目的分析安徽省某镇中心小学一起甲肝暴发疫情的原因和传播途径,为预防控制措施提供参考依据。方法将2011年4月1日至7月31日某中心小学学生和教职工中出现厌油、巩膜黄染、皮肤黄染、尿黄中的任何1项,并伴有谷丙转氨酶(ALT)2倍以上升高,且抗HAV-IgM阳性者为确诊病例。选取18例男生确诊病例,同时在有病例的班级中随机选取22例无任何临床症状且抗HAV-IgM阴性的男生为非病例组,对两组学生进行个案问卷调查。采用访谈和现场观察方法,对学校环境卫生与生活卫生状况进行调查。结果共搜索到29例甲肝病例,罹患率为4.2%,均为小学生,其中男生发病24例、女生发病5例,差异有统计学意义(χ2=9.78,P<0.01)。疫情持续39 d,流行曲线提示点源暴发。单因素分析显示,饮用生水是学生甲肝发病的危险因素(OR=9.00)。洗手习惯对学生甲肝发病具有保护作用(OR=0.81)。进一步分析显示,饮用未消毒的井水是疫情暴发的主要危险因素,不良的洗手习惯是次要因素;2个危险因素同时存在时,会增加学生甲肝发病风险(OR=70.00)。结论此次甲肝疫情暴发为学生饮用未消毒的井水所导致。学校应对学生供应开水,对水源进行改建和保护,加强健康教育知识宣传,提高学生的自我防病意识;公共卫生部门应加强学校饮水的卫生监管。 Objective To analyze the causes and routes of transmission of hepatitis A outbreak in a town center in Anhui Province and provide reference for prevention and control measures. Methods From April 1, 2011 to July 31, primary school students and faculty members of the center were obsessed with any of the following: oil-smearing, sclera yellowing, skin yellowing and urinary yellow, accompanied by alanine aminotransferase (ALT) 2 times higher, and anti-HAV-IgM positive for the diagnosis of cases. A total of 18 male cases were selected. At the same time, 22 non-HAV-IgM-negative boys were randomly selected from non-case-control group as the case-control group. Interviews and on-site observation methods were used to investigate the situation of school sanitation and life hygiene. Results A total of 29 cases of hepatitis A were found. The attack rate was 4.2%. All of them were primary school students, of which 24 were boys and 5 were girls. The difference was statistically significant (χ2 = 9.78, P <0.01). The epidemic lasted 39 days and the epidemic curve suggested a point source outbreak. Univariate analysis showed that drinking raw water was a risk factor for hepatitis A (OR = 9.00). Washing habits have a protective effect on the incidence of hepatitis A (OR = 0.81). Further analysis showed that drinking undischarged well water was the main risk factor of outbreak and the bad habit of washing hands was the secondary factor. When the two risk factors were both, it would increase the risk of hepatitis A (OR = 70.00). Conclusions The outbreak of hepatitis A was caused by the students drinking non-sterile well water. Schools should provide students with water, water to rebuild and protect the health education to enhance knowledge, awareness of self-protection of students to improve awareness; public health departments should strengthen the health supervision of drinking water in schools.