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Media Briefings for China CDC Weekly, Vol 6, No. 24, 2024

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Exposure to Chloropropanols and Their Fatty Acid Esters and Glycidyl Fatty Acid Esters in the Sixth Total Diet Study — China, 2016–2019
Chloropropanols and their esters, and glycidyl fatty acid esters (GEs) are prevalent contaminants in processed foods, with carcinogenicity, and genotoxicity. Dietary intake is the principal route of exposure to these contaminants, thus posing a potential health risk to humans. Based on the Sixth China Total Diet Study (TDS), the present study spanned 24 provincial-level administrative divisions (PLADs) across 12 food categories, seven chloropropanols and their esters, and GEs were analyzed. Combined with the food consumption and contamination levels data, the point assessment method was used to assess the levels of these contaminants exposure among Chinese residents. The results showed that 3-MCPD esters and GEs were identified as the predominant chloropropanols and their esters with higher detection frequency and contaminant levels in composite food samples. The average and high (95th percentile) dietary intake of 3-MCPD esters, 2-MCPD esters, and 3-MCPD for the Chinese residents were 1.07(2.20), 2.36 (0.63), and 0.14 (0.28) μg/kg BW per day, respectively. And the average dietary intake of 3-MCPD and its esters, which were below the health-based guidance value (4.0 μg/kg BW per day). The average and high dietary intake of GEs was 0.79 (1.42) μg/kg BW per day, with an average margin of exposure value of 12,963. Vegetables (47.0%) and cereals (15.4%) were the major contributors to exposure among the 12 food categories evaluated. The present study indicated the health risk of dietary exposure to chloropropanols and their esters at a low level, but a high health risk of exposure to GEs for many residents. 
氯丙醇及其脂肪酸酯和缩水甘油酯的膳食暴露-第六次总膳食研究 — 中国,2016–2019
氯丙醇,氯丙醇酯和缩水甘油酯是一类具有致癌性和生殖毒性的污染物,广泛存在于加工食品中。膳食摄入是暴露于这些污染物的主要途径,从而对人体造成潜在健康危害。基于第六次中国总膳食研究,本研究涵盖了24个省级行政区的12类膳食样品,分析了7种氯丙醇、氯丙醇酯及缩水甘油酯的污染水平,并结合消费量数据,采用点评估方法对中国居民中氯丙醇、氯丙醇酯及缩水甘油酯的暴露水平进行评估。结果显示,3-MCPD酯和缩水甘油酯在膳食中的检出率和污染水平较高,是主要的氯丙醇及其酯类污染物。中国居民3-MCPD 酯、2-MCPD酯和3-MCPD的平均和高(P95)膳食摄入量分别为1.07(2.20), 0.26(0.63)和0.14(0.28)μg/kg BW per day,均低于健康指导值(4.0 μg/kg BW per day)。缩水甘油酯的平均和(P95)膳食摄入量为0.79(1.42)μg/kg BW per day,平均暴露边界值为12,963。12类评估的膳食中,蔬菜(47.0%)和谷物(15.4%)是暴露的主要来源。本研究表明,,膳食摄入氯丙醇及其酯类的健康风险较低,但中国居民摄入缩水甘油酯存在较高的健康风险。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.110


Pathogenic Surveillance of Foodborne Illness-Related Diarrhea — Beijing Municipality, China, 2013–2023
This study analyzes 11 years of consecutive monitoring data to enhance understanding of the epidemiological and clinical features of foodborne diarrhea in Beijing. It aims to identify high-risk populations, assist in clinical pathogen identification and treatment, and support the development of tailored preventive strategies. Descriptive statistical methods were used to examine the case information and specimen test results reported by 36 actively monitored hospitals in Beijing. Monitoring results show that Norovirus and diarrheagenic Escherichia coli (DEC) are the most commonly identified foodborne diarrheal pathogens. Individuals aged 19–30 are at a higher risk of foodborne diarrhea in Beijing, with Salmonella infection being associated with fever symptoms. We advocate for improved food safety education for at-risk groups and the implementation of proactive and efficient control measures tailored to the epidemiological patterns of foodborne diarrhea cases in Beijing.
食源性腹泻主动监测结果分析 — 北京市,中国,2013–2023
本研究通过分析2013-2023年北京市食源性疾病的监测数据,更全面地了解了北京市食源性腹泻的流行病学特征和临床特征,确定高危易感人群,为临床病原鉴别诊断和治疗提供了参考,为制定有针对性的预防控制措施提供了依据。采用描述性统计学方法对北京市36家主动监测医院上报的病例信息及标本检测结果进行分析。监测结果显示,诺如病毒和致泻大肠埃希氏菌(DEC)是最常见的食源性腹泻病原体,19-30岁是食源性腹泻的高危易感人群,感染沙门氏菌的病例相比感染其他病原体的病例更容易产生发热症状。结合北京市食源性腹泻病例的流行病学特征,应进一步针对高危人群加强食品安全教育,并制定有针对性的、高效的预防控制措施。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.111


