上海市闸北区手足口病聚集性疫情流行病学特征分析  

Analysis of the epidemiological characteristics of hand-foot-mouth disease clustered cases in Zhabei District of Shanghai

作　　者：王静[1] 徐敏钢 李恩国[1] 周洲[1] 

机构地区：[1]上海市闸北区疾病预防控制中心,上海200072

出　　处：《现代预防医学》2013年第14期2577-2580,共4页Modern Preventive Medicine

摘　　要：目的了解上海市闸北区手足口病聚集性疫情流行病学特征,为做好手足口病聚集性疫情防治工作提供科学依据。方法收集2010年闸北区手足口病聚集性疫情资料,进行描述性流行病学研究和影响因素分析;采集29起56例病例标本开展real-timePCR检测。结果 40起聚集性疫情均发生在托幼机构,以3岁和4岁年龄组病例数最多,占总病例的72.15%,男女性别比为1.49︰1;3～6月为手足口发病季节高峰,占总起数的80%;病例在各街道中的分布不均,75%分布在区域的北部。疫情平均病例数为5.5例,持续时间中位数为7d。标本病毒核酸检测阳性率58.93%(33/56)。各等级托幼机构聚集性疫情发生率差异有统计学意义(P=0.014),示范类最低,民办类最高;扩散程度差异有统计学意义(P﹤0.001),示范最低,二级最高;发病密度托班最高;关班落实时间与疫情持续时间呈正相关r=0.327,P=0.045。结论托幼机构是手足口病聚集性发病的重点场所,疫情有年龄、性别、季节和地区差异,好发于托班和小班;早期防控措施的落实有助于防止疫情的扩散;要重点加强对二级托幼机构和民办托幼机构的防控指导工作。OBJECTIVE To understand the epidemiological characteristics of hand-foot-mouth disease （HFMD） clustered cases and to provide scientific evidence for clustered cases control and prevention. METHODS Descriptive epidemiological study and influential factors analysis were conducted on the HFMD clustered cases collected from China Information System For Diseases Control And Prevention （CISDCP）. Clinical specimens taken from 56 cases in 29 outbursts were detected by real-time PCR. RESULTS 40 outbursts all occurred in nurseries and kindergartens. Age groups of 3 years old and 4 years old had the largest case numbers, accounting for 72.15% of the total. The ratio of male to female was 1.49 ︰ 1. The incidence peak was from March to June, accounting for 80% of the total. There was unbalanced distribution among all the streets and 75% were reported in the northern. The average case number of outbursts was 5.5 and the median time period of outbursts was 7 days. The positive rate of real-time PCR detection was 58.93%. There were statistical significances in incidence and diffusion among different category nurseries and kindergartens （P = 0.014）, and the diffusion degree （P﹤0.001） positive relations between the off-school time taken after the first case accident in 38 outbursts and the time periods of the outbursts r = 0.327, P = 0.045. CONCLUSION Nurseries and kindergartens are the focuses location of HFMD. Outbursts and incidence of the disease differ between ages, genders, seasons and districts. HFMD outbursts most likely occurr in nursery class and bottom class of the kindergartens. Early implementation of prevention is beneficial for controlling outbursts. It is necessary to strengthen the prevention and direction in secondary and primary nurseries and kindergartens.

关 键 词：手足口病 聚集性病例 托幼机构 幼托儿童 

分 类 号：R725.125.7[医药卫生—儿科]