 205(119 573~137 391)84.66(79.03~90.60)
≥65790.1133 873(31 625~36 228)45.67(42.69~48.93)
), ArticleFig(id=1241050836529369466, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442781815084, language=EN, label=Table 3, caption=

Burden ranking of food category-pathogen combinations by Vibrio parahaemolyticus in Liaoning Province from 2014 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
食品种类YLDs*百分比(%)
水产品128.6750.20
肉与肉制品42.3016.50
水果及其制品23.819.29
蔬菜及其制品15.966.23
米面制品12.164.74
混合食品11.404.45
多种食品6.842.67
豆及豆制品5.832.27
冷冻饮品5.071.98
乳与乳制品2.280.89
蛋与蛋制品2.030.79
), ArticleFig(id=1241050836705530244, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442781815084, language=CN, label=表3, caption=

2014—2023年辽宁省副溶血性弧菌感染食品种类-病原体组合负担排序

, figureFileSmall=null, figureFileBig=null, tableContent=
食品种类YLDs*百分比(%)
水产品128.6750.20
肉与肉制品42.3016.50
水果及其制品23.819.29
蔬菜及其制品15.966.23
米面制品12.164.74
混合食品11.404.45
多种食品6.842.67
豆及豆制品5.832.27
冷冻饮品5.071.98
乳与乳制品2.280.89
蛋与蛋制品2.030.79
), ArticleFig(id=1241050836936216973, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442781815084, language=EN, label=Table 4, caption=

Ranking of specific food-pathogen combinations by Vibrio parahaemolyticus in Liaoning Province from 2014 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
具体食品YLDs*百分比(%)
贝类35.9714.03
24.329.49
西瓜15.706.13
螃蟹13.685.34
蚬子9.883.85
9.373.66
猪肉8.613.36
烧烤7.853.06
羊肉7.352.87
扇贝6.592.57
), ArticleFig(id=1241050837221429651, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442781815084, language=CN, label=表4, caption=

2014—2023年辽宁省副溶血性弧菌感染具体食品-病原体组合负担排序

, figureFileSmall=null, figureFileBig=null, tableContent=
具体食品YLDs*百分比(%)
贝类35.9714.03
24.329.49
西瓜15.706.13
螃蟹13.685.34
蚬子9.883.85
9.373.66
猪肉8.613.36
烧烤7.853.06
羊肉7.352.87
扇贝6.592.57
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辽宁省副溶血性弧菌食源性疾病负担评估及风险分级
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于浩淼 , 马雅洁 , 王凯琳 , 杜肖肖 , 张浩 , 刁文丽
现代预防医学 | 疾病预防控制 2025,52(11): 2096-2100
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现代预防医学 | 疾病预防控制 2025, 52(11): 2096-2100
辽宁省副溶血性弧菌食源性疾病负担评估及风险分级
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于浩淼, 马雅洁, 王凯琳, 杜肖肖, 张浩, 刁文丽
作者信息
  • 辽宁省疾病预防控制中心,辽宁 沈阳 110000
  • 于浩淼(2000—),女,硕士在读,研究方向:食品卫生

通讯作者:

刁文丽,E-mail:
Assessment of the burden and risk classification of Vibrio parahaemolyticus foodborne diseases in Liaoning Province
Hao-miao YU, Ya-jie MA, Kai-lin WANG, Xiao-xiao DU, Hao ZHANG, Wen-li DIAO
Affiliations
  • Liaoning Center of Disease Control and Prevention, Shenyang, Liaoning 110000, China
出版时间: 2025-06-10 doi: 10.20043/j.cnki.MPM.202502127
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目的

了解辽宁省副溶血性弧菌导致的食源性疾病负担状况,明确不同食物种类对感染造成的风险情况,为食源性疾病预防工作提供帮助。

方法

利用2014—2023年辽宁省食源性疾病病例监测数据,使用疾病负担金字塔模型估计副溶血性弧菌导致食源性疾病的人群负担水平,并对造成副溶血性弧菌感染的主要食品种类进行归因风险分级。