Community Incidence Estimates of Five Pathogens Based on Foodborne Diseases Active Surveillance — China, 2023
This study aims to estimate the community incidences of Salmonella spp., Shigella spp., Vibrio parahaemolyticus, diarrheagenic E. coli, and Norovirus causing acute gastroenteritis (AGI). Five pathogens infected cases were collected in 2023 under the framework of National Foodborne Disease Active Surveillance. The distribution of prevalence for each pathogen throughout the year was described. The community incidences were estimated using the pyramid model based on previous sentinel hospital AGI survey and community AGI prevalence survey data. Estimated community incidences per 100,000 population were: Norovirus, 3,188.28 (95% UI: 2,510.80, 3,872.96), the highest age group 1–4 age, 5,133.68 (95% UI: 4,047.24, 6,229.35); Salmonella spp., 1,295.59 (95% UI: 1,020.62, 1,573.11), the highest age group <1 age, 5,559.18 (95% UI: 4,377.10, 6,751.43); diarrheagenic E.coli, 782.62 (95% UI: 651.19, 923.05), the highest age group 20–24 age, 1,026.32 (95% UI: 808.21, 1,246.93); Vibrio paraholyticus 404.06 (95% UI: 342.19, 468.93), the highest age group 35–44, 716.57 (95% UI: 564.79, 869.70); Shigella spp., 26.73 (95% UI: 21.05, 33.46), the highest age group 5–9, 53.32 (95% UI: 41.99, 64.78). The community incidence of the five foodborne pathogens varies among different populations, and it is necessary to identify the populations with high incidence of different pathogens and implement targeted preventive measures to reduce the disease burden. These findings have important implications for public health decision-making and food safety risk management.
基于国家食源性疾病监测系统的五种食源性病原体社区发病率估计 — 中国,2023
本研究旨在估计沙门氏菌、志贺氏菌、副溶血性弧菌、致泻大肠埃希菌和诺如病毒引起急性胃肠炎的社区发病率。收集2023年国家食源性疾病主动监测系统中5种病原体监测结果,描述流行分布情况,结合哨点医院、既往社区急性胃肠炎调查调查数据,采用金字塔模型估计社区发病率。以每10万人计,中国2023年诺如病毒发病率为3,188.28 (95% UI: 2,510.80, 3,872.96),1–4岁年龄组最高,为5,133.68(95% UI: 4,047.24, 6,229.35); 沙门氏菌1,295.59(95% UI: 1,020.62, 1,573.11),<1岁年龄组发病率最高,为5,559.18(95% UI: 4,377.10, 6,751.43);致泻性大肠埃希氏菌782.62(95% UI: 651.19, 923.05),20–24岁年龄组发病率最高,为1,026.32(95% UI: 808.21, 1,246.93); 副溶血性弧菌404.06 (95% UI: 342.19, 468.93),35–44岁年龄组发病率最高,为716.57(95% UI: 564.79, 869.70);志贺氏菌为26.73 (95% UI: 21.05, 33.46),5–9岁年龄组发病率最高,为53.32(95% UI: 41.99, 64.78)。5种食源性病原体的社区发病率在不同人群中存在差异,确定不同病原体的高发人群,实施针对性预防措施以减轻疾病负担非常必要。这些发现对公共卫生决策和食品安全风险管理具有重要意义。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.112


