摘要
目的分析云南省腾冲县一起毒蕈中毒事件的流行病学调查结果,为预防与控制类似毒蕈中毒事件提供借鉴。方法接到中毒事件报告后,当地疾病预防控制中心(CDC)专业人员迅速赶往现场开展流行病学调查和毒物鉴定工作,并对调查结果进行分析。结果 2012年6月30日15时左右,同一家庭的6人,包括祖父(例1,56岁)、祖母(例2,47岁)和4个孙女(例3～6,分别为8、8、7、1.5岁)一起食用了含"麻栗菌"(祖父当日自采)的午餐。次日凌晨4～6时,2个孙女(例3、5)和祖父母先后出现恶心、呕吐、腹泻,就诊于当地卫生院,给予对症治疗后返家;例4仅出现腹泻,未就医;例6仅进食少量菜汁,未出现明显症状。7月2日例3、5出现嗜睡、昏迷,6人均被送往腾冲县人民医院,诊断为群体性毒蕈中毒并上报当地CDC。例3在急诊科经抢救无效死亡;例1入院,例2急诊留观治疗,分别在中毒后第26、19天痊愈;其他3例患儿当日转诊省级医疗机构,中毒后第10～13天痊愈。CDC专业人员在事发当地采集的新鲜"麻栗菌"标本经鉴定确认为毒蕈条盖盔孢伞(Galerina sulciceps),而非当地俗称"麻栗菌"的可食性酒色蜡蘑(Laccaria vinaceoevellanea),明确该起事件为误采误食条盖盔孢伞导致的急性中毒事件。结论条盖盔孢伞与酒色蜡蘑外观形态易混淆,故因误采误食导致中毒。专业机构应加强中毒信息管理,掌握不同地区毒蕈谱。应对医务人员进行毒蕈中毒诊断和救治知识的培训,并对普通群众开展预防常见毒蕈中毒的科普教育。
Objective To report the epidemiological investigation of a poisonous mushroom poisoning event occurring in Tengchong County,Yunnan Province in order to provide reference for preventing and controlling similar poisonous mushroom poisoning.Methods After receiving the report of poisoning event,the specialists in local Center for Disease Control and Prevention （CDC） hastened to the scene and they conducted epidemiological investigations,identification of poison and analysis of the results.Results Around 3 o＇clock in the afternoon on June 30,2012,six members of a family comprising a grandfather （case 1,56-year-old）,a grandmother （case 2,47-year-old）,and four granddaughters （case 3,4,5,and 6 aged 8,8,7,and 1.5 years,respectively） ate a dish containing ＂malijun＂ for lunch,which was picked by the grandfather at that day.Around 4-6 o＇clock the next morning,two granddaughters （cases 3 and 5） and the grandparents developed nausea,vomiting,and diarrhea successively and then presented to a local health center.They were treated with symptomatic therapy and then returned home.Case 4 experienced diarrhea only without seeking medical advice and case 6 just drank a little juice of the dish and she had no marked symptoms.On July 2,cases 3 and 5 developed lethargy and coma.All the six patients presented to the People＇s Hospital of Tengchong County and were diagnosed with group poisonous mushroom poisoning which was reported to local CDC.Case 3 died despite resuscitation attempts in the emergency department.Case 1 was admitted to hospital and case 2 was staying treatment in emergency department and both of them recovered on days 26 and 19 after poisoning,respectively.The other three kids were transferred to provincial medical institutions in the same day and recovered on days 10 to 13 after poisoning.The fresh sample of ＂ malijun＂,which was picked bv specialists of CDC at the location,was identified as Galerina sulciceps rather than the edible mushroom Laccaria vinaceoavellanea which was commonly called ＂ malijun ＂ by local people.This event was determined as a sudden acute poisonous mushroom poisoning event caused by picking and eating Galerina sulciceps by mistaken.Conclusions The appearance of Galerina sulciceps may be easily confused with that of Laccaria vinaceoavellanea,thus,the poisoning may occur due to picking and eating by mistaken.Management of the information on poisoning should be enhanced,and the spectrum of poisonous mushrooms in different districts should be controlled by professional institutes.Medical staff should be trained to reinforce knowledge of diagnosis and treatment of poisonous mushrooms,and popular science education in the prevention of common poisonous mushrooms poisoning to general public should be conducted.
出处
《药物不良反应杂志》
CSCD
2013年第1期22-26,共5页
Adverse Drug Reactions Journal
基金
卫生部卫生行业科研专项(201202006-02)
关键词
条盖盔孢伞
中毒
预防
Galerina sulciceps
Poisoning event
Prevention
