Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Epidemiological Investigation for Outbreak of Clostridium perfringens Enteritis among Students at a College in 2018

2018년 중부지방 일개 대학에서 집단 발생한 클로스트리듐 퍼프린젠스 감염증

  • Bae, Eun-Joo (Department Health Policy, Sejong Special Self-governing City) ;
  • Hwang, Se-Min (Department Health Policy, Sejong Special Self-governing City) ;
  • Kwon, Guen-Yong (Community Health Center of Sejong Special Self-governing City) ;
  • Lee, Moo-Sik (Department of Preventive Medicine, College of Medicine, Konyang University)
  • 배은주 (세종특별자치시 보건정책과) ;
  • 황세민 (세종특별자치시 보건정책과) ;
  • 권근용 (세종특별자치시보건소) ;
  • 이무식 (건양대학교 의과대학 예방의학교실)
  • Received : 2020.02.18
  • Accepted : 2020.05.21
  • Published : 2020.06.30
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Abstract

Purpose: This study was conducted to provide the results of the epidemiological investigation for outbreak of Clostridium perfringens enteritis among students at a college in Sejong City. Methods: This investigation was performed between May 25 and May 28, 2018. The Sejong City public health authority received a complaint which was about 40 university students experienced vomiting or diarrhea. We immediately set up an epidemiological investigation team and conducted a field epidemiological investigation. Results: The overall incidence was 86 out of 153 (56.2%). The estimated risk exposure time was 12 o'clock on the previous day, and the cause was contaminated during distribution and storage of the lunch box provided for lunch on the day of the athletic competition, with 13 hours of average incubation period. The outbreak was closed on May 28, and the identified pathogen was Clostridium perfringens. Conclusions: It was proposed that food poisoning by Clostridium perfringens was likely and contaminated during group meal.

2018년 5월 25일 10:00경 세종시 소재 일개 대학교 학생 40여명 정도가 설사 및 구토 증상 등을 주된 증상으로 하는 집단 발생으로 시청콜센터와 보건소를 통해 발생 신고가 접수되었다. 우리는 즉각 역학조사반을 구성(위생과 포함)하여 당일 14:30분에 현장 역학조사를 실시하였다. 역학조사결과, 최종 발생규모는 153명중 86명(56.2%) 등 이었다. 추정위험 노출시간은 전날 12시로, 원인은 체육대회 당일 점심으로 제공된 도시락의 유통·저장 과정에서 오염된 것으로 추정되었으며, 평균잠복기 13시간이었다. 발생은 5월 28일 종결되었으며, 검사결과는 6월 11일 통보되었는데 동정된 세균은 클로스트리듐 퍼프린젠스(Clostridium perfringens)이었다. 이러한 조사결과를 통하여 클로스트리듐 퍼프린젠스에 의한 식중독이 집단 급식, 도시락의 유통 및 저장과 전달과정에서 오염 가능성과 발생이 가능함을 확인하였다. 세종특별자치시의 검사의뢰전달체계의 구축이 필요하고, 향후 보건환경연구원 등 지역지원 임상병리 검사기관의 설치운영이 시급한 과제이다. 아울러 충분한 검사 예산과 이에 따른 신속한 검사지원체계의 구축이 필요하다. 클로스트리듐 퍼프린젠스에 의한 식중독이 집단 급식, 즉 도시락의 유통 및 저장과 전달과정에서 오염 가능성과 발생이 가능함을 확인하였다.

Keywords

References

  1. Lee KT, Kim S, Chong MS. Epidemiological study on acute diarrheal disease of children and adolescents in the Jeju region using a multiplex-PCR. Korean J Clin Lab Sci 2017;49(2):141-149 https://doi.org/10.15324/kjcls.2017.49.2.141
  2. Payne DC1, Vinje J, Szilagyi PG, Edwards KM, Staat MA, Weinberg GA, Hall CB, Chappell J, Bernstein DI, Curns AT, Wikswo M, Shirley SH, Hall AJ, Lopman B, Parashar UD. Norovirus and medically attended gastroenteritis in U.S children. N Engl J Med 2013;368(12):1121-1130 https://doi.org/10.1056/NEJMsa1206589
  3. Das JK, Salam RA, Bhutta ZA. Global burden of childhood diarrhea and interventions. Curr Opin Infect Dis 2014;27:451-458 https://doi.org/10.1097/QCO.0000000000000096
  4. Riddle MS, DuPont HL, Connor BA. ACG clinical guideline: diagnosis, treatment, and prevention of acute diarrheal infections in adults. Am J Gastroenterol 2016;111:602-622 https://doi.org/10.1038/ajg.2016.126
  5. Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, et al. Foodborne illness acquired in the United States: Major pathogens. Emerg Infect Dis 2011;17(1):7-15 https://doi.org/10.3201/eid1701.P11101
  6. Shim JO. Differential diagnosis of acute diarrheal disorders in children. J Korean Med Assoc 2012;55(6):516-524 https://doi.org/10.5124/jkma.2012.55.6.516
  7. Nam GW, Kim SJ, Yoon KS. Quantitative microbial risk assessment of Clostridium perfringens in beef jerky. Korean J Food Sci Technol 2018;50(6):621-628 https://doi.org/10.9721/KJFST.2018.50.6.621
  8. Uzal FA, Vidal JE, MaClane BA, Gurjar AA. Clostridium perfringens toxins involved in mammalian veterinary disease. Open Toxinology J 2010;3:24-42 https://doi.org/10.2174/1875414701003020024
  9. Korea Center for Disease Control and Prevention. Guideline for communicable diseases, 2018
  10. Korea Center for Disease Control and Prevention. Guideline for water borne and food borne diseases, 2018 pp. 249.
  11. Park SH, Choi OK, Jeong JA. Kim WH, Lee YE, Park KH, Yoon MH. Genetic diversity of Clostridium perfringens form food-poisoning outbreak in Gyeonggi-do, 2013-2014, Korean J Microbiol 2016;52(3):286-297 https://doi.org/10.7845/kjm.2016.6039
  12. Choi SM, Lee DS, Ha GY, Son DS, Lee CI, Enteric Pathogens in Pediatric Patients with Acute Gastroenteritis in Gyeongju, Korea: A Retrospective Study for 7 Years in a Regional Hospital. Microbiol Biotechnol Lett 2019;47(2):289-295 https://doi.org/10.4014/mbl.1810.10005
  13. Lee KT, Kim DS, Chong MS. Multiplex PCR based epidemiological study for the causes of acute diarrheal disease in adults living in Jeju island, Ann Clin Microbiol 2918;21(1):1-7 https://doi.org/10.5145/ACM.2018.21.1.1
  14. Lee K. Future management strategies for zoonoses based on one health, J Agric Med Community Health 2019;44(1):39-42 https://doi.org/10.5393/JAMCH.2019.44.1.039