目的描述上海市浦东新区幼托机构手足口病疫情特征和首发病例的流行病学特征,分析对聚集性疫情发生的影响。方法收集2012年上海市浦东新区远郊乡镇的幼托机构疫情资料,应用SPSS 13.0统计软件进行数据处理,采用描述性流行病学方法分析。采用χ2检验、多因素分析和秩和检验,P<0.05为差异有统计学意义。结果 2012年上海市浦东新区远郊乡镇幼托机构共发生手足口病疫情305起,聚集性疫情79起,病例数688人,其中聚集性疫情病例数462人,占总病例数67.15%,报告患病率为3.86%。聚集性疫情的高峰月份为5、6、11、12月份,占全年的62.03%;公立幼托机构手足口病患病率(3.17%)低于私立幼托机构(4.35%),差异有统计学意义(χ2=16.925,P<0.05);聚集性疫情发生率(36.94%)高于私立幼托机构(19.59%),差异有统计学意义(χ2=11.073,P<0.05);不同乡镇聚集性疫情的发生率不同,最高34.43%,最低18.49%。幼托机构类型影响聚集性疫情发生(OR=2.277,95%CI:1.283~4.040)。结论 5~6月、11~12月是手足口病聚集性疫情高发月份,要加强防控;首发病例的年龄、性别、诊断时间、发病月份、病例归属地对及聚集性疫情的发生无明显影响,男性病例发病率高的原因上需要进一步探讨;私立幼托机构的聚集性疫情的防控工作尚需加强。 Objective To describe the epidemiological characteristics of hand-foot-mouth disease and the first case of the epidemic in the kindergarten in Shanghai Pudong New Area and analyze the influence on the occurrence of cluster epidemic. Methods Epidemic data of kindergartens in the suburbs of Pudong New Area in Shanghai in 2012 were collected and processed by SPSS 13.0 statistical software and analyzed by descriptive epidemiological method. Using χ2 test, multivariate analysis and rank sum test, P <0.05 for the difference was statistically significant. Results In 2012, there were 305 hand-foot-mouth disease outbreaks in the township preschools in the suburbs of Pudong New Area, Shanghai. There were 79 catastrophic cases with 688 cases, of which 462 were epidemic cases, accounting for 67.15% of the total cases. The prevalence was 3.86%. The peak months of the aggregated outbreaks were May, June, November and December, accounting for 62.03% of the annual total. The prevalence of hand-foot-mouth disease in public kindergartens was 3.17% lower than that in private kindergartens (4.35%), (Χ2 = 16.925, P <0.05). The incidence of cluster epidemic situation (36.94%) was higher than that of private childcare institutions (19.59%) (χ2 = 11.073, P <0.05) The incidence of congregated epidemic is different, the highest 34.43%, the lowest 18.49%. The type of kindergarten affected the cluster epidemic (OR = 2.277, 95% CI: 1.283-4.040). Conclusions From May to June and from November to December, there was a high incidence of HFMD outbreak in months. It is necessary to strengthen the prevention and control. There was no significant difference in the age, sex, diagnosis time, onset of disease, case attribution and cluster epidemic in the first case Affect the reasons for the high incidence of male cases need to be further explored; prevention and control of the accumulation of private child care institutions need to be strengthened.