结果

基于哨点医院主动监测数据构建金字塔模型,副溶血性弧菌感染低估系数为86.50,即监测到1例副溶血性弧菌感染病例,哨点监测医院覆盖范围内共发生约87例病例;基于全省病例数据构建金字塔模型,副溶血性弧菌感染低估系数428.37(95%CI:424.05~432.62),即每监测到1例副溶血性弧菌感染病例,全省范围内共发生约428例病例。估计2014—2023年辽宁省全省共发生副溶血性弧菌感染440 448例(95%CI:421 202~460 607),年发病率约为103.41/10万(95%CI:98.85~108.11)。对导致副溶血性弧菌感染的各类食品进行风险分级,认为水产品造成的风险最高,50.20%的感染可归因于水产品,贝类是风险最高的食物种类,其次为虾类和西瓜。

结论

基于低估系数,可以认为辽宁省副溶血性弧菌感染负担水平略高于其他沿海地区,水产品,尤其是贝类,是导致辽宁省副溶血性弧菌食源性疾病的最主要原因,应继续加强对重点人群及地区的预防宣教工作,指导居民正确食用海产品,同时完善疾病负担评估工作。

食源性疾病  /  副溶血性弧菌  /  疾病负担  /  风险分级
Objective

To understand the burden of foodborne diseases caused by Vibrio parahaemolyticus in Liaoning Province and to clarify the risk associated with different types of food, thereby assisting in foodborne disease prevention efforts.

Methods

Using surveillance data of foodborne disease cases from 2014 to 2023 in Liaoning Province, the population level of foodborne diseases burden caused by Vibrio parahaemolyticus was estimated using the disease burden pyramid model. The main food types contributing to Vibrio parahaemolyticus infections were also classified by attributable risk.

Results

Based on active surveillance data from sentinel hospitals, the multiple factor for Vibrio parahaemolyticus infections was found to be 86.50,indicating that for every reported case, approximately 87 cases occurred within the coverage area of the sentinel monitoring hospitals. Utilizing provincial case data, the multiple factor was 428.37 (95% CI: 424.05-432.62), suggesting that for each reported case, around 428 cases occurred across the province. It was estimated that from 2014 to 2023, there were a total of 440 448 (95% CI: 421 202-460 607) cases of Vibrio parahaemolyticus infections in Liaoning Province, with an annual incidence rate of approximately 103.41 per 100 000 people (95% CI: 98.85-108.11). Risk classification for various food items indicated that seafood posed the highest risk, accounting for 50.20% of infections, with shellfish being the highest-risk food type, followed by shrimp and watermelon.

Conclusion

Based on the multiple factor; it can be concluded that the burden of Vibrio parahaemolyticus infections in Liaoning Province is slightly higher than in other coastal regions. Seafood, particularly shellfish, is the primary cause of foodborne diseases associated with Vibrio parahaemolyticus in Liaoning Province. Continued enhancement of prevention and education efforts targeting key populations and regions is necessary to guide residents in the proper consumption of seafood, as well as to improve disease burden assessment work.

