幼托机构手足口病暴发疫情后儿童隐性感染情况  

Recessive infection status after the outbreak of hand-foot-mouth disease in kindergartens

作　　者：颜玉炳[1,2] 郑惠能[1,2] 苏成豪[1,2] 

机构地区：[1]福建省厦门市疾病预防控制中心,361021 [2]福建医科大学公共卫生学院教学基地

出　　处：《中国学校卫生》2016年第2期250-252,共3页Chinese Journal of School Health

基　　金：厦门市科技局科技计划项目(3502Z20134028)

摘　　要：目的了解幼托机构手足口病暴发疫情后儿童隐性感染情况及相关因素,为疫情暴发后及时采取有效防控措施提供参考。方法收集2011年1月至2015年7月,厦门市报告的5起托幼机构手足口病暴发疫情的流行病学和实验室检测资料,采用荧光定量RT-PCR方法检测总肠道病毒及EV71和Cox A16分型,采用二分类因素Logistic回归分析方法分析儿童隐性感染情况及其相关因素。结果 250名研究对象接受调查和采样,其中疫情组的隐性感染率为32.4%（45/136）,高于对照组的14.0%（16/114）（χ2=11.408,P=0.001）。疫情组所在小小班、小班和中班的隐性感染率分别为44.2%,29.1%和17.2%,首例病例至停课的时间间隔〈3 d、3～5 d和〉5 d的隐性感染率分别为16.7%,24.1%和41.6%,差异均有统计学意义（χ2趋势值分别为6.558,6.952,P值均〈0.05）。Logistic回归分析显示,年级越低,首例病例至停课的时间间隔越长,儿童隐性感染率越高。结论幼托机构特别是低年级儿童发生手足口病暴发疫情后,及时采取停课措施是必要的,且越早停课越好。Objective To explore the recessive infection status and its risk factors after the outbreak of hand-foot-mouth disease in kindergartens. Methods During January, 2011 to July, 2015, epidemiological and laboratory data about five outbreaks of hand-foot-mouth disease were collected. Real-time RT-PCR was used to detect enterovirus（EV）, enterovirus 71 （EV71） and coxsackie virus A16 （CoxA16）, binary logistic regression were employed to explore the recessive infection status and its risk fac- tors. Results A total of 250 children received investigation and their specimens were collected, the recessive infection rate in out- break group was 32.4% （45/136）, which was higher than that of control group（14.0%） （P = 0. 001）. In outbreak group, the re- cessive infection rate in nursery class, bottom class and middle class was 44.2%, 29.1% and 17.2% respectively. The recessive infection rate of interval between index case and measure of suspending class within 3 days, 3-5 days and more than 5 days was 16.7%, 24.1% and 41.6%, respectively. The difference was statistically significant（χ2 =6. 558, 6. 952, P〈0.05）. Binary logis- tic regression showed that lower grades had higher recessive infection rate, the recessive infection rate also increased with the timeli- ness between index case and measure of closing class. Conclusion After outbreak of hand-foot-mouth disease in kindergartens, especially in low grade students, it is essential to suspend classes as soon as possible.

关 键 词：手足口病 儿童 疾病暴发流行 

分 类 号：R181.81[医药卫生—流行病学] R512.5[医药卫生—公共卫生与预防医学]