Two Photosensitive Dermatitis Outbreaks Caused by Cordierites frondosus — Chuxiong Yi Autonomous Prefecture, Yunnan Province, China, 2023
Cordierites frondosus is a toxic mushroom known to induce symptoms of photosensitive dermatitis. Comprehensive studies of patients with C.frondosus poisoning are scarce. In this research, we provide four C.frondosus ingestion cases, together with general conditions, clinical course, treatment regimen, and mushroom identification. Between May 17 and June 9, four cases of suspected mushroom poisoning were treated at the People’s Hospital of Chuxiong Yi Autonomous Prefecture. The patients presented with photosensitive dermatitis, including redness, swelling, itching, blister formation, and sharp pain in the facial region and the dorsal surface of their hands, 21 to 45 hours after ingesting wild “wood ear” mushrooms. The condition of two patients deteriorated after they were re-exposed to sunlight on the seventh day following the initial poisoning. Separately, an additional two patients reported experiencing a mild, needle-like sensation on areas of their skin exposed to the sun, recorded on the twelfth day subsequent to the poisoning. Morphological and molecular identifications of the toxic mushrooms — suggested that the poisonings were triggered by the inadvertent consumption of Cordierites frondosus (Kobayasi) Korf. Given that symptoms of photosensitive dermatitis, a potential severe consequence of C. frondosus poisoning, can manifest up to a week post sun exposure, it is advisable to avoid sunlight for a minimum of two weeks following poisoning.
两起叶状耳盘菌中毒事件调查 — 楚雄彝族自治州,云南省,中国,2023
叶状耳盘菌是一种能引起光敏性皮炎症状的毒蘑菇,但关于叶状耳盘菌中毒的综合研究较少。本研究对4例叶状耳盘菌中毒事件进行了调查和分析,包括患者的流行病学特征、一般情况、临床表现、诊治方案和蘑菇鉴定。2023年5月17日至6月9日期间,楚雄彝族自治州人民医院收治了4例疑似蘑菇中毒患者。患者食用野生“木耳”21至45小时后,出现了光敏性皮炎的症状,包括暴光的面部和手背出现的红肿、瘙痒、水疱及剧烈刺痛。2名患者在中毒后第7天再次暴露在阳光下后光敏性皮炎症状恶化。另外2名患者在中毒后第12天阳光照射部位出现轻微的针刺感。毒蘑菇经形态学和分子鉴定,确定为叶状耳盘菌。这是误食叶状耳盘菌引起的光敏性皮炎中毒事件。患者中毒1周后暴露在阳光下仍出现严重的光敏性皮炎症状。因此,建议在误食叶状耳盘菌中毒后,患者2周内要避免阳光照射。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.091


Potential Provoking Effects of Environmental Pollutants on Food Allergy: An Issue That Is Gaining Increasing Attention
The prevalence of food allergies has increased dramatically in recent decades. While genetic factors contribute around 50% of FA risk, the sharp rise cannot be solely attributed to genetics. Environmental pollutants like endocrine-disrupting compounds, particulate matter, and persistent organic pollutants are increasingly recognized as potential contributors to allergic diseases development. These pollutants can disrupt epithelial barriers, promote microbial dysbiosis, and dysregulate immune responses, increasing the risk of diseases like FA. At the molecular level, they may trigger inflammatory pathways, oxidative stress, and signaling disruptions that facilitate allergic sensitization. Emerging evidence suggests certain pollutant exposures are associated with increased food sensitization, providing insights into potential causal links. However, the specific mechanisms linking environmental exposures to FA onset require further investigation. As urbanization progresses, controlling environmental pollutant exposures and gaining deeper insights into their impacts on immune function is crucial for curbing the rising prevalence of FA. Enhancing mechanistic understanding will guide prevention strategies and policy interventions to address this escalating public health issue.
环境污染物对食物过敏的潜在激发效应:一个日益受到关注的问题
近年来,食物过敏(FA)的患病率显著上升。虽然遗传因素约占FA风险的50%,但这种急剧上升不能仅归因于遗传因素。内分泌干扰化合物、颗粒物和持久性有机污染物(POPs)等环境污染物越来越被认为是FA发展的潜在贡献者。这些污染物会破坏上皮屏障,促进微生物失调和免疫失调,从而增加FA风险。在分子水平上,它们可能会触发炎症途径、氧化应激和信号传导中断,促进过敏致敏。新兴证据表明,某些污染物暴露与食物致敏增加有关,为潜在因果关系提供了见解。然而,环境暴露与FA发病之间的具体机制仍需进一步研究。随着城市化进程不断推进,控制环境污染物暴露以及深入理解其对免疫功能的影响,对于遏制日益上升的食物过敏患病率至关重要。加强对发病机理的认知将为预防策略和政策干预提供指导,应对这一不断恶化的公共卫生问题。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.113


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