Foodborne diseases  /  Vibrio parahaemolyticus  /  Disease burden  /  Risk classification
于浩淼, 马雅洁, 王凯琳, 杜肖肖, 张浩, 刁文丽. 辽宁省副溶血性弧菌食源性疾病负担评估及风险分级. 现代预防医学, 2025 , 52 (11) : 2096 -2100 . DOI: 10.20043/j.cnki.MPM.202502127
Hao-miao YU, Ya-jie MA, Kai-lin WANG, Xiao-xiao DU, Hao ZHANG, Wen-li DIAO. Assessment of the burden and risk classification of Vibrio parahaemolyticus foodborne diseases in Liaoning Province[J]. Modern Preventive Medicine, 2025 , 52 (11) : 2096 -2100 . DOI: 10.20043/j.cnki.MPM.202502127
食源性疾病是指细菌病毒等物质通过摄食方式进入人体,从而引起一系列急慢性症状。估计我国每年由副溶血性弧菌引起的食源性疾病患病人数可达1 074万例[1]。副溶血性弧菌广泛存在于海水、海底沉积物及各种海鲜中,通常由食用未完全烹饪或受污染海产品导致感染,是我国沿海地区食源性疾病的主要原因[2-4]。辽宁省作为沿海省份,产出大量海产品,海产品消费者覆盖辽宁省内外,明确辽宁省副溶血性弧菌感染导致食源性疾病的负担水平及主要污染食品的风险情况,有助于确保食品卫生,保证人民健康,为食源性疾病预防工作提供数据支持。
研究数据来源于2014—2023年上报至辽宁省食源性疾病病例监测平台的副溶血性弧菌病例数据,包括各医疗机构上报的病例监测数据,及监测医院报告的主动监测数据,不纳入暴发数据。
副溶血性弧菌感染通常表现为腹痛腹泻、恶心呕吐,少数患者有发热头痛头晕等症状,患者腹痛多集中在上腹部与脐周,粪便多呈水样便,严重者可出现粘液便及黏血便。医疗机构上报符合临床症状且粪便标本检出副溶血性弧菌的病例至监测平台,粪便标本病原学检测遵从《国家食源性疾病监测工作手册》中生物标本检验标准进行。病例信息采集已征询患者同意,并通过伦理审查(伦理审查号:LNCDCEC- 2024-010号)。
研究使用@risk 4.3.0软件,基于蒙特卡洛模拟方法,模拟10 000次,实现病例概率估计,并使用Spearman相关系数对概率估计结果进行不确定性分析。使用R 4.3.0进行伤残调整寿命年(disability-adjusted life years,DALYs)计算及风险分级。所有统计分析结果均基于双侧检验,检验水准α=0.05。
考虑到病例上报的各环节均存在诊断不足和漏报的情况,使用疾病负担金字塔模型估计各层损失的数据情况,从而推测副溶血性弧菌感染的真实情况[5]。低估系数(multiple factor)为金字塔相邻两层间率的倒数的乘积,可以反应每监测到一例病例,人群中患病情况被低估的程度。将低估系数与报告病例数相乘,可以估计人群副溶血性弧菌感染的实际情况。疾病负担金字塔模型详见图1
概率估计方法见表1,模型各层率取值方法如下。
p1就诊率:由于辽宁省缺少急性胃肠炎人群就诊率数据,故参考黑龙江省急性胃肠炎病人就诊率[6],即就诊率p1=9.31%
p2采样率、p3标本检测率:基于辽宁省主动监测病例数据计算。
p4实验室监测敏感度:参考广东省实验室敏感度测量值[7],认为哨点医院监测敏感度p4=87.50%;其他各级医疗机构监测敏感度p4=47.50%。
p5报告率:基于以下公式进行计算:(1)副溶血性食源性疾病比例(%)=哨点医院副溶血性弧菌阳性数/哨点医院食源性疾病病例总数;(2)全省副溶血性食源性疾病阳性数=全省医疗机构报告病例数×副溶血性食源性疾病比例(%);(3)副溶血性弧菌感染报告率(%)=哨点医院副溶血性弧菌阳性数/全省副溶血性食源性疾病阳性数。
在本次风险分级中,主要危害的微生物为副溶血性弧菌。食品分类方案包括水产品、肉与肉制品、蛋及其制品等,具体分类如下。
