2021年10月新北市兩學校產氣莢膜桿菌腹瀉群聚事件調查

新北市兩校發生腹瀉群聚事件，多名師生於食用同一家團膳公司提供之餐點後陸續出現症狀。本調查針對其中一校之師生進行回溯性世代研究，利用問卷分析事件規模、病因物質與原因食品。在205份有效問卷中，共155人符合病例定義，侵襲率75.6%，症狀以腹瀉及腹痛為主。調查結果顯示，食用10月20日晚餐之宮保雞丁與發病相關，且達統計上顯著意義，人體與食餘檢體之檢驗則證實病因物質為產氣莢膜桿菌。另環境調查結果發現團膳公司出餐至學校師生開始食用餐點時間過長，建議校方在挑選團膳公司時，需考慮餐點運送到學校的時間，讓餐點能在完成後2–4小時內讓師生食用完畢；同時，校內需設置能提供保存溫度在60°C以上的食物存放空間，以避免細菌滋生。

In October 2021, over 100 students and staff from two boarding high schools developed gastroenteritis after dinner from the same caterer. We conducted a retrospective cohort study in one school using questionnaires to determine the possible sources of infection. The results showed that the median incubation period was 12.8 hours (range: 0.8–20 hours), and the most common symptoms were diarrhea (81.9%) and abdominal pain (70.0%). Kung-Pao chicken was significantly associated with illness (RR = 4.2; 95% CI 2.7–6.4). Leftovers and stool samples from 19 case-patients were positive for Clostridium perfringens, with whole genome sequencing revealing the same type of bacterial isolates from leftovers and two students from different schools. The growth of C. perfringens was likely due to improper food preservation. We recommend that, hen choosing a caterer, distance from the school should also be considered, so that cooked food could be stored above 60°C and consumed within 2 hours of preparation. Because only one sample was taken from leftovers from each school, it was difficult to determine the infection source from the dinner, even with positive pathogen findings. Therefore, we recommend that separate samples be taken from each meal during the dinner.