2024年屏東縣某餐廳諾羅病毒食品中毒事件

A Norovirus Foodborne Outbreak at a restaurant in Pingtung County, Taiwan, February 2024

2024年2月屏東縣某烤蚵吃到飽餐廳發生顧客用餐後出現腸胃道症狀等身體不適。針對通報之272名個案中便利抽樣72人（26%）進行問卷調查，成功收集資料者共60人（83%），其中符合病例定義者共50位（83%），潛伏期中位數為29小時（範圍6–54小時），使用病例對照法分析結果顯示烤蚵與此群突發事件達到統計顯著相關（p<0.001）。人體檢體結果為8名病例之新鮮糞便檢體皆驗出諾羅病毒，惟無食餘檢體可供佐證。綜合相關調查結果判定此事件為食用自助烤蚵引起之食品中毒事件，病因物質為諾羅病毒，並烤蚵為原因食品，可能與食用過程中生蚵未確實烤熟有關，建議餐飲業者應提供安全且徹底煮熟的食品。

Background:
In February 2024, an outbreak of gastroenteritis affected at least 272 persons who dined at a self-serve grilled oyster restaurant in Taiwan. We investigated to determine the causative agent, mode of transmission, and source of illness.
Methods:
We conducted a case-control study using a structured questionnaire for a convenience sample of customers who dined at the restaurant from February 11–15, 2024. Data on gender, symptoms, and food exposure were collected. A confirmed case had diarrhea or vomiting within 72 hours plus at least one of: abdominal pain, fever, or nausea. On-site investigations, staff interviews, and stool/environmental sampling were performed. Associations between food items, oyster grilling behaviors, and illness were analyzed using Chi-square or Fisher’s exact test.
Results:
Of the 72 (26%) individuals sampled from 272 affected persons, 60 (83%) responded to the questionnaire, and 50 met the confirmed case definition. The analysis revealed that only the consumption of grilled oysters was significantly associated with illness (p < 0.001). The restaurant was an open, well-ventilated space. No employees reported gastrointestinal symptoms within five days prior to the outbreak. Restaurant employees could not be sure that customers ate thoroughly grilled oysters, as there were no clearly posted signs providing oyster grilling instructions. Among the 11 stool specimens tested, norovirus of genotype GII.17 was identified in all eight specimens from confirmed cases, but not in the three specimens from staff. Environmental samples, including water, knives, and cutting boards, tested negative for pathogens.
Conclusion:
This outbreak of norovirus-related gastroenteritis was linked to the consumption of inadequately grilled oysters, likely due to a lack of clear cooking instructions for customers. We recommend that restaurants serve thoroughly cooked shellfish and educate the public on the risks of undercooked food to prevent future outbreaks.