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目的了解某幼儿园手足口病暴发疫情的流行病学及病原学特征,探讨发生此次疫情的危险因素,为本地区防控手足口病提供科学依据。方法利用描述性流行病学研究方法分析某幼儿园手足口病暴发疫情的流行病学及病原学特征,采用病例—对照的研究方法探讨引起此次疫情的危险因素。结果 2015年11月17日~12月7日某幼儿园累计共发生手足口病病例16例,罹患率为1.61%(16/994),其中临床诊断病例13例、确诊病例3例。发病高峰集中在11月22~28日,占总病例数的68.75%(11/16)。病例中男女性别比为0.33∶1,年龄均在3~5岁组之间。病原学方面,采集的5例病例中有3例是Cox A16阳性,其余样本均为通用肠道病毒阴性。单因素Logistic回归分析结果显示:有咬手指的习惯和饭前不洗手是此次手足口病疫情的危险因素。结论这是一起因Cox A16感染导致的幼儿园手足口病暴发疫情。对患儿的早期发现与隔离、对幼儿园教室及幼儿玩耍外环境、物品玩具的清洁消毒,加强晨检、午检、因病缺课登记工作,开展健康教育均为重要的防控措施。建议幼托机构培养儿童饭前便后要洗手、不咬手指等良好的卫生习惯,以达到预防手足口病传播的目的。
Objective To understand the epidemiological and etiological characteristics of hand-foot-mouth disease outbreak in a kindergarten and to explore the risk factors for the occurrence of this outbreak and to provide a scientific basis for preventing hand-foot-mouth disease in this area. Methods Descriptive epidemiological studies were used to analyze the epidemiological and etiological characteristics of hand-foot-mouth disease outbreak in a kindergarten. The case-control study was conducted to explore the risk factors of the outbreak. Results A total of 16 hand-foot-mouth disease cases occurred in a nursery from November 17, 2015 to December 7, 2015, with an attack rate of 1.61% (16/994), including 13 clinically diagnosed cases and 3 confirmed cases. The peak incidence concentrated on November 22-28, accounting for 68.75% (11/16) of the total number of cases. The male / female sex ratio in the case was 0.33: 1, all of whom were between 3 and 5 years old. In etiology, three of the five cases collected were positive for Cox A16, and the remaining samples were all negative for universal enterovirus. The results of univariate Logistic regression analysis showed that the habit of biting fingers and not washing hands before meals are the risk factors for the HFMD epidemic. Conclusion This is an outbreak of hand-foot-mouth disease in kindergarten caused by Cox A16 infection. The early detection and isolation of children, kindergarten classrooms and children playing outside the environment, the items of toys cleaning and disinfection, strengthen morning screening, lunch examination, registration due to illness work, to carry out health education are important prevention and control measures. Recommended that the child care institutions to develop children to wash their hands before and after meals, do not bite the fingers and other good health habits, in order to achieve the purpose of preventing the spread of hand, foot and mouth disease.