(1)水产品:虾类、蟹类、贝类、鱼类、乌贼、其他水产品。
(2)肉与肉制品:烧烤、猪肉、牛肉、羊肉、鸡肉、鸭肉、其他禽肉。
(3)蔬菜及蔬菜制品:新鲜蔬菜、干菜、蔬菜制品。
(4)水果及水果制品:西瓜、桃子、梨、草莓、其他水果、水果制品。
(5)豆与豆制品:非发酵豆制品、发酵豆制品。
(6)混合食品:凉拌菜、烤肉拌饭、麻辣烫。
(7)多种食品:自助餐、隔夜剩菜、其他多种食品。
(8)蛋及其制品:鸡蛋、鸭蛋、皮蛋。
(9)米面制品:米及其制品、面及其制品。
(10)冷冻饮品:雪糕、冰激凌。
(11)乳与乳制品:牛奶、酸奶。
以辽宁省2014—2023年经概率估计的副溶血性弧菌人群发病人数为可能性指标;以副溶血性弧菌的DALYs/病例数来估计严重性[8]。DALYs由疾病死亡所引起的早死损失寿命年(YLLs)和疾病伤残所引起的残损失寿命年(YLDs)两部分组成,即DALYs =YLLs + YLDs。YLDs = N×DW×D,N为不同致病因子导致的发病人数,DW为不同致病因子的伤残权重,D为不同致病因子的平均持续时间。
由于副溶血性弧菌感染食源性疾病通常较少发生死亡病例,且死亡病例导致的负担较重容易导致结果偏差,本研究不纳入YLLs指标。
2014—2023年,辽宁省主动监测哨点医院共报告70 309例病例,采集标本30 006例,29 405例进行实验室检测,确定副溶血性弧菌感染阳性病例1 023例,阳性检出率3.41%。根据主动监测数据建立负担金字塔模型,就诊率p1=9.31%、采样率p2=42.68%、标本检测率p3=98.00%、实验室敏感度p4=87.50%、副溶病例报告率p5=33.74%进行计算,各层系数分别为10.74、2.34、1.02、1.14、2.96,总低估系数为86.50,即监测到1例副溶血性弧菌感染病例,主动监测医院覆盖范围内共发生约87例病例。
2014—2023年,辽宁省医疗机构共监测食源性疾病208 455例,采样33 262例,共32 618例进行实验室检测,确定副溶血性弧菌感染阳性病例1 028例。根据全省医疗机构监测数据就诊率p1=9.31%、采样率p2=15.96%、标本检测率p3=98.06%、实验室敏感度p4=47.50%、副溶病例报告率p5=33.74%,各层系数分别为10.74、6.27、1.02、2.11、2.96,总低估系数为428.99,即监测到1例副溶血性弧菌感染病例,全省范围内共发生约429例病例。
使用概率估计方法,估计辽宁省全省副溶感染情况,经概率估计,就诊率p1=9.31%(95%CI:8.90%~9.72%)、采样率p2=15.96%(95%CI:15.80%~16.11%)、标本检测率p3=98.06%(95%CI:97.91%~98.21%)、实验室敏感度p4=47.50%(95%CI:46.93%~48.07%)、副溶病例报告率p5=33.75%(95%CI:32.08%~35.44%),模型总倍数为428.37(424.05~432.62),即每监测到1例副溶血性弧菌感染病例,全省范围内共发生约428例病例。估计2014—2023年辽宁省全省共发生副溶血性弧菌感染440 448例(95%CI:421 202~460 607),平均每年副溶血性弧菌感染44 030人,年发病率约为103.41/10万(95%CI:98.85~108.11)。各年龄组负担情况见表2
使用Spearman相关系数对补充病例数与实际病例数间关联程度进行分析,结果如图2所示,补充就诊数对实际病例数估计的贡献最多,呈正相关,说明就诊病例越多,在实际病例数估计中的不确定性分析影响越小,提高副溶血性弧菌病人就诊率,是准确估计人群实际病例数的关键。补充采样数及补充阳性数贡献较小,补充报告数及补充检测数对总体估计几乎无影响。
基于概率估计的发病率及实际患病人数估计副溶血性弧菌的疾病负担为256.32 DALYs。
将疾病负担归因到食品,以可能性和严重性为指标进行风险分级,结果显示,水产品造成的风险最高,肉与肉制品和水果及水果制品的风险分别位列第二位和第三位,计算食品类别与病原体组合的YLD值,水产品导致了辽宁省副溶血性弧菌感染率的50.20%,肉与肉制品导致了副溶血性弧菌感染率的16.50%。见图3表3
