| 中文摘要 |
於106年6月8日下午至6月9日食品藥物管理署（以下稱食藥署）陸續接獲花蓮縣衛生局通報轄內A、B兩所國小學生及C國中學生出現噁心、嘔吐、腹痛及腹瀉等症狀，計有203人就醫。經調查案內3所國中小營養午餐共同來源為A國小廚房，由某團膳業者承包供膳，食藥署初步判斷為校園午餐引起的食品中毒事件，即建議花蓮縣衛生局申請流行病學調查支援，同時針對3校6月8日午餐留樣檢體及環境檢體進行食品中病原菌及病毒檢驗，其中A國小之紅蘿蔔炒蛋檢出仙人掌桿菌（6.1×10^6 CFU／g），腹瀉型毒素基因nhe及hbl為陽性。疾病管制署（以下稱疾管署）則針對廚工及學生共14人之人體檢體，進行細菌培養及諾羅病毒檢測，其中2名廚工及6名學生糞便檢體檢出諾羅病毒陽性，基因型別均為GII.2型。比對本案流行病學調查結果，6月7日之午餐「麵條」為最有可能之原因食品，本案發病學生攝食「麵條」至發病時間中位數為34小時，與諾羅病毒常見潛伏期33至36小時相似，研判諾羅病毒為本案病因物質。花蓮縣衛生局命業者暫停作業，並依食品安全衛生管理法處罰。
On the afternoon of June 8 to 9, 2017, Taiwan Food and Drug Administration (TFDA) received notification from the Hualien County Health Bureau Health Bureau that diarrhea clusters occurred in 2 primary schools (referred as school A and school B) and 1 middle school (school C). Some of the students had various degrees of symptoms, such as nausea, vomiting, diarrhea with abdominal cramps and 203 of them visited hospitals for medical examinations and treatments. A preliminary investigation indicated that the outbreak of diarrhea clusters was related to school lunches, which were all provided by the foodservice company located in school A. TFDA suggested the local Health Bureau to request for epidemiological investigation assistance and screened the lunch meal samples provided on June 8 as well as the environmental swabs for pathogenic bacteria and enteric viruses. Bacillus cereus with enterotoxin gene nhe and hbl was detected in the sample of scrambled eggs with carrot from school A. The bacterial count was 6.1 × 10^6 CFU/g. Center for Disease Control (CDC) collected 14 human specimens to test for pathogenic bacteria and norovirus. Among the human specimens, stools from 2 kitchen workers and 6 students were found positive for Norovirus, which the genotype was identified as GII.2. Epidemiological investigation showed that the cause of foodborne outbreak was most likely related to the ＂noodles＂ which were provided for lunch on June 7. The median time from eating the ＂noodles＂ to the onset of symptoms was 34 hours, which correspond with the incubation period of norovirus infection. The investigation concluded that the norovirus was the etiologic agent and the ＂noodles＂ were the vehicle of this foodborne outbreak. The lunch provider was told to stop all kitchen operation as well as the supply of lunch meals and was penalized according to the Act of Governing Food Safety and Sanitation. |
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