广东省首起误食剧毒裂皮鹅膏菌所致食物中毒死亡分析
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(1.珠海市疾病预防控制中心,广东 珠海 519000;2.东莞市疾病预防控制中心,广东 东莞 523129;3.广东省疾病预防控制中心,广东 广州 511430;4.广州市天河区疾病预防控制中心,广东 广州 510660;5.广东省微生物研究所,广东 广州 510070)

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倪锡河 男 主管医师 研究方向为传染病及食物中毒防控 E-mail:634745589@qq.com通信作者:张巧利 女 主任医师 研究方向为传染病防控 E-mail:zql@dg.gov.cn

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Analysis on the first case of food poisoning death caused by mistaken eating of Amanita rimosa in Guangdong Province
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(1.Zhuhai Center for Disease Control and Prevention,Guangdong Zhuhai 519000,China;2.Dongguan Center for Disease Control and Prevention,Guangdong Dongguan 523129,China;3.Guangdong Provincial Center for Disease Control and Prevention,Guangdong Guangzhou 511430,China;4.Tianhe Center for Disease Control and Prevention,Guangdong Guangzhou 510660,China;5.Guangdong Institute of Microbiology,Guangdong Guangzhou 510070,China)

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    摘要:

    目的 调查分析本次食物中毒事件的流行病学特征,鉴定引起食物中毒的毒蘑菇种类,提出防控措施,预防食物中毒事件的再次发生。方法 通过制定病例定义及病例搜索、病例访谈、食谱调查、现场采样和毒蘑菇的形态学鉴定等方法对食物中毒事件进行分析。结果 5名外来务工人员自行采摘并进食野生蘑菇约150 g,8.3~10 h后出现恶心、呕吐、腹泻、腹痛等胃肠炎症状,临床检测提示病例肝功能损害。经洗胃、血浆置换、放置活性炭吸附、补液及护肝护胃等清除毒物和对症治疗后,其中2例病例出现假愈期,1 d后病情又急剧恶化。随后几天所有病例均出现肝功能衰竭,并因多器官功能衰竭而死亡,罹患率和病死率均为100%(5/5)。食谱调查显示除了自行采摘的蘑菇外未见其他可以引起中毒的食物,经形态学鉴定为裂皮鹅膏菌。本起事件系由于病例误食了M公园山上采集的野生蘑菇所致的食物中毒,毒蘑菇为剧毒的裂皮鹅膏菌。结论 误食裂皮鹅膏菌中毒在广东省为首次报道,本起事件对裂皮鹅膏菌中毒的疾病自然史进行了较为全面的描述。该菌与部分可食菌类外观极其相似,难以分辨极易误食,需进一步加强健康教育,提醒民众不要采食野生蘑菇是预防毒蘑菇中毒最根本的方法。

    Abstract:

    Objective To investigate and analyze the epidemiological characteristics of the poisoning incident, identify the poisonous mushroom species, put forward the prevention and control measures, and to explore measures to prevent the recurrence of poisoning incidents. Methods This poisoning event was analyzed by case definition, case search, case interview, recipe survey, field sampling and morphological identification of poisonous mushrooms. Results Five migrant workers picked and ate about 150 g of the wild mushrooms. 8.3-10 hours later, nausea, vomiting, diarrhea, abdominal pain and other gastrointestinal symptoms appeared, and the clinical examination showed liver damage. After 2 days of symptomatic treatment including gastric lavage, plasma exchange, activated carbon absorption, fluid infusion and protecting liver and stomach for clearance of toxic substance, 2 cases were found to have pseudo-recovery period. One day later, these 2 cases had a sharp deterioration. In the next few days all patients progressed to liver failure and died of multiple organ failure, both morbidity and mortality were 100% (5/5). The recipe survey showed that there was no other poisoning food except the mushrooms. The morphological identification result showed it was Amanita rimosa. The food poisoning incident was due to mistaken eating of wild mushrooms collected from park M, and the poisonous mushroom was virulent Amanita rimosa. Conclusion This poisoning incident of mistaken eating of Amanita rimosa was reported in Guangdong Province for the first time. The natural disease history of Amanita rimosa poisoning was described comprehensively in this study. The appearance of these fungi was extremely similar with those of some edible fungi, and was difficult to distinguish them, which cause the mistaken eating very easily. The health education should be further strengthened to remind people not to eat wild mushrooms, and it was the most basic way to prevent mushroom poisoning.

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倪锡河,张泽武,黄琼,张巧利,叶新,张萌,邓旺秋.广东省首起误食剧毒裂皮鹅膏菌所致食物中毒死亡分析[J].中国食品卫生杂志,2018,30(1):109-112.

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  • 收稿日期:2017-05-09
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  • 在线发布日期: 2018-04-02
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