为了锁定确切的可疑食品,我们对感染风险位于前三位的食物种类,即水产品、肉与肉制品、水果及水果制品进行更细致的分类,前十位具体食品风险见图4表4。贝类风险最高,辽宁省可归因于贝类的副溶血性弧菌感染率占14.03%,虾和西瓜分别位列第二位和第三位。
2014—2023年,辽宁省主动监测共报告1 023例副溶血性弧菌感染导致的食源性疾病,阳性检出率3.41%,低于无锡市[9]阳性率5.22%,与宁波市[10]阳性检出率3.06%相近。
基于主动监测的副溶血性弧菌感染低估系数约为87,基于被动监测的低估系数约为429,说明主动监测发现病人的能力更强,在病例报告的过程中漏诊漏报情况比被动监测好。基于被动监测数据,对辽宁省全省副溶血性弧菌感染情况进行概率估计,结果显示副溶血性弧菌感染低估系数为428.37,低于我国[1]研究低估系数4 137,高于浙江省[11]低估系数136.2,上海市[2]低估系数59,估计2014—2023年辽宁省副溶血性弧菌人群实际病例达440 448例,平均每年发生44 030例,副溶血性弧菌感染年发病率约为103.41/10万,低于我国[1]研究计算的806/10万、浙江省[11]的206/10万及上海市[2]的183/10万。加强居民就诊率可以保证负担估计的准确性。辽宁省副溶血性弧菌低估系数高于其他沿海地区,而发病率低于其他沿海地区,与监测系统报告的副溶血性弧菌病例数差异有关,此类差异可能与医院医疗水平、研究时间、区位及人口差异等因素有关。
在导致副溶血性弧菌感染的食品中,水产品造成的风险最高,导致了副溶血性弧菌感染的50.20%,这符合沿海地区水产品消费量大,食源性致病菌多以副溶血性弧菌为主的特点[12]。本研究表明贝类、虾类海产品的风险高于其他海产品,这与江苏省的研究结果类似[13]。辽宁省作为中国重要的贝类养殖地之一,贝类种类多、消费量大,造成副溶血性弧菌感染的风险高。鲜切西瓜容易受到致病微生物的污染,有很高的健康风险[14],同时辽宁省是重要的西瓜种植地之一,西瓜产量大、消费大,上市时间多在夏季,其高风险可能与存放不当、易造成交叉污染有关。
研究初步了解了辽宁省副溶血性弧菌的负担水平及各类食品造成的风险情况,建议加强水产品及其制品的污染监测工作,指导居民正确烹饪食用海产品。本研究数据来源于食源性疾病监测平台,未就医患者的患病情况并未纳入统计,研究就诊率参考其他省市研究结果所得,与辽宁省实际就诊情况可能有所不同,对研究结果产生影响,后续可以通过开展人群抽样调查以了解居民的患病、就医情况,补全缺失数据,纳入其他统计学方法进一步完善研究,评估副溶血性弧菌感染造成的疾病负担情况,保证研究结果的可靠性。
  • 辽宁省食源性疾病预测预警分析模型建立及人群疾病负担等相关食品安全关键技术研究(2024JH2/102500073)
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doi: 10.20043/j.cnki.MPM.202502127
  • 接收时间:2025-02-10
  • 首发时间:2026-03-18
  • 出版时间:2025-06-10
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  • 收稿日期:2025-02-10
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辽宁省食源性疾病预测预警分析模型建立及人群疾病负担等相关食品安全关键技术研究(2024JH2/102500073)
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    辽宁省疾病预防控制中心,辽宁 沈阳 110000

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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