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Epidemiological Investigation on an Outbreak of Enterotoxigenic E. coli among the Baseball Club Students of High School in Ulsan City, 2014

2014년 울산시 일개 고등학교 야구부원들에서 발생한 장독소생성대장균의 유행에 관한 역학조사

  • Kang, Young-Eun (Nam-gu Health Center) ;
  • Lim, Hyun-Sul (Department of Preventive medicine, College of Medicine, Dongguk University) ;
  • Lee, Kwan (Department of Preventive medicine, College of Medicine, Dongguk University) ;
  • Kim, Byung-Seok (Department of Preventive medicine, College of Medicine, Dongguk University)
  • 강영은 (울산시 남구 보건소) ;
  • 임현술 (동국대학교 의과대학 예방의학교실) ;
  • 이관 (동국대학교 의과대학 예방의학교실) ;
  • 김병석 (동국대학교 의과대학 예방의학교실)
  • Received : 2015.03.19
  • Accepted : 2015.05.07
  • Published : 2015.06.30

Abstract

Objectives: An outbreak of food poisoning occurred among the baseball club students at a high school in Ulsan city in 2014. An epidemiological investigation was carried out to examine the infection source and the transmission route of pathogen, and to prevent a recurrence. Methods: A questionnaire survey was conducted for 26 male students and 2 food handlers. Rectal swabs were examined in 7 students and the 2 food handlers, and an environmental investigation was performed. A retrospective cohort study was used to evaluate the association between risk factors and disease. Results: The attack rate was 35.7% (10 persons/28 persons) from June 9 to 14, and Enterotoxigenic E. coli ST/LT was isolated from 7 among 28 persons. The study revealed that no food was a significant risk factor for the outbreak. There were no connection between environmental factors and the outbreak. Conclusions: The major risk factors for this outbreak were presumed to be the contaminated ice cube and ice making machines and eating ice cube from the machines. More strict personal and environmental hygiene need to be enforced to prevent such outbreaks.

2014년 울산광역시 일개 고등학교에서 장독소생성대장균의 유행이 발생하였고, 이에 대한 원인과 전파 양식 등을 규명하고 예방 및 관리대책을 마련하기 위해 역학조사를 시행하였다. 학교 야구부원 26명과 조리담당 학부모 2명을 대상으로 설문조사를 실시하였으며, 6월 13~14일 발생한 의심환자 7명과 조리담당 학부모 2명을 대상으로 보건환경연구원에서 세균 10종 및 바이러스 5종에 관한 검사를 시행하였다. 일별로 가장 많이 발생한 6월 14일을 기준으로 3일 전인 11일부터 13일까지의 식단을 이용하여 후향적 코호트 연구를 시행하였다. 학교 운동부 학생 26명 및 조리담당 학부모 2명 등 총 28명 중 환례는 10명으로 장독소생성대장균의 발병률은 35.7%이었다. 위험요인 분석에서 통계적으로 유의한 음식은 없었다. 이번 유행의 원인으로 생활관 식당 내 제빙기의 얼음퍼개 및 얼음이 6월 9일 초발자에 의하여 사용 과정에서 오염된 것으로 추정하였다. 오염된 얼음퍼개가 제빙기 내부에 보관되어, 얼음과 주변 녹은 물이 오염되고 그로 인해 원인병원체의 전파가 이루어졌다고 추정하였다.

Keywords

References

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